Medicine composition: The active component is tramadol hydrochloride. Dosage form: tablets. Pharmacotherapeutic group: analgesics.
Indications for use
Tramadol is used to manage pain syndrome of severe and medium intensity within malignant neoplasms, acute myocardial infarction, injury, during painful diagnostic and therapeutic procedures.
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Treatment with Tramadol should be approached with caution for the following cases:
- sensitivity to the active component;
- alcohol intoxication or substances that depress the CNS;
- impaired liver and kidney function;
- children under the age of 14.
Treatment with Tramadol is prohibited for those who are taking MAO inhibitor drugs.
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Methods of administration
The dosage is prescribed independently for each case (depending on the severity of the symptoms and patient’s response). The period of treatment is also determined individually, but the drug should not be administered beyond the term warranted by the therapeutic necessities.
For adults and adolescents older than 14, the usual dose for a single oral intake is 0.05 g with a small amount of fluid. In case of insufficient effect, following 30-60 minutes you can repeat the administration of the same quantity, but not more than 8 doses per day. The daily dose limit is 0.4 g (400 mg). In exceptional cases, for example, patients who experience cancer, it is possible to reduce the break to 6 hours and add to the daily dosage.
The effect persists for an average of 4-8 hours, depending on the nature and intensity of the pain. Tramadol is used in elderly patients with increased intervals.
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Tramadol Adverse effects
Tramadol is relatively well tolerated, does not cause significant respiratory opression in therapeutic doses and does not affect considerably the circulatory system and the gastrointestinal tract. May, however, cause lightheadedness, dysphoria, excitement, hallucinations, decreased cognitive abilities, seizures, nausea, epigastric pain, vomiting, constipation, difficulty urinating, tachycardia and palpitation. In rare cases, with long-term use of tramadol are possible to develop addiction, dependence, withdrawal syndrome; severe respiratory depression, decreased arterial pressure, collapse. When patient who have allergy are using tramadol it is possible for them to develop allergic reactions.
The frequency of adverse effects increases in proportion to the duration of therapy with using this drug.
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What can you do in Case of an Overdose?
Most common signs: miosis, seizures, loss of consciousness, coma, oppression of the respiratory center, apnea.
Methods of treatment: ensuring airway patency, maintaining adequate pulmonary ventilation, maintaining the cardiovascular system, symptomatic therapy (opiate effects can be stopped by naloxone, seizures – benzodiazepines). With chronic tramadol poisoning is possible the appearance of an abstinent syndrome.
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This medication is prescribed with caution to patients with abnormal renal and hepatic function, with craniocerebral injury, ICP, and patients suffering from epilepsy. Treatment with Tramadol can complicate the diagnosis of acute pain in the abdominal region.
Tramadol should be used under careful supervision and in reduced doses, together with of anesthetic agents, hypnotics, anxiolytics and antidepressants to evade excessive central nervous system depression and inhibition of respiratory center activity.
Influence on ability to drive a car and potentially dangerous machines: treatment with Tramadol makes it difficult to perform work that demands high efficiency of physical and mental responses and increased focus.
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Interaction with other types of medicine
Tramadol enhances the activity of hypnotics, sedatives and medicine used for anesthesia, anxiolytics and ethanol. Reduces the activity of central respiratory stimulants and psycho stimulants, completely blocking – naloxone and naltrexone. When administered together with neuroleptics and inhibitors, the possibility of epileptiform seizures increases. In case of patients who are taking Carbamazepine for a long period of time, the metabolism of Tramadol is significantly enhanced, which may require an additional dose of the analgesic.
This medicine is not recommended to be taken together with narcotic analgesics from the group of full or partial agonists, as well as nalbuphine, butorphanol opioid receptors. Long-term treatment with opioid analgesics and barbiturates increases the chances of cross tolerance appearance. Quinidine increases the plasma quantity of Tramadol and reduces the quantity of M1 metabolite due to competitive inhibition of coenzyme CYP2D6. There is evidence of a decrease in plasma quantity of fluoroquinolones (ciprofloxacin, ofloxacin) during premedication with Tramadol during surgical interventions.
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