Tramadol

What is Tramadol?

Tramadol is an opioid analgesic which acts on the central nervous system and is used for the relief of moderately severe pain. It is also used for the treatment of restless legs syndrome. Because it has serous addiction potential it is best avoided in patients who have a history of substance abuse.

How does Tramadol work?

Tramadol is a weak opioid agonist. It also precipitates the release of serotonin and inhibits norepinephrine reuptake.

What does Tramadol look like?

Tramadol is available in a number of proprietary and generic presentations, usually in pills of 50 mg and sometimes in a combined formulation with acetaminophen.

Tramadol dosing and administration

The usual starting dose of Tramadol is 25 mg once daily in the morning. Another 25 mg dose may be added each day until you are taking 25 mg four times a day. Your doctor may increase this to 50 mg four times a day. The maximum dosage should be 400 mg in any 24 hour period.

Common adverse effects from Tramadol

The most common side effects of tramadol are addiction, confusion, serotonin syndrome, tachycardia, nausea, vomiting, diarrhea, hallucinations, blood glucose problems, agitation, fever, sweating, seizures coma, respiratory distress and allergic reactions.

Precautions when taking Tramadol

You should take Tramadol without discussing it with your doctor if you have or have epilepsy, liver or kidney disease, a recent head injury, severe abdominal pain, or any lung disease. Tramadol should also be avoided if you are or have been dependent on alcohol or any other drug. Women who are pregnant or may become pregnant, or who are breastfeeding should also discuss this with their doctor. Tramadol has the potential to be a drug of addiction, so care should be exercised if taking it for a long period or in larger doses.

Interactions with Tramadol

Tramadol may interact with many drugs including alcohol, carbamazepine, digoxin, linezolid and promethazine. It may also potentiate the action of drugs such as antipsychotics, anxiolytics and most antidepressants and sleeping pills. It may also interact with the common herbal remedy St John’s Wort. Dextromethorphan, a component of many patent cough medicines can combine with tramadol to cause serotonin syndrome which can be an extremely serious condition.

What should I do if I take an accidental overdose of Tramadol?

As with all opiates, tramadol overdose can be extremely serious. The symptoms could included dyspnea, lethargy coma, seizures, cardiac arrest and death. If you suspect that you or someone else has taken an overdose of Tramadol you should seek urgent medical intervention. Naloxone may be given to reverse the effects of tramadol, but brings an increased risk of seizures.

Is it safe to take Tramadol if I am pregnant?

Tramadol has been classified as Pregnancy Category C by the US Food and Drug Administration. This means that extensive studies of the use of the drug in pregnancy have not been undertaken, but there is good reason to believe that it may be harmful to the fetus. In animal studies, tramadol has caused low-weight births, skeletal deformities, delayed development and an increased rate of miscarriage. Tramadol has been demonstrated to cross the human placenta, leading to neonatal problems.