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What is Tramadol?
Tramadol Gruenenthal GmbH’s trade name for tramadol hydrochloride, a synthetic opioid, an analogue of codeine. It is an analgesic which acts through the central nervous system and is used for the relief moderate to severe pain. It is used for a variety of conditions and is of particular use for fibromyalgia and restless leg syndrome. Tramadol is often used when constant relief is needed for chronic pain. The drug has high addictive potential because it produces euphoria and is also serotonergic and noradrenergic.
How does Tramadol work?
Tramadol is believed to produce its analgesic effect by inhibiting the reuptake of norepinephrine and stimulating the release of serotonin. In addition it has an antagonist for a wide range of neuroreceptors. It is also a mild agonist of the µ-opioid receptors. It is known however to have additional non-opioid effects although these are not fully understood. Tramadol is a 5HT2C antagonist and it is thought that this could be involved in the effectiveness of the drug in relieving symptoms of depression and obsessive-compulsive symptoms in patients with neurological diseases involving pain. Tramadol is more effective than codeine in relieving chronic pain but slightly less effective than hydrocodone.
What does Tramadol look like?
Tramadol is sold in a wide number of forms, the best known of which is a 50 mg tablet made by several manufacturers. Typically these are round and in most cases are white. It is also commonly sold in a compound formulation with Acetaminophen as Ultracet, which contains a 325 mg of Acetaminophen and 37.5 mg of tramadol. It is also sold as effervescent tablets and powders, extended release tablets, capsules and suppositories. Preparations for hospital use include sterile ampoules of solution, ultra-pure injection solutions for spinal injections, and in special solutions, sometimes in compounds with other analgesics for patient-controlled pain pumps.
Dosage and administration of Tramadol
The usual recommended starting dosage of tramadol is 25 mg, once daily, taken in the morning. This may be gradually increased by 25 mg up to 25 mg four times a day. The maximum dosage that should be reached is 400 mg a day in four to six doses. For rapid pain relief, a starting dose of 100 mg four times a day may be used, but this risks increased side effects. Patients with kidney problems should take no more than 100 mg every twelve hours and those with cirrhosis of the liver should take no more than 50 mg every twelve hours. Dosages should be reduced and limited to a maximum of 300 mg a day in people over 65 years. Tramadol may be taken with or without food.
Common adverse effects of Tramadol
Tramadol can occasionally cause an allergic reaction which may included hives, itching or wheezing. The most common side effects are constipation, nausea, vertigo, drowsiness, headache, vomiting or agitation. Less common are itching, indigestion, dry mouth, euphoria, contracted pupils, loss of appetite or urinary retention.
Serious adverse effects of Tramadol
Serious side effects of Tramadol occur rarely but may include seizures, serotonin syndrome consisting of confusion or a rapid heart rate or nausea, diarrhea, hallucinations, jumpy reflexes, fever, rapid changes in blood pressure, shivering, sweating, agitation or slow or irregular breathing.