Tramadol
Generic Name:
Tramadol hydrochloride
Brand Names:
Ultram, Ultram ER, Tramal, Mabron, Ralivia, Ryzolt, Tradonal, Tramacet, Tridural, Ultracet, Zamadol, Zydol
Tramadol Description:
Tramadol is an analgesic pain medication used for the management of moderate to moderately severe chronic pain in adults 17 years of age and older. Tramadol is most commonly prescribed under the brand names Ultram and Ultram ER. It is a centrally-acting opioid analgesic that acts on the brain and nervous system to ease pain, causing side effects similar to those seen in codeine medications.
Tramadol Uses:
Tramadol is an opioid medication used for the treatment of moderate to moderately severe pain. The drug acts on nerves in the brain, binding to opioid receptors to change the way the body perceives pain.
Tramadol Interactions:
The following drugs may negatively interact with tramadol and should be avoided during treatment:
- Amitriptyline
- Carbamazepine
- Cimetidine
- Digoxin
- Erythromycin
- Fluoxetine
- Ketoconazole
- Lithium
- MAO inhibitors
- Paroxetine
- Quinidine
- Rifampin
- SSRIs/SNRIs
- St. John’s Wort
- Triptan
- Warfarin
Use caution when combining tramadol with tranquilizers, hypnotics, or other drugs containing opiates.
Tramadol Dosage Information:
Typical Dosage Recommendation:
Treatment with tramadol is usually started at 25 mg per day, taken in the morning. Dosage can be gradually increased to 100 mg per day, taken in four separate doses. Once the initial phase is completed, dosage is usually recommended as 50 mg taken every 4 to 6 hours or as needed for pain, for a total of 200 mg per day. Doses should not exceed 400 mg per day.
In patients with cirrhosis, the recommended dosage is 50 mg every 12 hours.
Elderly patients should use caution when taking tramadol. Patients over the age of 65 may need lower doses because of decreased liver, kidney, or cardiac function. Patients over the age of 75 should not take more than 300 mg per day.
Missing a Dose:
If you miss a dose of tramadol, take the dose as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and wait to return to your regular dosing schedule. Do not double dose to make up for a missed dose.
Overdosing:
If you suspect an overdose of tramadol, seek emergency medical attention. Fatalities have been reported with both intentional and unintentional overdose. Signs of overdose include:
- Respiratory depression
- Lethargy
- Coma
- Seizure
- Cardiac arrest
Tramadol FDA Approval:
March 3, 1995
Tramadol Recall/Black Box Warning Information:
There is currently no Black Box warning on tramadol medications.
Other Warnings
The manufacturer of Ultram (tramadol) sent out a warning letter in March 2009, advising physicians of the drug’s potential for dependence, withdrawal, abuse, and drug tolerance. The risk for abuse is greater in those patients with a prior history of substance abuse. Withdrawal symptoms may occur if treatment is stopped suddenly. Signs of withdrawal include anxiety, diarrhea, hallucinations, nausea, insomnia, pain, rigors, tremors, sweating, and upper respiratory symptoms. Tramadol has properties similar to morphine medications and may induce psychic and physical dependence and cravings.
Seizure Risk
There have been reports of seizures occurring in patients taking even the recommended dose of Ultram (tramadol). The risk for seizures increases with higher doses that are above the recommended levels. Risk also increases if Ultram is taken along with selective serotonin re-uptake inhibitors (SSRI antidepressants or anorectics), tricyclic antidepressants, tricyclic compounds, MAO inhibitors, neuroleptics, other opioids, and any drugs that reduce the seizure threshold.
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July 30, 2010, 2:23 pm
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July 29, 2010, 12:33 pm
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July 28, 2010, 3:58 pm
