Warnings for special population
Use of this medicine is not recommended for use in pregnant women as there is a lack of conclusive evidence from clinical studies. However, the potential benefits might warrant the use of this medication inspite of the risks involved. You should consult a doctor before using this medicine.
This medicine is not likely to be present in the breastmilk in alarming quantities. However, the risk of adverse effects on the nursing infant can not be ruled out and hence it is not recommended for use. You should consult your doctor and discuss the potential benefits and risks before deciding to take this medicine.
Tramadol has a high potential for addiction and abuse even at recommended dosages especially with the extended release form. You should be properly counselled about the abuse potential of this medicine. Proper safety monitoring and management of dose quantity is necessary in these cases.
Tramadol should be used with caution if you are suffering from an acute or chronic form of Bronchial asthma. Other diseases that might show asthma-like symptoms like Chronic Obstructive Pulmonary disease, Hypercapnia, Hypoxia should also be considered while prescribing this medication. Proper safety monitoring and dose adjustments should be done in such cases. It is advised to administer this medication in a monitored environment with equipments to handle any possible emergency.
Fall in blood pressure
Tramadol can cause a temporary fall in blood pressure which can worsen based on posture (Orthostatic Hypotension). This can happen due to a pre-existing disease or other medications being administered at the same time. Proper clinical monitoring and dose adjustments are recommended in such cases. It should not be administered if you are suffering from severe heart ailments.
Impaired brain function
Tramadol can increase the risk of side effects in patients suffering from a brain tumor or head injury. The dose should be adjusted based on the severity of impairment and the patient should be monitored in the initial stages of administration. It is not recommended for use in patients who are in a coma.
Tramadol should not be given to patients having an obstructive disease of the Gastrointestinal Tract. The side effects may become more severe and sometimes the symptoms or the disease itself might worsen.
Tramadol has a potential of interacting with a large number of medications. Report the use of all medications including supplements and herbs so that the side effects can be minimized.
Prolonged use of Tramadol can reduce fertility in males and females in the reproductive age group. Patients should be informed about the potential effect on reproductive capabilities.
Tramadol can cause seizures even at recommended doses especially in patients suffering from epilepsy and other conditions of the brain. Suitable dose adjustment and clinical monitoring are advised in such cases.
Tramadol should be administered with caution in patients who have shown suicidal tendencies in the past or present. This can be attributed to certain conditions or use of other medication that are known to cause suicidal tendencies upon administration.
Tramadol should be admistered with caution in the elderly as the risk of severe adverse effects are very high. Suitable adjustment in dose quantity and safety monitoring may be required in such cases.
Use in children
Tramadol is not recommended for use in children below 17 years of age as safety parameters are not set for this age group.
Withdrawal of Tramadol should be slow and steady especially with the extended release form of the medicine. Symptoms of withdrawal include tremors, nausea and vomiting, chills and fever, diarrhea and even hallucinations in some cases. The dose reduction should be based on the symptoms and should be properly tapered.
Method of intake
Tramadol should be taken as prescribed by the doctor. Use of this medicine without prescription should be avoided. Never adopt other means like crushing the tablet and inhaling or injecting in veins. These methods of intake can be fatal.