Tramadol

Description

Tramadol is a painkiller medicine that belongs to a group of medicines known as opioid analgesics. It is used to provide effective relief from moderate to severe pain associated with various arthritic conditions, low back pain, neck pain, headache, etc. It is also used to relieve post-operative pain. Tramadol is available in injection, tablet, tablet DT, capsule, suppository, and gel dosage forms. Tramadol may cause some side effects like heartburn, stomach pain, redness of the skin, and diarrhoea. Consult your doctor if these symptoms persist or worsen. Do not take this medicine if you are allergic to it. Do not indulge in any work that requires mental focus as you may feel dizzy after receiving this medicine. Avoid alcohol consumption as it may increase the risk of dizziness or sleepiness. Tramadol should be used only with a doctors prescription. Its injectable form should only be administered in a hospital setting by healthcare professionals. Do not try to self-administer. The injection is prescribed for faster pain relief when the pain is severe or unbearable when oral administration is not possible. Inform your doctor if you have kidney or liver problems, before taking this medicine as it may worsen your condition. Tramadol will be prescribed by your doctor in a suitable dose based on your clinical condition. Discuss the potential risks and inform all the medications that you are taking with your doctor before receiving this medicine. Consult your doctor if you are pregnant, planning a pregnancy, or are breastfeeding before using this medicine. Tramadol should not be taken with any antidepressants as it can cause severe adverse effects and behavioural changes. Tramadol is not recommended for use in children below the age of 12 years due to the lack of sufficient data on its safety and efficacy.

Side effects

Major & minor side effects for Tramadol

  • Constipation
  • Nausea or vomiting
  • Dizziness
  • Sense of imbalance
  • Headache
  • Sleepiness
  • Agitation and anxiety
  • Indigestion
  • Convulsions
  • Irregular heartbeat
  • Shortness of breath
  • Itching or rash
  • Nervousness

Uses of Tramadol

What is it prescribed for?

  • Moderate to severe pain
  • Chronic pain
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Concerns

Commonly asked questions

  • Onset of action
    Tramadol starts showing its effects within 1- 2 hours after taking oral forms. Tramadol injection shows its effects within 1 hour of administration. Tramadol gel and rectal suppositories start showing their effects within 3-4 hours of administration.
  • Duration of effect
    The amount of time for which the Tramadol oral dosage forms (tablet, extended-release tablets and dispersible tablets) remains active is 6-7 hours. The duration of the action of tramadol injection is about 48 hours. The amount of time for which tramadol gel and suppositories remains active in your body is not known.
  • Safe with alcohol?
    Consumption of alcohol is not recommended while receiving Tramadol due to the increased risk of serious side effects such as severe stomach and intestinal bleeding, dizziness, fatigue, weakness, rashes, nausea, joint pain, fever, jaundice, etc.
  • Is it habit forming?
    Mild to moderate habit forming tendencies have been reported for Tramadol and hence it requires careful administration and withdrawal.
  • Usage in pregnancy?
    Tramadol is not recommended for use in pregnancy unless necessary. The risks and benefits should be discussed with your doctor before using this medicine.
  • Usage while breast-feeding?
    Tramadol is not recommended for use in breastfeeding. Consult your doctor before using this medicine.

Allergy

Do not take Tramadol if you are allergic to it. Seek immediate medical attention if you notice any symptoms of serious allergic reactions such as skin rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, breathing difficulty, etc.

Severe asthma and breathing problems

Asthma is a condition in which your airways become narrow and swell and produce extra mucus, which makes it difficult to breathe. Do not take Tramadol if you have breathing problems such as asthma, hypercapnia (a buildup of carbon dioxide in your bloodstream), etc., because it may worsen your condition.

Gastrointestinal obstruction

Tramadol is not recommended for use if you have any stomach or intestinal blockage issues like paralytic ileus as it may worsen your condition.

Gastrointestinal ulcers

Tramadol may cause stomach and intestinal bleeding. Therefore, it is not recommended for use if you have gastric ulcers because it may worsen your condition.

Monoamine oxidase inhibitors (MAO)

Tramadol is not recommended for use if you are taking monoamine oxidase inhibitors (antidepressant medicines like Selegiline) due to the increased risk of serious side effects. A time gap of at least 14 days should be maintained between stopping therapy with MAOIs and starting therapy with this medicine.
Warnings for special population

Pregnancy

Tramadol is not recommended for use in pregnancy unless necessary. The risks and benefits should be discussed with your doctor before using this medicine.

Breast-feeding

Tramadol is not recommended for use in breastfeeding. Consult your doctor before using this medicine.
General warnings

Drug abuse

Tramadol has a high potential for addiction and abuse even at recommended doses, especially with long term use. Appropriate monitoring, safety precautions are recommended to reduce the risk of drug abuse.

Bronchial Asthma

Tramadol should be used with caution if you have acute or chronic asthma. Your doctor may monitor your lung functioning while you are using this medicine. Report any unusual symptoms to the doctor immediately.

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 pre-existing medical conditions or the use of other medicines at the same time.

Impaired brain function

Tramadol can increase the risk of side effects if you have a brain tumour or head injury. Your doctor will prescribe a suitable dose depending on your condition. He may monitor your condition while using this medicine. This medicine is not recommended for use in people who are in a coma.

Other medicines

Tramadol has a high 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.

Reduced fertility

Prolonged use of Tramadol may reduce fertility in men and women. Therefore caution should be maintained while using this medicine.

Seizures

Tramadol should be used with caution if you have a history of seizures as it can trigger a fresh attack of seizure and worsen your condition. Your doctor may adjust the dose of this medicine if required, based on your clinical condition.

Suicidal Tendencies

Tramadol may cause suicidal thoughts. This risk is especially high upon the prolonged usage of the medicine. Any changes in behaviour and mood should be reported to the doctor immediately.

Use in Elderly

Tramadol should be used with extreme caution in elderly people due to the increased risk of severe side effects. Appropriate dose adjustments or replacement with a suitable alternative may be required based on the clinical condition.

Use in children

Tramadol is not recommended for use in children less than 12 years of age because the safety and efficacy data is not available.

Withdrawal symptoms

Tramadol may cause withdrawal symptoms if the usage is stopped abruptly. This risk is especially higher after prolonged usage of this medicine. The treatment should be withdrawn gradually under the close supervision of your doctor. Do not stop the use of this medicine without consulting your doctor.

Method of intake

Tramadol should be taken as prescribed by the doctor. The 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 lead to serious side effects.

Driving or Operating machinery

Tramadol may cause dizziness or drowsiness in some people. It is advised that you do not perform activities that require high mental alertness like driving vehicles or operating machines if you experience any of these symptoms during the treatment with this medicine.

Missed Dose

Oral forms: Take the missed dose as soon as you remember. If it is almost the time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose. Injection: Parenteral forms: Since this medicine is usually administered by a qualified healthcare professional in the clinical/hospital setting, the likelihood of a missed dose is very low.

Overdose

Oral forms: Seek emergency medical treatment or contact the doctor in case of an overdose. Injection: Since this medicine is administered in the hospital setting by a qualified healthcare professional, the likelihood of an overdose is very less. However, emergency medical treatment will be initiated by the doctor if an overdose is suspected.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

N/A

Instructions

Consumption of alcohol is not recommended while receiving Tramadol due to the increased risk of serious side effects such as severe stomach and intestinal bleeding, dizziness, fatigue, weakness, rashes, nausea, joint pain, fever, jaundice, etc.
Interaction with Medicine

Amitriptyline

Fluoxetine

Ketoconazole

Ofloxacin

Warfarin

Codeine

Selegiline

Theophylline

Buprenorphine

Alprazolam

Baclofen

Clomipramine

Venlafaxine

Rivastigmine

Zolpidem

Hydroxychloroquine

Disease interactions

Liver disease

Tramadol should be used with caution if you have liver problems due to the increased risk of severe side effects. Your liver functions need to be closely monitored while you are using this medicine. Your doctor may adjust the dose of this medicine if required based on your clinical condition.

Kidney diseases

Tramadol should be used with caution if you have kidney problems due to the increased risk of severe undesirable effects. Your kidney functions need to be closely monitored while using this medicine. Your doctor may adjust the dose of this medicine if required based on your clinical condition.

Seizures

Tramadol should be used with caution if you have a history of seizures due to the increased risk of worsening your condition. Report any unusual symptoms to the doctor immediately. Your doctor may adjust the dose of this medicine if required based on your clinical condition.

Asthma

Tramadol should be used with caution if you have acute or chronic asthma. Your doctor may monitor your lung functioning while you are using this medicine. Report any unusual symptoms to the doctor immediately.
Food interactions
Information not available.
Lab interactions
Information not available.
Oral Forms ( Tablet, Tablet DT, Capsule): Take Tramadol as advised by your doctor. Your dose is likely to be changed by the doctor during the course of treatment and hence all changes should be properly followed. Do not take in larger amounts than advised/prescribed. Consult the doctor if you experience any undesirable effects. Do not stop taking the medicine without consulting your doctor. Injection: This medicine is usually administered in the clinical/hospital setting under the supervision of a qualified healthcare professional. Follow all the instructions given by your doctor. Inform the doctor if you have a known allergy to this medicine. Report all your current medicines as well as your medical conditions to the doctor before receiving this medicine.
Miscelleneous

Usage does not depend on food timings

To be taken as instructed by doctor

Causes sleepiness

How it works
Tramadol works by interfering with the transmission of pain signals to the brain and also changes the brain's perception of pain.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Narcotic analgesics

Schedule

Schedule H 1

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https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ae7c54b1-b440-4cca-97e8-e5b825413d32>

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https://pubchem.ncbi.nlm.nih.gov/compound/33741>

Drugs, H., 2021. Tramadol: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 7 September 2021].

https://medlineplus.gov/druginfo/meds/a695011.html>

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https://www.who.int/medicines/areas/quality_safety/6_1_Update.pdf>

Medicines.org.uk. 2021. Tramadol hydrochloride 50 mg/ml solution for injection or infusion - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 7 September 2021].

https://www.medicines.org.uk/emc/product/4405/smpc>

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Information on this page was last updated on 20 Sep 2021

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