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GENERIC NAME: tramadol
BRAND NAME:
Ultram
DRUG CLASS AND MECHANISM:
Tramadol is a man-made (synthetic) analgesic
(pain reliever). Its exact mechanism of action
is unknown but similar morphine. Like morphine,
tramadol binds to receptors in the brain (opioid
receptors) that are important for transmitting
the sensation of pain from throughout the body
to. Tramadol, like other narcotics used for the
treatment of pain, may be abused. Tramadol is
not a nonsteroidal antiinflammatory drug (NSAID)
and does not have the increased risk of stomach
ulceration and internal bleeding that can occur
with NSAIDs.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets
(immediate release): 50 mg. Tablets (extended
release): 100, 200, and 300 mg.
STORAGE: Store at room
temperature, 15-30°C (59-86°F). Store in a
sealed container.
PRESCRIBED FOR: Tramadol is
used in the management of moderate to moderately
severe pain. Extended release tablets are used
for moderate to moderately severe chronic pain
in adults who require continuous treatment for
an extended period.
DOSING: The recommended
dose of tramadol is 50-100 mg (immediate release
tablets) every 4-6 hours as needed for pain. The
maximum dose is 400 mg/day. To improve tolerance
patients should be started at 25 mg/day, and
doses may be increased by 25 mg every 3 days to
reach 100 mg/day (25 mg 4 times daily).
Thereafter, doses can be increased by 50 mg
every 3 days to reach 200 mg day (50 mg 4 times
daily). Tramadol may be taken with or without
food.
Recommended
dose for extended release tablets is 100 mg
daily which may be increased by 100 mg every 5
days but not to exceed 300 mg /day. Extended
release tablets should be swallowed whole and
not crushed or chewed.
DRUG INTERACTIONS:
Carbamazepine reduces the effect of tramadol by
increasing its inactivation in the body.
Quinidine (Quinaglute, Quinidex) reduces the
inactivation of tramadol, thereby increasing the
concentration of tramadol by 50%-60%. Combining
tramadol with monoamine oxidase inhibitors (for
example, Parnate) or selective serotonin
inhibitors [(SSRIs, for example, fluoxetine
(Prozac)] may result in severe side effects such
as seizures or a condition called serotonin
syndrome.
Tramadol may
increase central nervous system and respiratory
depression when combined with alcohol,
anesthetics, narcotics, tranquilizers or
sedative hypnotics.
PREGNANCY: The safety of
tramadol during pregnancy has not been
established.
NURSING MOTHERS: The safety
of tramadol in nursing mothers has not been
established.
SIDE EFFECTS: Tramadol is
generally well tolerated, and side effects are
usually transient. Commonly reported side
effects include nausea, constipation, dizziness,
headache, drowsiness, and vomiting. Less
commonly reported side effects include itching,
sweating, dry mouth, diarrhea, rash, visual
disturbances, and vertigo. Some patients who
received tramadol have reported seizures. Abrupt
withdrawal of tramadol may result in anxiety,
sweating, insomnia, rigors, pain, nausea,
diarrhea, tremors, and hallucinations.
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