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Tramadol - 10 Things You Should Know

Painkiller Associated With Decreased Side Effects

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Updated August 09, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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Tramadol, the generic version of Ultram, is a synthetic analgesic medication. The exact mode of action of tramadol is unknown but it is said to work like morphine. Tramadol binds to opioid receptors in the brain -- receptors that transmit the sensation of pain throughout the body. Here are 10 things you should know about tramadol to ensure its safe use.

1 - Tramadol is prescribed to treat moderate to moderately severe pain.

Tramadol belongs to the class of drugs known as opiate agonists. Primarily, tramadol works by changing the way the body senses pain. Some people mistakenly believe that tramadol is an NSAID (nonsteroidal anti-inflammatory drug), but it is not.

2 - Tramadol is available in immediate release and extended release formulations.

Tramadol may be prescribed as an immediate release tablet (50 mg.) or as an extended release tablet (100, 200, or 300 mg.). The extended release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment. Your doctor will determine the appropriate dosage schedule for you.

3 - Tramadol extended release tablets must be taken whole, not split, chewed or crushed.

It is important to take tramadol properly and to follow prescribing instructions. If taken improperly or in a way that is not recommended, serious side effects and even death can result.

4 - Tramadol can be habit-forming for some people.

Do not take more tramadol than has been prescribed for you. Taking more tramadol or taking it more often can cause dependency on it. You should also not stop taking tramadol without first consulting your doctor. You may experience withdrawal symptoms if you stopped it suddenly. You doctor will likely decrease your dose of tramadol gradually.

5 - Drug interactions are possible with tramadol.

Be aware of the following possible drug interactions:

  • Carbamazepine reduces the effect of tramadol
  • Quinidine increases the concentration of tramadol by 50% to 60%
  • Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects.

Be sure to tell your doctor about all medications you are taking.

6 - Tramadol, when combined with certain other substances, can increase central nervous system and respiratory depression.

In other words, breathing may be affected or even stop if tramadol is combined with alcohol, narcotic drugs, anesthetics, tranquilizers, or sedatives.

7 - The use of tramadol during pregnancy should be avoided.

Because the safety of tramadol use during pregnancy has not been established, the medication should not be used during pregnancy. The safe use of tramadol in nursing mothers has also not been established.

8 - Tramadol is usually well-tolerated. Any side effects are usually temporary.

Some of the common side effects associated with tramadol include:

  • nausea
  • constipation
  • dizziness
  • headache
  • drowsiness
  • vomiting

Less common side effects include: itching, sweating, diarrhea, rash, dry mouth, and vertigo. There have been patients who developed seizures after taking tramadol.

9 - A Cochrane Review of tramadol to treat osteoarthritis revealed some small benefit.

The Cochrane Review stated that when tramadol is taken for up to 3 months, there may be decreased pain, improvements in function and stiffness and overall well-being. However, tramadol can cause side effects that are significant enough to require that the patient must stop taking the medication. Risks outweigh benefits for many people who have tried tramadol.

10 - If an overdose of tramadol has occurred, call your local poison control center, or call 911 if it appears to be an emergency situation.

Symptoms of an overdose include decreased pupil size, difficulty breathing or staying awake, unconscious, coma, heart attack, or seizure. Call for help, even if you are unsure about what to do.

Sources:

Tramadol. MedlinePlus. 7/1/2007.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a695011.html>

Tramadol for Osteoarthritis. Cochrane Reviews. Cepeda MS, Camargo F, Zea C, Valencia L. 5/23/2006.

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