Tramadol Uses, Benefits, Side Effects and Related Warnings

Tramadol is a high-order painkiller drug that falls under the category of Opioid Analgesics. It is only prescribed under extreme and severe conditions, especially during post-operative recovery. It is also prescribed when normal NSAIDs (Paracetamol or Ibuprofen) cannot be taken by patients with chronic kidney and liver diseases.  Tramadol is a narcotic substance and is only available on the prescription of registered medical practitioners. Since it works on the opioid receptors, it has the potential for abuse and therefore the sale and purchase of Tramadol are controlled.

Additionally, a majority of the opioid receptors are located and distributed at every part of the body, giving rise to the side effects of tramadol and contraindications.  Tramadol is highly effective in relieving unbearable pain but its use and dosage given must be monitored by the healthcare professional. Common side effects of tramadol include nausea, dizziness, drowsiness, dry mouth, constipation, and headache.  Read along to find out more about this potent opioid analgesic.

Tramadol composition

Tramadol contains the active ingredient tramadol hydrochloride, which is an opioid analgesic. It comes in tablet form that also includes inactive ingredients such as starch, cellulose, magnesium stearate, lactose, and polyethylene glycol.

Highlights of Tramadol

• Tramadol is a strong opioid analgesic that is used to relieve chronic pain.
• It is only available on a prescription from a doctor.
• Tramadol can cause addiction and must not be used for long-term pain management.
• Tramadol is safe to use when the user is monitored and the prescription is followed correctly.

Also, Read Combiflam Tablet: Uses, dosage, benefits and side effects

Tramadol Dosage

Here is a general overview of tramadol dosage recommendations:
Tramadol is a prescription pain medication that comes in immediate-release and extended-release oral tablet forms. The usual dosage for adults is:
Immediate-release tramadol:

• Initial dose: 25-50 mg every 4-6 hours as needed for pain relief. The maximum dose is 400 mg per day.

Extended-release tramadol:

• Initial dose: 100 mg once daily, can increase by 100 mg every 5 days based on pain severity, up to 300 mg/day.

Elderly patients over 75 years:

• Initial dose: Maximum of 300 mg per day in divided doses every 4-6 hours as needed. Extended release not recommended. Lower doses may be sufficient.

Children under 16 years:

• Not FDA approved and not recommended. can cause serious harm to children.

Dosing adjustments:
Dosage may need lowering with kidney disease, liver disease, or certain medicine interactions. Never exceed 400 mg total daily dose from all sources. Also, always consult your doctor for appropriate dosage based on your overall health.

When is Tramadol used?

Tramadol is used to relieve severe pain, especially during a severe injury or during surgery. Common tramadol tablets uses include:

• Neuropathic pain - seen in Diabetes and Parkinson's disease
• Post-operative pain
• Pain in the lower back
• Pain during labor
• Post delivery
• Inflammatory arthritis - seen in spondylitis, rheumatoid arthritis, osteoarthritis 
• Fibromyalgia 
• Cancer therapy
• Tramadol acts on serotonin reuptake inhibitors, which leads to a higher concentration of serotonin in the bloodstream. Due to this serotonergic effect, Tramadol is also used as a low-dose antidepressant, anxiolytic, and for tremors
• Tramadol is also used off-label for the treatment of premature ejaculation.

How is Tramadol used?

Tramadol is available in three forms:

• Oral tablets in the doses of 50mg and 100mg.
• Oral extended-release tablets in doses of 100mg, 200mg, and 300mg.
• Injectable in doses of 50mg/ml.

When Tramadol is prescribed, be sure to follow these instructions to ensure safe administration.

• Not to be used in children under the age of 17 years
• Do not exceed 400 mg per day unless under doctor's supervision
• Do not bite into the tablet or crush it in your mouth. This will expose you to unpleasant amounts of Tramadol and cause side effects. 
• Ingest the whole tablet.
• If you use Tramadol for long periods, make sure to taper the dose and gradually get off the drug. This will reduce your chances of having withdrawal symptoms from Tramadol.

Also, Read about Zincovit Tablet - Benefits, Uses, Side effects, and Precautions.

What benefits of Tramadol?

Benefits of taking Tramadol over traditional analgesics include:

• Fast acting 
• Immediate relief from extreme, excruciating pain
• Can be administered for painful surgical procedures
• Post-operative recovery is faster
• Can be safely given to patients with chronic kidney disease
• can relieve neuromuscular and neuropathic pain, whereas NSAIDs cannot

What are the Side effects of Tramadol?

Tramadol acts on opioid receptors that are located all along the body. This makes its effects widespread which gives rise to more side effects. Tramadol side effects that are seen in each system are as follows:

1. CNS side effects

these symptoms occur as a result of Tramadol acting on the brain and the nervous system.

• Dizziness
• Delirium
• Somnolence (excessive drowsiness)
• Nausea
• Sweating
• Hallucinations 
• Seizures - observed even in people with no history of epilepsy.
• Convulsions - more pronounced in patients with epilepsy and family members of patients with epilepsy.

2. Cardiac side effects

Cardiac symptoms arise as a result of Tramadol acting on the receptors in the heart and blood vessels.

• Orthostatic hypotension- you feel dizziness when you stand up from a sitting position.
• An increased heart rate may lead to arrhythmia.
• High blood pressure

3. Respiratory side effects

these symptoms occur as a result of Tramadol acting on the brain and the nerve endings in the respiratory tract.

• Respiratory depression
• Depressed cough reflex - Tramadol directly affects the cough center in the medulla to decrease cough reflex sensitivity.
• Shortness of breath.

4. Serotonin syndrome 

Tramadol acts on serotonin reuptake inhibitors, which leads to higher concentrations of serotonin in the bloodstream. Therefore, when taking Tramadol, avoid the use of any serotonergic drugs (antidepressants, migraine medication) that will further add to serotonin in the system and lead to tragic side effects such as,

• Hyperthermia
• rigid body
• Myoclonus
• Autonomic instability

5. Gastrointestinal side effects

Tramadol affects the general motility of the muscles and reduces their contractions causing these side effects:

• Reduction in muscle motility
• Delayed digestion
• Constipation - occurs due to decreased peristaltic movements in the large intestine and the colon.

6. Allergic response:

Tramadol may cause an allergic reaction in those sensitive to the drug.

• Pruritus
• Skin rashes and itching

Also, read Nimesulide and Paracetamol tablets: Uses, Benefits, Side effects, and Warnings.

Related warnings

To avoid any side effects of tramadol, you should consider following warnings.

• Reduced rate of breathing- Tramadol carries a warning for reduced breathing, especially for asthma patients. Talk to your doctor if you suffer from upper respiratory tract issues.
• Accidental ingestion - accidental ingestion by children below the age of 12 can cause death in children. Children process the effects of Tramadol faster than adults.
• Drug interactions - Tramadol causes several drug interactions, especially with serotonergic drugs. These drugs must strictly be avoided when taking Tramadol.
• Drugs such as Sertraline, Ritonavir, Fluoxetin, and Amiodarone must either be monitored or avoided. 
• Benzodiazepines and other antidepressant drugs must be avoided
• Drinking alcohol while taking Tramadol can drastically reduce breathing and decrease heart rate. 
• Mental health: Tramadol increases the risk of mental health issues, especially in people who have a history of epilepsy.
• Epilepsy - seizures are more frequent when taking Tramadol
• Depression- Do not take Tramadol if you have suicidal tendencies. 
• Pregnancy - mothers who take Tramadol for long periods during pregnancy may cause withdrawal symptoms in their babies. Withdrawal symptoms in a baby can even cause death. Withdrawal symptoms usually appear such as crying, agitation, irritability, and vomiting.
• Addiction and misuse- The major warning of this drug is its potential for dependency and addiction. This occurs only when the prescription is refilled without the doctor's instructions and due to negligence by the pharmacist. 

Caution

To avoid side effects of tramadol A few precautionary measures that absolutely must be followed while taking Tramadol are:

1. Do not drive
2. Do not drink alcohol
3. Do not take it if you have suicidal thoughts 
4. Do not use it for more than 20 days unless prescribed and monitored by your healthcare provider. 

Also Read Flexon Tablet: Uses, Benefits, Side Effects, and related Warnings.

Conclusion 

Tramadol is safe to use under the right dosage and can be safely administered to relieve pain in all adults above the age of 12. The benefits of Tramadol far exceed its side effects, however, contact my doctor immediately if you notice any troubling or abnormal symptoms upon using Tramadol for pain relief. This drug has the potential for addiction and abuse. Use this drug strictly in a manner instructed by your doctor and for your safety and concerns, reach out to your nearest pharmacist or doctor for more information. 

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