tramadol, Ultram, Ultram ER, Conzip
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: tramadol
BRAND NAME: Ultram, Ultram ER, Conzip
DRUG CLASS AND MECHANISM: Tramadol is a man-made (synthetic) analgesic (pain reliever). Its exact mechanism of action is unknown, but it is similar to morphine. Like morphine, tramadol binds to receptors in the brain (narcotic or opioid receptors) that are important for transmitting the sensation of pain from throughout the body to the brain. Tramadol, like other narcotics used for the treatment of pain, may be abused. Tramadol is not a nonsteroidal anti-iinflammatory drug (NSAID) and does not have the increased risk of stomach ulceration and internal bleeding that can occur with NSAIDs.
GENERIC AVAILABLE: Yes
STORAGE: Tramadol should be store at room temperature, 15 C to 30 C (59 F to 86 F). It should be stored 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 25-50 mg every 3 days to reach 50-100 mg/day every 4 to 6 hours.. Tramadol may be taken with or without food.
The 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. To convert from immediate release to extended release, the total daily dose should be rounded down to the nearest 100 mg. Extended release tablets should be swallowed whole and not crushed or chewed.
DRUG INTERACTIONS: Carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) 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% to 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. This can reduce the level of consciousness or lead to respiratory insufficiency.
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.
Tramadol can cause psychological or physical dependence similar to other narcotics.
Reference: FDA Prescribing Information
Last Editorial Review: 10/22/2013
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