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- What is tramadol and what is it used for?
- What are the side effects of tramadol?
- Is tramadol a narcotic? Is it addictive?
- What is the dosage for tramadol? How should I take it?
- How does tramadol compare with other pain management drugs?
- Which drugs or supplements interact with tramadol?
- Is tramadol safe to take tramadol if I am pregnant or breastfeeding?
- What else should I know about tramadol?
What is tramadol and what is it used for?
Tramadol is a synthetic (man-made) pain reliever (analgesic). Researchers and doctors do not know the exact mechanism of action of tramadol, 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.
Like other narcotics used to treat pain, patients taking tramadol may abuse the drug and become addicted to it.
Doctors prescribe tramadol to manage 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.
Tramadol should not be used to treat pain in children younger than 12 years of age, and it should not be used to treat pain after surgery to remove the tonsils and/or adenoids in children younger than 18 years of age. Children between 12 and 18 years of age who are overweight or have breathing problems such as obstructive sleep apnea or severe lung disease should not receive tramadol.
What are the side effects of tramadol?
Tramadol is generally well tolerated, and side effects are usually temporary.
Commonly reported side effects of tramadol include:
- drowsiness, and
Less commonly reported side effects include:
Is tramadol a narcotic? Is it addictive?
Tramadol is a narcotic and is addictive. Tramadol is a Schedule IV controlled substance that has been associated with addiction, abuse, and misuse. Tramadol may be addictive, even at the dosage your doctor has prescribed. Abuse or misuse of tramadol can lead to overdose and death.
Like other opioids, people who take tramadol for a long time will develop withdrawal symptoms if your doctor reduces the dosage, or if you suddenly stop taking tramadol.
Withdrawal symptoms that may occur include:
- Excessive tear production
- Muscle pain
- Joint pain
- Abdominal cramps
- Weight loss
- Increased blood pressure
- Respiratory rate
- Heart rate
Infants born to mothers who were taking tramadol during the pregnancy will develop symptoms of withdrawal and difficulty breathing.
What is the dosage for tramadol? How should I take it?
- The recommended dose of tramadol is 50 mg to 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 to 50 mg every 3 days to reach 50-100 mg/day every 4 to 6 hours.
- 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.
- Tramadol may be taken with or without food.
How does tramadol compare with other pain management drugs?
To review how tramadol compares to other pain medications, please refer to this information.
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Which drugs or supplements interact with tramadol?
- 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 or MAOIs (for example, tranylcypromine [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.
Is tramadol safe to take tramadol if I am pregnant or breastfeeding?
Because researchers have not established the safety of tramadol during pregnancy, the safety of tramadol during pregnancy has not been established.
Mothers who are breastfeeding should not take tramadol because the infant may develop side effects, and will develop symptoms of withdrawal and difficulty breathing.
What else should I know about tramadol?
- Tablets (immediate release): 50 mg.
- Tablets (extended release): 100, 200, and 300 mg.
- Capsule (extended release): 100, 200, 300 mg.
Store tramadol at room temperature, 15 C to 30 C (59 F to 86 F), in a sealed container.
Ultram, Ultram ER, and Conzip are the current brand names available for tramadol in the US. Discontinued brands include Rebix OTD, and Ryzolt.
Tramadol is available in generic form, and you need a prescription for it from your doctor or other health care professional.
The FDA approved tramadol in March 1995.
Tramadol (Ultram) is an opioid painkiller (analgesic) indicated for the management of moderate to moderately severe pain in adults. Side effects are similar to other opioid and include dizziness, nausea, drowsiness, and others. Like other opioid medication, tramadol may cause addiction and withdrawal symptoms. Do not discontinue abruptly.
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Related Disease Conditions
Lower Back Pain
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Shoulder and Neck Pain
Shoulder and neck pain may be caused by bursitis, a pinched nerve, whiplash, tendinitis, a herniated disc, or a rotator cuff injury. Symptoms also include weakness, numbness, coolness, color changes, swelling, and deformity. Treatment at home may incorporate resting, icing, and elevating the injury. A doctor may prescribe pain medications and immobilize the injury.
Neck Pain (Cervical Pain)
Neck pain (cervical pain) may be caused by any number of disorders and diseases. Tenderness is another symptom of neck pain. Though treatment for neck pain really depends upon the cause, treatment typically may involve heat/ice application, traction, physical therapy, cortisone injection, topical anesthetic creams, and muscle relaxants.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Restless Leg Syndrome
Restless leg syndrome (RLS) is a common cause for painful legs that typically eases with motion, and becomes worse and more noticeable at rest. This characteristic nighttime worsening can frequently lead to insomnia. Treatment of the symptoms of restless leg syndrome is generally with medication as well as treating any underlying condition causing restless leg syndrome.
A broken foot is a common injury. There are 26 bones in the foot, and these bones can be broken (fractured) in a variety of ways. Signs and symptoms of a broken bone in the foot are pain, swelling, redness, bruising, and limping because the person is not able to walk on the affected foot. You can tell if you have a broken foot by medical examination that includes imaging studies. The healing and recovery time for a broken bone in the foot depends upon the type of fracture and the bones broken.
Coccydynia (Tailbone Pain)
Coccydynia is an inflammation of the bony area (tailbone or coccyx) located between the buttocks. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. Pain is often worsened by sitting. There are many causes of tailbone pain that can mimic coccydynia including: fracture, pilonidal cysts, infection, and sciatica. Treatment methods include medication and rest.
Ankle Pain (Tendinitis)
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Acute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Arthritis, bursitis, IT band syndrome, fracture, and strain are just some of the causes of hip pain. Associated symptoms and signs include swelling, tenderness, difficulty sleeping on the hip, and loss of range of motion of the hip. Treatment depends upon the cause of the hip pain but may include anti-inflammatory medications and icing and resting the hip joint.
Fibromyalgia is a chronic pain condition characterized by symptoms such as fatigue, sleep disturbances, and tender points. Stress reduction, exercise, and medication are the standard treatments for fibromyalgia.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Postherpetic neuralgia (PHN) is a painful complication of shingles. Symptoms include severe pain, itchy skin, and possible weakness or paralysis of the area. There is no treatment for postherpetic neuralgia that is effective for all patients.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Nonsteroidal Anti-inflammatory Drugs and Ulcers
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Migraine and Stroke (Symptoms, Types, Causes, Treatment)
Migraine headache is a type of headache in which the exact cause is not known; however, they may be inherited, and certain foods and environmental factors can trigger and may contribute them. A stroke (brain attack) happens when a blood vessel in the brain leaks, bursts, or becomes blocked, which can be caused by many other health problems. Both migraines and strokes can can cause severe head pain (migraine pain usually is only on one side of the head). Migraine aura symptoms may mimic or feel like a stroke or mini-stroke (transient ischemic attack, TIA) because they have similar symptoms and signs like severe headache, numbness in the legs, feet, arms, hands, or face, nausea, vomiting, and dizziness. Other migraine aura symptoms include vision problems like flashing lights or blind spots in one eye. The main difference between migraine headache and stroke symptoms and signs is that a migraine headaches usually come on gradually while a stroke symptoms come on suddenly and unexpectedly. A migraine may cause photophobia (sensitivity to light and sound). Migraine triggers include hormonal changes, alcohol, insomnia, caffeine, stress, anxiety, bright lights, loud noises, strong odors, aspartame, MSG, and changes in the weather. Symptoms of a stroke that do not occur with migraines include confusion, speech, vision, and balance problems. You can have a migraine headache and a stroke at the same time, but migraines do not cause strokes. However, in certain individuals with migraines with auras there may be related to a higher risk of stroke. Stroke is a medical emergency. If you have stroke symptoms, call 9-1-1 and get medical attention immediately.
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.