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Tramadol
Brand name:Tramadol, Ultram Generic name: Tramadol hydrochloride
Tramadol is a centrally acting analgesic with opioid-like
effects. It relieves pain by acting on the specific nerve endings of the
spinal cord and brain. These nerve endings diminish the severity of the
pain you feel, a natural function that is increased with the administration
of Tramadol. Tramadol is indicated for the treatment of moderate to severe
pain

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Most important fact about Tramadol
You should not drive a car, operate machinery, or perform
any other potentially hazardous activities until you know how Tramadol
affects you.
How should you take Tramadol ?
It's important to take Tramadol exactly as prescribed.
Do not increase the dosage or length of time you take Tramadol without
your doctor's approval.
If you miss a dose of Tramadol
Take Tramadol as soon as you remember. However, if it
is almost time for your next dose, skip the one you missed and go back
to your regular schedule. Never take 2 doses at once.
Storage information for Tramadol
Store in a tightly closed container at room temperature.
What side effects when taking Tramadol may occur
?
Side effects of Tramadol cannot be anticipated. If any
develop or change in intensity, tell your doctor as soon as possible.
Only your doctor can determine if it is safe for you to continue taking
Tramadol.
More common side effects when taking Tramadol
may include:
Agitation, anxiety, bloating and gas, constipation, convulsive
movements, diarrhea, dizziness, drowsiness, dry mouth, feeling of elation,
hallucinations, headache, indigestion, itching, nausea, nervousness, sweating,
tremor, vomiting, weakness.
Less common side effects when taking Tramadol
may include:
Abdominal pain, confusion, coordination problems, feeling
of illness, flushing, frequent urination, inability to urinate, loss of
appetite, menopausal symptoms, rash, sleeping problems, visual problems
Rare side effects when taking Tramadol may include:
Accidental injury, allergic reaction, altered taste, amnesia,
coma, difficult or labored breathing, difficulty concentrating, dizziness
or light-headedness upon standing, fainting, feeling of "pins and
needles," fever, heightened reflexes, hives, menstrual problems,
mental sluggishness or clouding, painful urination, rapid heartbeat, seizures,
shivering, seizures, suicidal tendencies, weight loss.
Why should Tramadol not be prescribed ?
Avoid Tramadol if it has ever given you an allergic reaction.
Also avoid Tramadol after taking large doses of sleeping pills such as
Halcion, Dalmane, and Restoril; narcotic pain relievers such as Demerol,
morphine, Darvon, and Percocet; or psychotherapeutic drugs such as antidepressants
and tranquilizers. And do not take Tramadol after drinking excessive amounts
of alcohol.
Special warnings about Tramadol
If you have stomach problems such as an ulcer, make sure
your doctor is aware of them. Tramadol may hide the symptoms, making them
difficult to diagnose and treat.
Tramadol can cause mental and physical addiction. If you've
ever had a problem with narcotic painkillers such as Percocet, Demerol,
or morphine, you should avoid Tramadol. Withdrawal symptoms may occur
if you stop taking Tramadol abruptly. Such symptoms include anxiety, sweating,
insomnia, pain, nausea, tremor, diarrhea, and respiratory problems. A
gradual decrease in dosage will help prevent these symptoms.
Do not take more than the recommended dose of Tramadol,
since larger doses have been known to cause seizures, especially if you
have epilepsy or are taking medications that also increase the risk of
seizures. Among such medications are almost all antidepressant drugs,
plus narcotics and major tranquilizers such as Loxitane and Stelazine.
If you have liver or kidney disease, be sure your doctor
knows about it. Your dosage of Tramadol may have to be reduced.
Before you have any kind of surgery, make sure the doctor
knows you are taking Tramadol.
If you have any kind of breathing problem, use Tramadol
with caution or take a different kind of painkiller. Tramadol can impair
respiration, especially if taken with alcohol.
If you have experienced a head injury, consult your doctor
before taking Tramadol. Tramadol´s effects may be stronger and could hide
warning signs of serious trouble.
Possible food and drug interactions when taking
Tramadol
Tramadol may increase the drowsiness caused by alcohol.
Do not drink alcohol while taking Tramadol.
Avoid Tramadol, too, if you are taking the seizure medication
Tegretol.
If Tramadol is taken with certain other drugs, the effects
of either could be increased, decreased, or altered.
It is especially important to check with your
doctor before combining Tramadol with the following:
Cyclobenzaprine (Flexeril)
Drugs known as MAO inhibitors, including the antidepressants Nardil and
Parnate
Serotonin-boosting antidepressants such as Paxil, Prozac, and Zoloft
"Tricyclic" antidepressants such as Elavil, Norpramin, and Tofranil
Major tranquilizers such as Thorazine and Stelazine
Narcotic pain relievers (Demerol, morphine, Darvon, Percocet)
Promethazine (Mepergan, Phenergan)
Quinidine (Quinidex)
Sleeping pills (Halcion, Dalmane, Restoril)
Tranquilizers (Valium, Xanax)
Special information if you are pregnant or breastfeeding
There have been reports of serious harm to developing
babies when Tramadol was used during pregnancy. If you are pregnant or
plan to become pregnant, tell your doctor immediately. Tramadol appears
in breast milk and may affect a nursing infant. If Tramadol is essential
to your health, your doctor may advise you to discontinue breastfeeding
until your treatment is finished.
Recommended dosages for Tramadol
ADULTS
The usual starting dose of Tramadol for chronic pain is
25 milligrams once a day in the morning. The daily dosage is then increased
every 3 days until it reaches 200 milligrams taken in four doses of 50
milligrams each. After the phase-in period, Tramadol may be taken in doses
of 50 to 100 milligrams every 4 to 6 hours, depending on the severity
of pain. If rapid pain relief is needed, the phase-in steps can be skipped,
though side effects will be more likely. The maximum dosage under any
circumstances is 400 milligrams a day (300 milligrams for those over age
75).
For people with kidney problems, the usual starting dose
is 50 to 100 milligrams every 12 hours; and the maximum per day is 200
milligrams. For those with cirrhosis, the usual dose is 50 milligrams
every 12 hours.
CHILDREN
Safety and effectiveness of Tramadol in children under
16 years of age have not been established.
Overdosage with Tramadol
An overdose of Tramadol can be fatal. If you suspect an
overdose of Tramadol , seek emergency medical treatment immediately.
Symptoms of Tramadol overdose include:
Difficult or slowed breathing, drowsiness, coma, seizures,
cardiac arrest
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