Generic
Tramadol Hydrochloride
74 brands available in the market
At a glance
Tramadol Hydrochloride is a pain relieving medicine used to manage persistent, moderate to severe chronic pain that requires continuous, around-the-clock treatment.
Description
Tramadol is a centrally acting synthetic analgesic compound. It inhibits the reuptake of serotonin and noradrenaline and binds to mu-opiate receptors in the CNS, altering perception and response to pain.
Indications
- Moderate to severe pain
- Postoperative pain
- Colic and spastic pain
- Cancer pain
- Joint pain
- Neck and back pain
- Pain associated with osteoporosis
Therapeutic class
Opioid analgesics
Pharmacological class
Opioid Analgesic
Pharmacology
Tramadol inhibits the reuptake of serotonin and noradrenaline, modifying the transmission of pain impulses by activating descending serotonergic and noradrenergic pathways. Analgesic effects are mediated via mu-opioid receptor stimulation and indirect modulation of central monoaminergic inhibitory pathways.
Mechanism of action
Stimulates mu-opioid receptors and inhibits serotonin/noradrenaline reuptake, reducing pain.
Dosage
Adult Dose (Oral):
- Immediate release: 50-100 mg every 4-6 hours as needed; max 400 mg/day
- Extended release: 100 mg once daily initially; increase by 100 mg/day every 5 days; max 300 mg/day
Parenteral:
- IM/IV: 50-100 mg every 4-6 hours
Renal impairment: CrCl 10-30: increase dosing interval to 12 hours; CrCl <10: contraindicated
Administration
- Administered by a healthcare professional; do not self-administer
- Take with food to avoid upset stomach
Missed dose
If you miss a dose, take it as soon as possible; if almost time for next dose, skip it; do not double the dose.
Side effects
Common Side Effects:
- Dizziness
- Sleepiness
- Vomiting
- Nausea
- Constipation
- Injection site reactions
- Headache
- Fatigue
- Dry mouth
- Sweating
Precautions & warnings
- May affect ability to drive or operate machinery
- Use only for severe acute pain for not more than 5 days
- Prolonged use may result in physical and psychological dependence
- Take with food to avoid upset stomach
- Dose adjustment may be needed in liver or kidney disease
Contraindications
- Suicidal patients
- Acute alcoholism
- Head injuries
- Raised intracranial pressure
- Severe renal impairment
- Lactation
Drug interactions
- SSRI, SNRI, TCA, bupropion, mirtazapine, tetrahydrocannabinol: increased risk of convulsions or serotonin syndrome
- Carbamazepine: decreased serum concentrations
- Norepinephrine, 5-HT agonists, lithium: may potentiate antidepressant effect
- Warfarin: increased INR and ecchymoses
- MAOIs: increased risk of seizure and serotonin syndrome (potentially fatal)
Food interactions
It is unsafe to consume alcohol with Tramadol Hydrochloride.
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies show harmful effects; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited human data suggests no significant risk; consult doctor immediately if baby shows increased sleepiness, difficulty breastfeeding, breathing problems, or limpness.
Pediatric use
Safety and efficacy not established in children under 17 years; may be given at 1-2 mg/kg in children over 1 year
Geriatric use
Increase dosing interval in elderly over 75 years
Renal / hepatic impairment
Renal Impairment: CrCl 10-30: increase dosing interval to 12 hours; CrCl <10: contraindicated
Hepatic Impairment: Severe: immediate release 50 mg every 12 hours; extended release not recommended
Overdose effects
Symptoms: Respiratory depression, drowsiness, convulsions.
Treatment: Supportive; naloxone may be used.
Storage conditions
Store below 30°C, away from light and moisture; keep out of reach of children.