Tramadol (HCl)

Tramadol (HCl) is a centrally-acting analgesic with a unique, dual mechanism of action, within the CNS; it exerts agonistic properties at opiate receptors and interferes with neurotransmitter reuptake. Tramadol also binds weakly to µ-opiate receptors blocking the transmission of pain signals to the brain. It was originally thought that the drug had negligible abuse potential, but after its marketing, reports of drug abuse and withdrawal have been noted. The WHO guidelines indicate there is a place for tramadol in controlling moderate, but not severe, cancer pain. Tramadol has been effective in the control of post-operative pain, but is not suitable as an adjunct to anesthesia because of low sedative properties. Comparative studies with other analgesics for the treatment of postoperative pain indicate that tramadol is equivalent in potency to meperidine, one fifth as potent as nalbuphine, and one thousandth as potent as fentanyl. Respiratory depression caused by tramadol is less than that caused by morphine or meperidine but is apparent after overdose.

Tramadol (HCl) is primarily indicated in conditions like Moderate to severe pain, Pain, Post-therapeutic Neuralgia, HIV-Associated Neuropathy.

Tramadol (HCl) is contraindicated in conditions like Respiratory disease, GI obstruction, Unconsciousness, Acne rosacea.

The severe or irreversible adverse effects of Tramadol (HCl), which give rise to further complications include Seizures, Physical dependence. The signs and symptoms that are produced after the acute overdosage of Tramadol (HCl) include Respiratory depression, Shock, Hallucination. The symptomatic adverse reactions produced by Tramadol (HCl) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Nausea, Vomiting, Diarrhea, Restlessness, Constipation, Dry mouth, Pruritus, Somnolence, Bronchospasm, Angioedema, CNS stimulation, Dyspepsia, Asthenia, Pruritus, Miosis, Sleep disorder, Euphoria.

Tramadol should be used with caution in patients with pre-existing kidney disease, liver disease, seizure disorder, lungs disease, history of drug dependency or have any allergy. It should be used with caution during pregnancy or lactation.

Drug should not be given to patients suffering from Kidney dysfunction, patients suffering from Liver Malfunction, Geriatrics, and Neonates. If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

100 mg (100 (100)) 4 hourly Rectal — maximun oral dose is 400mg, IV injection given over 2 to 3min 50 to 100 mg (75 (75)) 6 hourly PO,IV,IM — maximun oral dose is 400mg, IV injection given over 2 to 3min

1 to 2.5 mg/kg (1.8 (1.75)) 8 hourly Intra Muscular — - 1 to 2.5 mg/kg (1.8 (1.75)) 8 hourly Oral — - 1 to 2.5 mg/kg (1.8 (1.75)) 8 hourly Slow IV — -

1 to 2.5 mg/kg (1.8 (1.75)) 8 hourly Intra Muscular — - 1 to 2.5 mg/kg (1.8 (1.75)) 8 hourly Oral — - 1 to 2.5 mg/kg (1.8 (1.75)) 8 hourly Slow IV — -

Tramadol (HCl) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCarbamazepineCarbamazepine reduces effects of Tramadol.cyclobenzaprine hydrochlorideThe risk of seizures may be increased during coadministration with tramadol. MajorCaution is advised if tramadol is administered with any substance that can reduce the seizure threshold, particularly in the elderly and in patients with epilepsya history of seizures, or other risk factors for seizures (e.g., head trauma, brain tumor, metabolic disorders, alcohol and drug withdrawal, CNS infections). LithiumNoradrenaline (Acid Tartrate)Ondansetron (HCl)post operative analgesic activity of tramadol is decreased.OpiumConcomitant use of tramadol increases the seizure risk in patients taking other opioids.OxymorphoneConcomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. CNS- and respiratory-depressant effects may also be additive. In patients who have been previously dependent on or chronically using opioids, tramadol can also reinitiate physical dependence or precipitate withdrawal symptoms.ModerateConcomitant use of tramadol and other opioids should be avoided in general. Tramadol should not be used in opioid-dependent patients, and use in patients who are chronically on opioids is also not recommended. Tramadol is contraindicated in patients with acute opioid intoxication. Tramadol dosage should be reduced if it must be used in patients receiving opioids. Patients should be monitored for development of seizures and CNS and respiratory depression. ParegoricConcomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. CNS- and respiratory-depressant effects may also be additive. In patients who have been previously dependent on or chronically using opioids, tramadol can also reinitiate physical dependence or precipitate withdrawal symptoms.MajorConcomitant use of tramadol and other opioids should be avoided in general. Tramadol should not be used in opioid-dependent patients, and use in patients who are chronically on opioids is also not recommended. Tramadol is contraindicated in patients with acute opioid intoxication. Tramadol dosage should be reduced if it must be used in patients receiving opioids. Patients should be monitored for development of seizures and CNS and respiratory depression.PhenelzinePhenelzine and other MAOI inhibitors causes serotonergic over activity.QuinidineVORICONAZOLEVoriconazole may increase the serum concentration of tramadol by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects Vortioxetineincreases the toxicity of vortioxetineuse alternativeWarfarin (Na)anticoagulant effect of warfarin is increased. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Tab Store Below 40°C. Protect from Sunlight and Heat.