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Tramadol is a medicine used to treat moderate to moderately severe pain. Researchers first synthesized tramadol in the 1970s. It changes the way the central nervous system responds to pain.
Tramadol works in two ways: about 20% of its pain-relieving effects come from opioids and 80% from ingredients that inhibit the reuptake of serotonin and norepinephrine, two brain chemicals associated with mood and pain response.
Because tramadol has a lower opioid content than other addictive pain relievers such as oxycodone, hydrocodone, and morphine, it is incorrectly considered safer by many doctors. But tramadol carries risks: people can still abuse and overdose tramadol due to its opioid component. Its interaction with serotonin may also affect people taking other serotonin medications such as antidepressants.
However, the opioid and serotonergic effects of tramadol are important because they allow tramadol to treat pain and its psychological components.
Indications
Tramadol is used to treat the following types of pain:
- toothache
- pain in osteoarthritis
- neuropathic pain
- post-traumatic pain
- postoperative pain
- acute musculoskeletal pain
- post-caesarean section pain, labor pain, obstetric analgesia
- renal colic
- diabetic neuropathy
- postherpetic neuralgia
- lower back pain
- chronic pain in pancreatitis
- pain in rheumatoid arthritis
Dosage
Tramadol is available in several forms: tablet, lozenge, capsule and extended release tablet and suspension. Extended-release tablets and capsules are prescribed for patients requiring around-the-clock pain relief.
The safe dosage of tramadol depends on the patient and their needs. For chronic pain, doctors often prescribe a low dose first, usually after surgery. Doctors also prescribe tramadol to treat arthritis, fibromyalgia, and other chronic pain conditions. The regular tablet and lozenge are usually taken every four to six hours as needed. The extended release formulation should be taken once a day.
Patients should not take a larger dose or take it more frequently or for a longer period of time than prescribed. If you miss a dose, take it as soon as you remember, unless it is very close to the time for the next dose. Then skip the missed dose and continue with your regular schedule. The dose may be increased by the doctor, but the patient should not take more.
It is also important not to stop taking tramadol. It can cause withdrawal symptoms such as nervousness, panic, sweating, difficulty falling asleep, runny nose, chills, nausea, diarrhea, and hallucinations. Your doctor will likely decrease your dose gradually.
Side effects
As noted, tramadol can interact with drugs that affect serotonin levels, such as antidepressants, sometimes leading to serotonin syndrome, which causes mental changes and high body temperature.
Seizures have been reported in both animals and humans taking tramadol. Seizures can occur even at recommended doses, but are more common if a person misuses or overdoses the drug, or if tramadol interacts with another drug, especially antidepressants, according to a 2009 study published in the journal Psychiatry.
Common tramadol side effects include:
- Abdominal problems such as diarrhea, constipation, nausea, or stomach pain
- Depression, including feelings of sadness and disappointment
- Skin problems such as itching, rash or sweating
General aches and pains in muscles and joints.