Mechanism of Action:

Tramadol hydrochloride performing synthetic opioid analgesics in an orally dissecting MB form. The mode of action of tramadol is not yet fully understood, but it is believed to work through modulation of the noradrenergic and serotonergic systems in addition to mild pain of the opioid receptor. The contribution of non-opioid activity by the analgesic effect of tramadol is not completely antagonistic by the OP-opioid receptor agonist naloxone.

Opioid activity is due to the low-affinity binding of the parent compound and the high-affinity binding of the O-demethylated metabolite M1 to io opioid receptors.

Half- life:

3-5 hours.

Indications:

Management of moderate to moderately severe pain.

Pharmacokinetic Properties:

The tandem is well absorbed orally and with full bioavailability of 75%. The tandem has a delivery volume of approximately 2.7 L / kg and is 20% bound to plasma proteins. Tramadol is largely metabolized not by one. CYP2D6 and CYP3AA as well as conjugates by parent metabolites. M1 construct is dependent on CYP2D6 and is subject to such inhibition, which may affect the non-therapeutic response. Tandem metabolites are mainly excreted in urine with observed plasma.

Drug-Drug interactions:

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription / nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: certain pain medications (mixed opioid agonist-antagonists such as pentazocine, nalbuphine, butorphanol), naltrexone.

Precautions: 

Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders (such as head injury, tumor, seizures), breathing problems (such as asthma, sleep apnea, chronic obstructive pulmonary disease-COPD), kidney disease , liver disease, mental / mood disorders (such as confusion, depression, suicidal thoughts), personal or family history of a substance use disorder (such as overuse of or addiction to drugs / alcohol), stomach / intestinal problems (such as blockage, constipation, diarrhea due to infection, paralytic ileus), difficulty urinating (such as due to enlarged prostate), gallbladder disease, disease of the pancreas (pancreatitis), obesity.

Fertility:

Post-marketing surveillance does not suggest the effect of tramadol on fertility. Animal studies did not show an effect of tramadol on fertility.

Dosage:

Trendum (tramadol hydrochloride) for the treatment of painful conditions may be administered from 50 mg to 100 mg every four to six hours as needed for relief, no more than 400 mg per day. For moderate pain, 50 mg as the initial dose may be sufficient, and for more severe pain, dimensional 100 mg is usually more effective than the initial dose.

Duration of action:

The total daily dose can then be increased to 50 mg as tolerated to 200 mg/day (50 mg four times a day) every 3 days. After titration, ULTRAM 50 to 100 mg may be taken no more than 400 mg/day every 4 to 6 hours as needed for pain relief.

Adverse Reaction:

Nausea, vomiting, sweating and constipation, drowsiness, respiration, depression. A common side effect of most opioids by themselves, it can lower the seizure threshold and when SSRIs combine with tricyclic antidepressants.

Storage:

Store in a cool (below 25°C), dry place. Keep out of reach of children.

Overdosage:

There have been some cases of overdose with tramadol. Ingestion dose estimates for foreign mortality are in the range of 3 to 5 grams. A 3G intentional overdose was produced in a patient in a clinical study and there were no sequels. The lowest dose was reported to be associated with a fatal disease, which was possibly between 500 and 1000 mg in a 40 kg female, but the details of the case are not fully known.

Contraindications:

There have been some cases of overdose with tramadol. Ingestion dose estimates for foreign mortality are in the range of 3 to 5 grams. A 3G intentional overdose was produced in a patient in a clinical study and there were no sequels. The lowest dose was reported to be associated with a fatal disease, which was possibly between 500 and 1000 mg in a 40 kg female, but the details of the case are not fully known.

Warnings:

Tramadol can only be used with special caution in opioid-dependent patients, with a head injury, shock, decreased level of consciousness of indeterminate origin, increased respiratory center or disorder of function, intracranial pressure.

The product should only be used with caution in patients sensitive to opiates.

Concomitant use of tramadol and medicinal products infused with benzodiazepines or related substances may result in sedation, respiratory depression, coma, and death. Because of these risks, concomitant patients prescribed with these seductive medicinal products should be reserved for patients for whom alternative treatment options are not possible. If it is decided to prescribe tramadol conjugated with medicinal products, the lowest effective dose of tramadol should be used, and the duration of concomitant treatment should be as short as possible.

Breast-feeding: Contraindicated.

Pregnancy: Contraindicated.