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The meta-analysis was carried out on nine postsurgical pain trials and nine dental extraction trials. All trials showed a significantly superior analgesia to placebo, with a clear dose response for tramadol (higher doses associated with higher benefit and lower NNTs). Tramadol 100 mg had an NNT of 4.6 (3.6-6.4).
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Having had a traumatic amputation of my lower leg I was given Tramadol. 8 months on I am well and truly hooked. Any lower dose of Tramadol gives me sweats anxiousness, loss of temper, loss of patience, flu-like joint pain and hyper alertness. The pain specialists advised me at the time that it was not addictive but It most definitely is a dependancy inducing drug. I am going to try to come off again but I fear I will have to take a couple of weeks off work to try and come off without shouting at a customer or getting into trouble! Don - Scotland
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American Society of Health-System Pharmacists, Inc. Disclaimer The MedMaster Patient Drug Information database provides information copyrighted by the American Society of Health-System Pharmacists, Inc., Bethesda, Maryland Copyright© 2007. All Rights Reserved.
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3 It is this combination of safety with good efficacy that has made tramadol a unique addition to the analgesic armamentarium.
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Metabolism: Tramadol is extensively metabolized after oral administration. Approximately 30% of the dose is excreted in the urine as unchanged drug, whereas 60% of the dose is excreted as metabolites. The remainder is excreted either as unidentified or an unextractable metabolites. The major metabolic pathways appear to be N- and O-demethylation and glucuronidation or sulfation in the liver. Only the one metabolite (mono-O-desmethyltramadol denoted M1) is pharmacologically active. Production of M1 is dependent on the CYP2D6 isoenzyme of cytochrome P-450.
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Your pharmacist has more information about tramadol written for health professionals that you may read.
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If you use the tramadol extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.
The molecular weight of tramadol hydrochloride is 299.8. Tramadol hydrochloride is a white, bitter, crystalline and odorless powder. It is readily soluble in water and ethanol and has a pKa of 9.41. The water/n-octanol partition coefficient is 1.35 at pH 7. Ultram tablets contain 50 mg of tramadol hydrochloride and are white in color. Inactive ingredients in the tablet are corn starch, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, titanium dioxide and wax.
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I developed more severe symptoms like muscle tightness which was debilitating; the tightness affected my sleep and my ability to relax. I had headaches all over my skull and my brain felt like it was swimming or bouncing around inside. Then anxiety, insomnia and fatigue drove me to the point where I couldn't work and I started to believe I had mental problems! I had an alarming sensation of crawling under my skin and sought medical help. I had a MRI which showed I had previously had a minor stroke. However, my doctors were aware of this before I was placed on Tramadol.
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MORE ON DOSAGE AND ADMINISTRATION: For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, the tolerability of Tramadol can be improved by initiating therapy with the following titration regimen: Tramadol should be started at 25 mg/day qAM and titrated in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg q.i.d.).Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg q.i.d.).After titration, Tramadol 50 to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.
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Seizures (convulsions) have occurred in some people taking tramadol. You may be more likely to have a seizure while taking tramadol if you have a seizure history or some form of head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, or medicine for nausea and vomiting.
cldh1522 said... Our geriatric dobe X had her first dose of tramadol last night at bedtime. A couple of hours later I noticed her awake and pantingsomething that has never happened beforeI'm sure as a result of the tramadol. I also noticed the panting after her dose this morning. I see panting listed as a side effect on another website. On the other hand, her pain seems to be somewhat diminished. Is there any reason to discontinue the meds because of this?
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If your doctor has told you to take tramadol regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
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DEA, unlike other opioid analgesics. Nevertheless, the prescribing information for Ultram warns that tramadol "may induce psychological and physical dependence of the morphine-type". In addition, there are widespread reports by consumers of extremely difficult withdrawal experiences.
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In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or
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Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, headache, or weakness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you are taking tramadol regularly, it may be useful to start using a laxative right away instead of waiting until you become constipated. Consult your pharmacist for details regarding the correct use of laxatives (e.g., stimulant-type with stool softener).Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes, unusual or extreme stiffness in the muscles, shaking (tremor), severe stomach/abdominal pain, change in the amount of urine, vision changes.Tell your doctor immediately if any of these rare but very serious side effects occur: slow/shallow breathing, seizures, fever/flu-like symptoms.A very serious allergic reaction to this drug (which may occur as early as the first dose) is rare. However, seek immediate medical attention if you notice any of the following symptoms: rash, itching, swelling (especially of the lips, tongue, or throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
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Distribution: The volume of distribution of tramadol was 2.6 and 2.9 liters/kg in male and female subjects respectively following a 100 mg intravenous dose. The binding of tramadol to human plasma proteins is approximately 20% and binding also appears to be independent of concentration up to 10 µg/ml. Saturation of plasma protein binding occurs only at concentrations outside the clinically relevant range. Although not confirmed in humans, tramadol has been shown in rats to cross the blood-brain barrier.
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frogsndogs said... Hi,My 12 year old Sibe was diagnosed with hip dysplasia when he was 2, and up until this past year, we have been able to keep his pain well managed with nutraceuticals (Glucosamine and chondroiton), vitamins and supplements (Vit C, Vit E, Fish Oil), acupuncture (works wonders!), acupressure, and massage. His age is finally catching up with him and early this year we put him on Rimadyl intermittently to control his increased pain. He started urinating frequently and having accidents in the house, so we tested him for UTI and kidney fxn. Both were fine, but we found elevated liver enzymes, so immediately pulled him off of the Rimadyl. Our vet prescribed Zentonil to try to help with the liver (this is working well), and Zubrin for the pain. One capsule of Zubrin was given and he immediately vomited it up - no tolerance. We then tried Metacam. He tolerated it for the first 10 days, then started vomiting again - no tolerance, and it didn't really seem to be helping anyway. Our vet has now prescribed Tramadol (1/2 50mg tablet b.i.d - he is 51 lbs.) and within the first 24 hours we saw an immediate change in his attitude. He is no longer the "grumpy old man" he has been the past few months. He actually wants to trot when we walk to the park, and he is asking to play catch with his ball again. We are wishing we would have been told about this drug months ago. He has been on it less than a week, but in this time we have not seen anything to indicate any adverse reactions. I just thought it would be nice to share some good feedback on this drug. This is a very helpful site and I appreciate everyones' input. I did notice that somebody had asked about interaction with DGP (Dog Gone Pain), but saw no response. Could somebody please address this, as we have been using that intermittently since last year?Thank you!DG in Colorado
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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Click here for more information on
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Take tramadol exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Do not take more than 300 milligrams of tramadol in one day.
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Change in consciousnessChest pain or discomfortConvulsions (seizures)Decreased awareness or responsivenessDifficulty in breathingDizziness or faintingLack of muscle toneLightheadednessLoss of consciousnessPinpointed pupils of the eyesSevere sleepinessShortness of breathSlow or irregular heartbeatUnusual tirednessCheck with your doctor as soon as possible if any of the following side effects occur:
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This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at
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Tramadol is an analgesic. It works in certain areas of the brain and nervous system to decrease pain.
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Take Tramadol exactly as directed by your doctor. Soluble tablets should be dissolved in water before taking as directed. The orodispersible (melt in the mouth) tablets will dissolve quickly in the mouth or can be dissolved in half a glass of water, stirred and drunk immediately Modified release forms that release drug slowly over time to give a more even effect should not be broken, crushed or chewed otherwise they may release the drug too quickly and cause side effects.
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This medicine contains the active ingredient tramadol hydrochloride, which is a type of medicine called an opioid analgesic or painkiller. Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors. Tramadol mimics the action of our natural endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain. Therefore, even though the cause of the pain may remain, less pain is actually felt. Tramadol also works by enhancing the activity of neurotransmitters in the brain and spinal cord. Neurotransmitters are chemical compounds that act as chemical messengers between the nerve cells. Tramadol enhances the effect of the neurotransmitters serotonin and noradrenaline, and this action also helps relieve pain.
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The molecular weight of tramadol hydrochloride is 299.8. Tramadol hydrochloride is a white, bitter, crystalline and odorless powder. It is readily soluble in water and ethanol and has a pKa of 9.41. The n-octanol/water log partition coefficient (logP) is 1.35 at pH 7. ULTRAM tablets contain 50 mg of tramadol hydrochloride and are white in color. Inactive ingredients in the tablet are corn starch, hydroxypropyl methylcellulose,
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Tramadol is called Ultram in the U.S, it appears on the site under that name, but I've never heard it called that in England. I've been taking Tramadol for three years, and although it helped with the pain initially the side effects are dramatic. It now no longer helps the pain, but my body is completely addicted, so I'm attempting to come off them slowly. They make me tired a lot of the time, faint, nauseous, very dehydrated, I have to sleep for much longer periods, sleep is unpleasant and interrupted, and I get viruses very easily. I think it could be advisable to take Tramadol in very acute periods of RSD, but not long term. Lucy - Oxford, England I have been taking Pregabelin (Lyrica) for a number of weeks now, along with Tramadol. I am very aware that when I take a full dose of both drugs together I feel a very strange almost "spaced out" feeling. I feel unsteady on my feet and find it difficult to walk a few yards without having to hold on to something to steady myself. If I reduce the Pregabelin dose it is a bit better. I would be interested to hear from anyone with similar experiences when using both drugs. Andy - Taunton, Somerset, UK
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A Comparison of the Abuse Liability of Tramadol, NSAIDs, and Hydrocodone in Patients with Chronic Pain". Journal of Pain and Symptom Management 31 (5): 465–76. Retrieved on
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Do not crush the tramadol tablet. This medicine is for oral use only. You should not crush tablets or diluted with liquid and inject into the body. Using this medicine by inhlation or injection can cause life-threatening side effects, overdose, or death.
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