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126 comments for ranucci et al compared the effect of tramadol, propacetamol and ketorolac after cardiac surgery..Comment #30: buy tramadol online nn ...In the USA, the goal of treatment for drug dependence is generally total abstinence from all drugs, which while theoretically the ideal outcome, is in practice often very difficult to achieve. Other countries particularly in Europe view the aims of treatment for drug dependence to be more complex, with treatment aims including reduction in use to the point that drug use no longer interferes with normal activities such as work and family commitments, shifts away from more dangerous routes of drug administration such as injecting to safer routes such as oral administration, reduction in crime committed by drug addicts, and treatment of other comorbid conditions such as AIDS, hepatitis and mental health disorders. These kind of outcomes can often be achieved without necessarily eliminating drug use completely, and so drug treatment programs in Europe often report more favourable outcomes than those in the USA because the criteria for measuring success can be met even though drug users on the programme may still be using drugs to some extent.
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cody said... I myself am a vet tech, but am looking for more opinions on helping my 14yr old, 93lb. mixed breed dog. She has had arthritis issues for about 7yrs now. One repaired acl, one not(just crate rest for 2wks for partial tear). She has been on several NSAID's and adequan injections for about 4yrs. Lately she has progressed further, and upon x-ray we found severe lubosacral stenosis, and arthritis in both hips, hocks and stifles. She is "knuckling" and losing control of her bowels. I tried tramadol to no effect- 50mg bid because she has elevated liver enzymes and is in a fragile state(also living w/an incompletely excised MCT for one yr. with no recurrence:). She was on previcox for over a year and i just recently switched to metacam b/c previcox seemed to be losing it's effectiveness. I tried prednisone- at a very very low dose (5mg bid) and she did great but absolutely cannot tolerate the drug. Severe aggitation, urinated on herself twice and ravenously hungry) I do know these are symptoms as I am a tech but they were severe with my dog. Unfortunately it worked the best. I even tried a natural hydrocortisone- same symptoms to a slightly lesser degree. I am desperate to give her relief- she is still very much alive in spirit. Have you any experience with amantadine or neurontin? Anything at all I could use in place of pred??? thanks so much!
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Increased Intracranial Pressure or Head Trauma Ultram should be used with caution in patients with increased intracranial pressure or head injury. Pupillary changes (miosis) from tramadol may obscure the existence, extent or course of intracranial pathology. Clinicians should also maintain a high index of suspicion for adverse drug reaction when evaluating mental status in these patients if they are receiving Ultram.
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Generic Name: Tramadol Tablets (TRA-ma-dole) Brand Name: UltramTramadol is used for:
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An amazing pain reliever Doctors prescribe Ultram to treat many types of pain. It is used to treat the pain of cancer, spinal problems like scoliosis, and arthritis. Ultram is also prescribed for patients who have recently undergone surgery. It is effective for people with chronic pain conditions such as headaches and endometriosis as well.
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7:10 PM, Anonymous said... Question - is profuse drooling a known side effect of Tramodol? My dog just had surgery to implant a rod in a broken femur and every time I give his Tramodol, he drools for a good hour. Should I discontinue use until I consult my vet in the morning?
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Get emergency help immediately if any of the following symptoms of overdose occur:
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Tramadol may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, drowsiness, or decreased breathing may occur if tramadol is taken with any of these medications. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicines, including herbal products, without first talking to your doctor during treatment with tramadol.
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In the gap between non-steroidal anti-inflammatory drugs (NSAIDs) like Rimadyl and Deramaxx, which some dogs cannot tolerate and some owners aren't willing to give, and can rarely be safely used in cats, and heavy-duty narcotics like Fentanyl and morphine, is a human pain drug getting recent increased attention in veterinary practice. This is the drug tramadol (Ultram).I first heard of tramadol when it was prescribed for post-surgical pain for a dog of mine at the specialty practice where he had his surgery. Being the kind of dog owner I am, I investigated it thoroughly before giving it to him, and when I did, I wondered how I'd managed to miss it before - and to wish I'd known about it when I had a senior dog who became intolerant of NSAID drugs, and ended up being put to sleep when I could no longer control her pain or maintain her quality of life.There are many ways to inhibit pain. NSAIDs do so by interfering with the production of an enzyme known as "cyclo-oxygenase," or "COX," which is involved in inflammation (as well as many beneficial and essential organ functions). The class of drugs known as opioids does so by stimulating opiate receptors in the brain. Some opiate receptors are responsible for beneficial effects such as pain relief, while others can produce hallucination, sedation, and heart and respiratory problems. Tramadol works by stimulating the "mu" receptor, which provides pain relief without sedation and without addiction.Some Side Effects and ContraindicationsLike all drugs, tramadol has side effects, although they are usually mild. There is a wide range of possible dosing with this drug, and sedation sometimes can occur at higher doses; if this happens, it is recommended that the dosage be reduced.Constipation can occur rarely in some dogs, and will resolve when the drug is discontinued.Although tramadol does not harm the gastrointestinal lining as NSAID drugs can, it can cause nausea. This is rare.Contraindications include dogs who are being treated with L-Deprenyl for Cushings or cognitive disorders, or dogs taking serotonin reuptake inhibitors, monoamine oxidase inhibitors, or certain antidepressant medications.Note: The human drug Ultracet is a combination of Ultram (tramadol) and Tylenol (acetaminophen). This drug must not be given to animals.FeaturesUnlike NSAIDs, tramadol can be taken with steroids. It can also be taken with NSAIDs to provide additional pain relief and allow a lower dose of both drugs to be used.Tramadol is a prescription human medication and will require a prescription from a veterinarian. It is not a controlled substance and no special paperwork is required to prescribe, stock, or dispense this medication in veterinary practice.Tramadol is not passed to nursing puppies through the dam's milk so can be used for pain control in lactating bitches.Dosing InformationThere is a wide range of dosing possible with this medication. Within the recommended safe dosing levels as given in the veterinary literature, it's possible to experiment with different intervals and amounts to achieve the desired level of pain relief and minimize unwanted effects or sedation. Some animals do very well on the minimum dosage given in two equal doses, 12 hours apart, while others might need the same dose, but given in six doses 4 hours apart, or four doses 6 hours apart, or three doses 8 hours apart. And still other animals might need a higher overall dose, given at any of those intervals.The lower doses are typically used for chronic pain relief, such as with arthritis pain, while the higher are for severe post-surgical pain. But this is extremely variable and each animal's and owner's needs should be taken into account on an individualized basis before a dosage schedule is finalized. For example, sometimes giving a slightly higher overall dosage at greater intervals will allow the animal to experience relief of pain without the owner having to adminster the medication repeatedly throughout the day (which is not always possible).Because tramadol is not in widespread use yet in veterinary practice, it's possible that a veterinarian you consult or work for is not familiar with it. For more information, including recommended dosages, veterinary professionals should consult
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Other adverse experiences, casual relationship undetermined: A variety of other adverse events were reported infrequently in patients taking Ultram during clinical trials. A casual relationship between Ultram and these events has not been determined. However, the most significant events are listed below as alerting information to the physician.
Metrebian N, Shanahan W, Wells B, Stimson GV. Feasibility of prescribing injectable heroin and methadone to opiate-dependent drug users: associated health gains and harm reductions. Medical Journal of Australia. 1998 Jun 15;168(12):596-600.
I was also chronically constipated and bloated. If I took Tramadol at night, I would stay awake all night and the next day. My skin and mouth were chronically dry.
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vertigo. Some patients who received tramadol have reported seizures. Abrupt withdrawal of tramadol may result in
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Although the mean pain relief score after 24 hours was similar in both groups (2.7 ± 1.3 and 2.30 ± 1.34 for Tramadol and Propacetamol groups, respectively; P = 0.345); the higher dose of morphine consumption in the Propacetamol group should be kept in mind when considering this similarity.
The novel way in which tramadol provides analgesia with fewer side effects may be explained by its dual mechanism of action, opioid and monoaminergic. Its major metabolite O-desmethyl tramadol (M1) has a weak affinity at μ-opioid receptors as an agonist. The monoaminergic activity comes through the two stereoisomers of tramadol itself, which act synergistically on serotonergic and noradrenergic mechanisms of pain transmission. More specifically, tramadol enhances spinal pain inhibitory pathways by inhibiting neuronal re-uptake of serotonin (5-HT) and noradrenaline (NA), and stimulating 5-HT release.
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For the treatment of painful conditions Ultram (tramadol hydrochloride) 50 mg to 100 mg can be administered as needed for relief every four to six hours, not to exceed 400 mg per day. For moderate pain Ultram 50 mg may be adequate as the initial dose, and for more severe pain Ultram 100 mg is usually more effective as the initial dose.
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Consult your pharmacist or physician if you have questions about drug interactions with Tramadol.
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Food and Drug Administration offers a 180 day exclusivity period to generic drug manufacturers in specific cases. During this period only one (or sometimes a few) generic manufacturers can produce the generic version of a drug. This exclusivity period is only used when a generic manufacturer argues that a patent is invalid or is not violated in the generic production of a drug, and the period acts as a reward for the generic manufacturer who is willing to risk liability in court and the cost of patent court litigation. There is often contention around these 180 day exclusivity periods because a generic producer does not have to produce the drug during this period and can file an application first to prevent other generic producers from selling the drug.
... Comment #260: tramadol hcl acetaminophen par max dosage ...tricyclic antidepressants, or in patients with epilepsy, the seizure threshold is further decreased. Seizures have been reported in humans receiving excessive single oral doses (700 mg) or large intravenous doses (300 mg). An Australian study found that of 97 confirmed new-onset seizures, eight were associated with Tramadol, and that in the authors' First Seizure Clinic, "Tramadol is the most frequently suspected cause of provoked seizures" (Labate 2005). Dosages of coumadin/
Robin said... I should mention that during this week's trial with Tramadol, that the diarrhea started hours after the 2nd 75 mg dose.Stool formation started getting better when I went to just 50 mg of Tramadol per day.And the vomiting ... well, he seemed to be doing better (since he ate more willingly with the baked chicken yesterday) but I opted to give him another 50 mg of Tramadol last night on an empty stomach. And then...woomph....vomited.Essentially: I feel like the tramadol has caused him to vomit and have diarrhea....
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El tramadol puede provocar somnolencia y visión borrosa. No se aconseja la conducción de vehículos ni el manejo de maquinaria peligrosa o de precisión, especialmente durante los primeros días de tratamiento.
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arthritis. These medications act by inhibiting cyclo-oxygenase (abbreviated "COX"), an enzyme that leads to production of assorted inflammatory biochemicals. Suppressing this enzyme, suppresses the pain as well as the inflammation. Unfortunately, cyclo-oxygenase also helps produce some much needed biochemicals and it becomes tricky to suppress production of inflammatory products while keeping the helpful ones. Occasionally, a dog will develop a reaction to one of these anti-inflammatory medications or will develop a liver or kidney problem which is incompatible with their use. These dogs still require pain management and for these patients, a mu agonist like tramadol may be just the ticket.
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Some side effects can be serious. If you experience any of these symptoms or those listed in the SPECIAL PRECAUTIONS section , call your doctor immediately: seizures sores on the inside of your mouth, nose, eyes, or throat flu-like symptoms hives rash difficulty swallowing or breathing swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness hallucinations (seeing things or hearing voices that do not exist)
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Tramadol may be habit-forming. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor.
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Tramadol is used to treat moderate and severe pain and most types of
Traditionally, new pharmacotherapies are quickly adopted in primary care settings, however, drugs for substance abuse treatment have faced many barriers.
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Gass JT, Olive MF. Glutamatergic substrates of drug addiction and alcoholism. Biochemical Pharmacology. 2007 Jun 30.
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At the beginning of the 21st century, legally prescribed psychoactive drugs used for legitimate purposes have been targeted by the US Justice System. In Florida, Richard Paey was sentenced to 25 years in prison for possession of painkillers he requires to eliminate the ecruciating pain in his back. Paey was recently pardoned after serving three years of the 25 year sentence. However, not everyone is as lucky as Paey. In California, Richard Gajewski, diagnosed with narcolepsy in 1979, was unable to get a prescription for Xyrem (sodium oxybate) from a San Mateo County physician. Instead, the physician, David Cecil Gershan,MD wrote "SPEED ABUSE" on Gajewski's medical record after Gajewski revealed that he had used Desoxyn (methamphetamine hydrochloride) prescribed by physicians for 14 years until he began using a healthfood store product that is now sodium oxybate. When Gajewski's medical records were transferred to a Santa Clara County clinic, he was unable to obtain housing assistance, leading his long-time domestic partner, Brian Weber, to take a loan at the bank where he worked to make backpayments on rent. The case has not yet gone to trial.
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6:14 PM, Anonymous said... Well, it has been a few days. I'm pretty far off the subject of this discussion, but I'll stay with it since I started. To try and stay on subject, I'll start by saying we are still on Tramadol and have upped the dosage significantly. We were at 10mg total per day (5mg x 2 times) and we are up to 25 mg total (12.5mg x 2 times).We have taken some pretty big steps backwards. Our dog can barely walk. We have been back to the vet and had x-rays. The dog has three problem vertabra on the x-rays. Probably two of them are old injuries that healed, and one is the current problem. We aren't sure if it is a herniated/ruptured disc, or a spinal infection. Our vet (Upstate Veterinary Specialists - Dr. Dermot Jevens) seems to think the highest likelihood is the discospondylitis - or spinal infection. So we are agressively treating with Zeniquin (marbofloxacin) and hope to see results by Friday. (Today is Wed, and we started treatment on Tues)Making matters worse (and worrying me that it still could be a disc and we aren't treating that anymore) is that our dog started having severe vomiting and diarrhea and we believe that was brought on by the prednisone.So we have discontinued the prednisone for now and the diarrhea is almost completely gone and we aren't seeing any vomiting now but his mobility has greatly decreased at this point, and while he can still walk, he chooses not to if at all possible. We are hoping and praying that the anti-biotic starts making a difference soon.If that doesn't work, then we have to do a CT scan and try to find the exact disc that is the problem and see if we have surgical options. I'll be back in a few days to report.-TSGreenville, SC
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Some side effects can be serious. If you experience any of these symptoms or those listed in the SPECIAL PRECAUTIONS section , call your doctor immediately: seizures sores on the inside of your mouth, nose, eyes, or throat flu-like symptoms hives rash difficulty swallowing or breathing swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness hallucinations (seeing things or hearing voices that do not exist)
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Special Populations: Renal: Impaired renal function results in a decreased rate and extent of excretion of tramadol and its active metabolite M1. In patients with creatinine clearances of less than 30/ml/min adjustment of the dosing regimen is recommended (see DOSAGE AND ADMINISTRATION). The total amount of tramadol and M1 removed during a dialysis period is less than 7% of the administrator dose.
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10- Schaffer J, Hagemann H, Holzapfel S, Panning B, et al. Investigation of Tramadol for post-operative analgesiain children. Forschr Anesth 1998; 3: 42-45.
9:31 PM, Anonymous said... This page has been so helpful...thanks to everyone whom shares their stories.I have a 12 year old boxer lab that suddenly couldn't lay down or walk very well. After I took him to the emergency vet, they put him on 2 pills of 50 mg of tramadol and predisone...which so far seems to have helped. He does however whince and pants at night. My vet said it was a side effect of Tramadol...but, I have seen a few entries where people have been told it is a sign of pain...Just was curious which is correct.Our vet still has not told us what is causing his pain possibly cancer on the spine or a ruptured disc...was curious what the different outcomes could be for either.Any help is appreciated.HS, Colorado
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Ultram (tramadol hydrochloride) has been studied in three long-term controlled trials involving a total of 820 patients with 530 patients receiving Ultram. Patients with chronic conditions such as low back pain, cancer, neuropathic pain and orthopedic and joint conditions entered a double-blind phase of one to three months. Average daily doses of approximately 250 mg of Ultram in divided doses produced analgesia comparable with five doses of acetaminophen 300 mg with codeine phosphate 30 mg (Tylenol® with Codeine #3) daily five doses of aspirin 325 mg with codeine phosphate 30 mg daily and with two to three doses of acetaminophen 500 mg with oxycodone hydrochloride 5 mg (Tylox®) daily. Following the double-blind period, some patients took Ultram in an open period for up to two years.
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A good pain reliever for moderate to severe pain is the analgesic medication Tramadol. Also called Ultram, this pain reliever is not a member of the NSAID (nonsteroidal anti-inflammatory drug) class of medications that are commonly prescribed for pain. It is not a narcotic drug either. Tramadol is a unique medication that has properties of both NSAIDs and narcotics while not having the negative side effects of either one.
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During the preparation of the editorial there was a suggestion that the popularity of tramadol may be related to the availability of repeat prescriptions on the Pharmaceutical Benefits Scheme (PBS). The Editorial Executive Committee therefore invited the Pharmaceutical Benefits Advisory Committee (PBAC) to comment.
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In our study, although pain intensity score was comparable between the two groups at any time, patients in the Propacetamol group needed considerably higher dose of morphine for pain control (8.50 + 5.15 vs. 4.75 + 4.9;P = 0.025) than Tramadol group. It seems that equal pain control in the Propacetamol group was achieved at the expense of more morphine consumption. Need for rescue medication was also more in the Propacetamol group, as 10 patients (50%) in this group needed additional morphine compared to 3 patients (15%) in the Tramadol group (P= 0.041).
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