Tramadol: Uses, Side Effects, Dosage, Warnings & Safe Use Guide

When pain becomes severe, Tramadol medications offer fast-acting relief. As a powerful prescription pain reliever, it works effectively to manage chronic pain, injury-related discomfort, and post-operative recovery compared to over-the-counter medications. Let's explore the blog and learn about Tramadol uses, composition, benefits, side effects, precautions, and many more important facts!

Tramadol: A Quick Overview

• Tramadol is a strong opioid analgesic that is used to relieve chronic pain.

• It is only available on a prescription from a doctor.

• Tramadol can cause addiction and must not be used for long-term pain management.

• Tramadol is safe to use when the user is monitored and the prescription is followed correctly.

Tramadol is a high-order painkiller drug that falls under the category of opioid analgesics. It is FDA-approved for relieving moderate to severe pain. But, its use and given dosage are monitored by the healthcare professional. Moreover, it is prescribed under extreme and severe conditions, like during post-operative recovery. Since it works on the opioid receptors, it has the potential for abuse, and therefore, the sale and purchase of Tramadol are controlled.

Tramadol Composition

Tramadol contains:

• Active ingredients: Tramadol hydrochloride, an opioid analgesic.

• Inactive ingredients: Starch, cellulose, magnesium stearate, lactose, and polyethylene glycol.

It is available in different forms:

• Tablets ((immediate-release & extended-release)

• Capsules

• Oral drops

• Injections

Its common brand names include Tramal, Ultram, Ryzolt, Qdolo, and ConZip, depending on the manufacturer. 

Tramadol Uses

Tramadol is used to relieve severe pain, especially during a severe injury or during surgery. Common tramadol tablet uses include:

• Neuropathic pain - seen in diabetes and Parkinson's disease

• Post-operative pain

• Pain in the lower back

• Pain during labor

• Post delivery

• Inflammatory arthritis - seen in spondylitis, rheumatoid arthritis, osteoarthritis 

• Fibromyalgia 

• Cancer therapy

Tramadol is also used off-label for the treatment of premature ejaculation, restless leg syndrome, or fibromyalgia, but with caution.

How Does Tramadol Work?

Here's how it works:

• Acts on the central nervous system: Works on the spinal cord and the brain to lower the perception or feeling of pain.

• Attaches to opioid receptors: Binds to mu-opioid receptors, which block pain signals.

• Prevents neurotransmitter reuptake: Stops reabsorption of norepinephrine and serotonin, the brain chemicals that control pain sensation and mood.

This dual-action mechanism of opioid receptor binding & neurotransmitter reuptake inhibition makes Tramadol medications most effective for acute and chronic pain. Compared to potent opioids such as morphine, Tramadol has comparatively less dependency risk when used appropriately. However, misuse can lead to addiction. 

Tramadol Dosage Information

The dose and length of duration of Tramadol medicine will depend on the medical issue being treated:

For chronic pain:

• For oral form (extended-release capsules):

1. Adults: The Initial dose is 100 mg per day, which can be increased as needed. However, the dosage is not over 300 mg a day.

2. Children over 12 years: Should be determined by doctors.

3. Children under 12 years: Not recommended.

• For oral form (extended-release tablets):

1. Adults: The Initial dose is 100 mg per day, which can be increased as needed. However, the dosage is not over 300 mg a day.

2. Children: Should be determined by doctors.

For moderate-severe pain:

• For oral form (tablets):

1. Adults: The Initial dose is 25 mg per day, taken each morning, which is increased as needed and tolerated. However, the dose is not over 400 mg a day.

2. Older adults above 75 years: The Initial dose is 25 mg per day, taken each morning, which is increased as needed and tolerated. However, the dose is not over 300 mg a day.

3. Children above 12 years: Should be determined by doctors.

4. Children under 12 years: —Not recommended.

• For oral form (solution):

1. Adults: The Initial dose is 25 mg per day, which may be increased as needed. However, However, the dosage is not over 400 mg a day.

2. Children under 12 years: Not recommended.

Missed Dose: In case you missed the dose, skip it, and continue with the regular dosing schedule. Avoid double-dosing.

Overdose: In case you accidentally take an excessive dose and experience the following overdose symptoms, seek emergency medical help by calling 911 or contacting 1-800-222-1222 to reach out to the Poison Control Center:

• Change in consciousness

• Reduced awareness

• Lightheadedness

• Loss of consciousness

• Difficulty breathing

• Slow or irregular heartbeat

• Lack of muscle tone

• Severe sleepiness

• Unusual tiredness

How is Tramadol Used?

Tramadol is available in three forms:

• Oral tablets in the doses of 50mg and 100mg.

• Oral extended-release tablets in doses of 100mg, 200mg, and 300mg.

• Injectable in doses of 50mg/ml.

When Tramadol is prescribed, be sure to follow these instructions to ensure safe and proper administration.

• Not to be used in children under the age of 17 years.

• Do not exceed 400 mg per day unless under a doctor's supervision.

• Ingest the whole tablet.

• Do not bite into the tablet or crush it in your mouth. This will expose you to unpleasant amounts of Tramadol and cause side effects.

• If you use Tramadol for long periods, make sure to taper the dose and gradually get off the drug. This will reduce your chances of having withdrawal symptoms from Tramadol.

Benefits of Tramadol

Benefits of taking Tramadol over traditional analgesics include:

• Fast acting 

• Immediate relief from extreme, excruciating pain

• Can be administered for painful surgical procedures

• Post-operative recovery is faster

• Can be safely given to patients with chronic kidney disease

• Can relieve neuromuscular and neuropathic pain, whereas NSAIDs can’t.

Tramadol Side Effects

Tramadol acts on opioid receptors that are located all over the body. This makes its effects widespread, which gives rise to more side effects. Tramadol side effects that are seen are:

Common Side Effects:

• Nausea and vomiting

• Dizziness or lightheadedness

• Constipation

• Headache

• Loss of appetite

• Drowsiness or fatigue

• Dry mouth

If any of these symptoms last or worsen, see a doctor. 

Severe Side Effects:

• Seizures

• Serotonin syndrome (symptoms are agitation, muscle stiffness, hallucinations, and a quick heartbeat)

• Respiratory depression (slow or shallow breathing)

• Dependence or addiction, particularly with prolonged use

• Allergic reactions (symptoms include rash, trouble breathing, itching, or swelling)

Immediately seek medical help in case of severe symptoms.

Precautions and Related Warnings

To avoid any side effects and improve the effectiveness of tramadol, you should consider the following precautions and warnings while using this medicine:

• Reduced rate of breathing: A study reports that Tramadol carries a warning for reduced breathing, especially for bronchial asthma patients. Talk to your doctor if you suffer from upper respiratory tract issues.

• Accidental ingestion: Can occur in children below the age of 12, which can cause death. Children process the effects of Tramadol faster than adults.

• Allergies: If you are allergic to any of the ingredients of Tramadol, avoid it. Inform a doctor about your allergies to foods, preservatives, dyes, or if you have had an allergic reaction to other medicines. 

• No alcohol intake: Taking alcohol and Tramadol together can drastically reduce breathing and decrease heart rate. 

• Increased risk of mental health: Tramadol increases the risk of mental health issues like seizures, especially in people who have a history of epilepsy.

• Depression risk: Do not take Tramadol if you have suicidal tendencies, as it leads to depression and suicidal thoughts due to its impact on brain chemicals like norepinephrine and serotonin.

• Use in children: Avoid Tramadol with brand name Ryzolt in children under 16 years, and Conzip extended-release capsules, Ultram tablets, Qdolo oral liquid in children under 12 years, as no efficacy and safety have been confirmed.

• Use in older people: As older people are more prone to side effects and live with age-related issues like kidney, heart, or liver problems, use Tramadol only under a doctor's supervision. 

• Pregnancy: Research reports that taking Tramadol close to the delivery date can lead to withdrawal symptoms such as crying, agitation, extreme drowsiness, irritability, diarrhea, and vomiting in the babies.

• Breastfeeding: Avoid Tramadol during breastfeeding as it can accumulate in the baby’s system and cause difficulty breathing or sleepiness during feeding. 

• Addiction and misuse: Tramadol has the potential for dependency and addiction when the prescription is refilled without the doctor's instructions, and due to negligence by the pharmacist. 

Interactions of Tramadol

Drug-Drug Interactions

Using Tramadol with the following drugs is not recommended as they can reduce Tramadol’s efficacy and worsen the side effects:

• Isocarboxazid

• Naltrexone

• Linezolid

• Mavorixafor

• Methylene Blue

• Moclobemide

• Procarbazine

• Ozanimod

• Phenelzine

• Rasagiline

• Safinamide

• Samidorphan

• Selegiline

• Desflurane

Drug-Food Interactions

Though there is no significant interaction, avoid:

• Foods causing nausea: Examples are spicy, fatty, greasy, and fried foods, as they trigger side effects of Tramadol.

• Foods interacting with acetaminophen: Avoid cruciferous vegetables (like broccoli, cabbage, and Brussels sprouts), high pectin-rich foods like jellies, and carbohydrates if Tramadol contains acetaminophen. This is because these foods can disrupt the absorption of acetaminophen.

• Grapefruit juice: By inhibiting an enzyme (CYP3A4) that helps break down drugs in the liver, grapefruit increases the concentration of Tramadol in the body. Increased Tramadol levels lead to symptoms of dizziness, drowsiness, and seizures (in rare cases).

• Alcohol: Increases the risk of severe side effects and makes you sleepy.

Drug-Disease Interactions

The presence of pre-existing medical issues can impact the absorption of Tramadol. Inform a doctor if you have these problems:

• Diabetes

• Hormonal problems

• Gallstones

• Adrenal problems

• Acute or severe asthma

• Alcohol abuse or history

• Brain tumor

• Lung or breathing problems

• Kidney or liver disease

• Severe stomach problems like bowel blockage

• Depression or history

• Drug abuse or history

• Head injury

• Mental illness

• Undergone surgery of the nasopharyngeal tonsils

Safety Precautions

To avoid the side effects of tramadol, follow these precautionary measures while taking Tramadol:

• Do not drive

• Do not drink alcohol

• Do not take it if you have suicidal thoughts 

• Do not use it for more than 20 days unless prescribed and monitored by your healthcare provider. 

Storage and Disposal Tips

• Store Tramadol at room temperature and away from excessive heat and moisture.

• Keep it in a tightly closed container and out of the reach of your children and pets.

• Throw away unwanted medicines.

• Avoid flushing it down the toilet. 

Are There Alternatives to Tramadol?

Yes, there are several alternatives to tramadol to relieve pain and minimize side effects. However, always consult the healthcare professionals before using these alternatives:

Non-Opioid Pain Medications:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen and naproxen

• Acetaminophen (also called Tylenol)

• Prescription medications like gabapentinoids or tricyclic antidepressants

• Topical pain relievers such as gels, creams, and patches with ingredients like lidocaine or capsaicin

Non-Drug Therapies:

• Physical Therapy: Reduces pain and improves function. 

• Acupuncture: Blocks pain signals. 

• Injections & Nerve Blocks: Relieve nerve pain and muscle spasms when injected.

• Lifestyle Changes: Improving physical fitness, practicing relaxation techniques, and activity pacing, and managing overall health to alleviate chronic pain. 

Final Thoughts

Tramadol is safe to use under the right dosage and can be safely administered to relieve pain in all adults above the age of 12. The benefits of Tramadol far exceed its side effects; however, contact a doctor immediately if you notice any troubling or abnormal symptoms. Moreover, as this drug has the potential for addiction and abuse, use it as prescribed. For your safety and concerns, reach out to your nearest pharmacist or doctor for more information.

Also, read: Combiflam Tablet: Uses, dosage, benefits, and side effects.