Tramadol (Generic)

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One of the most used hypnotic analgesic classes of drug, Tramadol is commonly referred by the doctors. This drug is used for the cure of the mild to severe pain treatment in humans. Not only in the treatment of pain inducing conditions but also in cure of many other problems this drug is made in use in combination with other medicines.

Uses

Tramadol is available in oral tablet formulation and users should not take it themselves. It is very important that the use of this drug is made on proper medical consultation only. Any kind of manipulation in the dosage can be harmful and it is a strict no. Also for safety it is advised that the users should always follow all the precautions as mentioned on the label of the drug for proper use. This will help them to use this drug without any concern for side effects.
The tablets of Tramadol are formulated for consumption as a whole. You should never break down the tablets for consumption. This will result in sudden release of the drug in high quantity in your body which can lead to serious consequences. Also there are medical conditions that you should convey to your doctor prior starting use of Tramadol. If you have a history of drug or alcohol abuse, any kind of allergy or using any other sedative drug then inform your doctor. Also if you witness any unusual change from the intake of this drug then immediately consult your doctor. With little care you all can make side effects free use of Tramadol easily.

How To Take

Usual Adult Dose for Pain 

Immediate-release: 50 to 100 mg orally every 4 to 6 hours as needed for pain
Maximum dose: 400 mg per day

Usual Adult Dose for Chronic Pain

For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, tolerability can be improved by initiating slowly
Immediate-release:
-Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days to reach a dose of 50 mg four times a day
-Maintenance dose: After titration, 50 to 100 mg orally as needed for pain every 4 to 6 hours
-Maximum dose: 400 mg per day
Extended-release:
-Initial dose (tramadol-naive): 100 mg orally once a day; titrate upwards in 100 mg increments every 5 days as needed and as tolerated.
-Maximum Dose: 300 mg orally per day

-Initial Dose for patients CURRENTLY receiving immediate-release tramadol: Calculate the 24-hour immediate-release requirement and initiate with a total daily dose rounded down to the next lowest 100 mg increment given orally once a day
-Individualize dose as needed and as tolerated
-Maximum Dose: 300 mg per day

Usual Geriatric Dose for Pain

Immediate-release:
-65 years or older: Start at the low end of the dosing range
-75 years or older: Maximum dose: 300 mg per day in divided doses

Usual Geriatric Dose for Chronic Pain 

Immediate-release:
-Age 65 years or older: Start at the low end of the dosing range
-Age 75 years or older: Maximum dose is 300 mg per day
Extended-release:
-Age 65 years or older: Use caution; start at the low end of the dosing range
-Age 75 years or older: Use even greater caution

Usual Pediatric Dose for Pain

17 years or older:
Immediate-release: 50 to 100 mg orally every 4 to 6 hours as needed for pain
Maximum dose: 400 mg per day
For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, tolerability can be improved by initiating slowly:
Immediate-release:
-Initial dose: 25 mg orally once daily; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days to reach a dose of 50 mg four times a day
-Maintenance dose: After titration, 50 to 100 mg orally as needed for pain every 4 to 6 hours
-Maximum dose: 400 mg per day

Renal Dose Adjustments

Immediate-release:
-CrCl less than 30 mL/min: Dosing interval should be increased to every 12 hours; maximum dose should not exceed 200 mg per day
Extended-release:
-CrCl less than 30 mL/min: Use is not recommended.

Liver Dose Adjustments 

Immediate-release:
-Patients with cirrhosis: 50 mg orally every 12 hours
Extended-release:
-Severe hepatic impairment (Child-Pugh Class C): Use is not recommended

Side Effect

Get emergency medical help if you have any signs of an allergic reaction to tramadol: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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Tramadol is not for use in children. Seek emergency medical attention if a child has taken this medicine and has: noisy breathing, sighing, slow breathing with long pauses between breaths; being unusually sleepy or hard to wake up; blue colored lips.

Call your doctor at once if you have:

• seizure (convulsions);
• weak or shallow breathing;
• infertility, missed menstrual periods;
• impotence, sexual problems, loss of interest in sex; or
• low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or
• severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common tramadol side effects may include:

• headache, dizziness, drowsiness, tired feeling;
• constipation, diarrhea, nausea, vomiting, stomach pain; or
• feeling nervous or anxious.
• itching, sweating, flushing (warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur.

Precautions

Do not drink alcohol.Dangerous side effects or death can occur when alcohol is combined with tramadol. Check your food and medicine labels to be sure these products do not contain alcohol.

Tramadol may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Drug interactions

Some medicines can cause unwanted or dangerous effects when used with tramadol. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects.Ask your doctor before taking tramadol with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with tramadol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Missed dose

Since tramadol is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.