Everything You Ever Wanted To Know About Tramadol

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A few years ago my wife was prescribed Tramadol for her Rheumatoid Arthritis pain. At the time we had never heard of Tramadol and there wasn't a lot of information about it online. Being the inquisitive type I like to know a lot about everything so I set out to learn all I could about the drug. Through my research I was able put together quite a bit of information from various medical journals, websites, etc and thought it would be wise to share the information online.

The first question you may be asking is:

"What is Tramadol?"

Tramadol (also known as Ultram) is a time release analgesic used for the treatment of mild to moderate pain. It is a synthetic form of Codeine but is non-narcotic so it is not considered a controlled substance. Because of its extended release actions it is commonly used to treat moderate to severe chronic pain when treatment is needed around the clock. Tramadol works by changing the way the body senses pain.

Because Tramadol is non-narcotic some people believe it is an NSAID (Non-Steroidal Anti-Inflammatory Drug) but it is not. Tramadol is different than a typical narcotic because the body does not build up the same tolerance with extended usage.

Tramadol was invented in Germany in the 1970's and approved by the FDA in 1998. It is considered less addictive than its narcotic counterparts such as Codeine or Hydrocodone but can still be very addictive if not used correctly. It is a very effective pain reliever but also has antidepressant qualities because of its selected serotonin reuptake inhibitor (SSRI) properties. Tramadol is most often prescribed to treat pain associated with neuralgia but also has several off label uses such as restless legs syndrome, migraines, withdrawal of other more addictive medications, fibromyalgia, and obsessive compulsive disorder.

Tramadol is available in immediate release and extended release formulations.

It may be prescribed as an immediate release tablet (50 mg.) or as an extended release tablet (100, 200, or 300 mg.). The extended release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment.

Tramadol is a preferred drug for people suffering from chronic pain conditions because it tends to be well tolerated without huge risk serious side effects when used appropriately.

A Cochrane Review of tramadol to treat arthritis revealed some benefit.

The Cochrane Review stated that when tramadol is taken for up to 3 months, there may be decreased pain, improvements in function and stiffness and overall well-being. However, tramadol can cause side effects that are significant enough to require that the patient must stop taking the medication. Risks outweigh benefits for many people who have tried tramadol. This turned out to be the case with my wife as she is no longer on Tramadol.

Dangers of using Tramadol:

Being an opioid, tramadol carries all possible risks known from other opiates. Tramadol can cause respiratory depression, although usually weaker than that seen with other opiates. Tramadol can cause psychological and physical addiction similar to that of other opiates. Nausea and the possibility of choking on one's own vomit, are also possible. Those experienced with opiates are probably familiar with these and will usually be able to tolerate them

Seizures from tramadol occur at least once in about 0.87% of persons prescribed to tramadol. Risk factors included a history of drug abuse (which might involve high-dose use) and combining tramadol with other drugs.
Seizures are likely to be caused by tramadol itself. The risk of seizure increases with dosage (that is why the daily limit is 400 mg). Most reported seizures have been caused by exceeding this limit.

It can be concluded that seizures from tramadol are a real possibility, especially if it is used by the wrong persons, combined with wrong substances or used in high amounts.

Drug Interactions:

There are many drugs that interact with tramadol including 345 known to have major interactions such as Ambien, Cymbalta, Flexeril, Lexapro, and Vicodin. Tramadol should never be used in conjunction with other SSRIs such as Prozac, Zoloft, Paxil, Luvox since this can cause a complication known as serotonin syndrome. Severe cases of this condition may result in seizures and death. When patients take any type of antidepressant they should make sure doctors are aware of this fact before they take tramadol.

Who should not take Tramadol:

You should not take this medication if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, or if you have ever attempted suicide. Do not take tramadol while you are intoxicated (drunk) or taking any of the following:

* alcohol or street drugs;
* narcotic pain medicine;
* sedatives or tranquilizers (such as Valium);
* medicine for depression or anxiety; or
* medicine for mental illness (such as bipolar disorder, schizophrenia).

Seizures have occurred in some people taking tramadol. Talk with your doctor about your seizure risk, which may be higher if you have:

* a history of drug or alcohol addiction;
* a history of epilepsy or other seizure disorder;
* a history of head injury;
* a metabolic disorder; or
if you are also taking an antidepressant, muscle relaxer, narcotic, antipsychotic, or medicine for nausea and vomiting.

To make sure you can safely take tramadol, tell your doctor if you have any of these other conditions:

* kidney disease (or if you are on dialysis);
* cirrhosis or other liver disease;
* a stomach disorder; or
* a history of depression, mental illness, or thoughts of suicide.

Tramadol and Pregnancy:

It is not known whether tramadol will harm an unborn baby. Tramadol may cause serious or fatal side effects in a newborn if the mother uses this medication during pregnancy or labor.

Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Tramadol can pass into breast milk and may harm a nursing baby.

You should not breast-feed while you are taking tramadol. Do not give this medication to anyone younger than 16 years old without the advice of a doctor.

Side Effects:

Common side effects in regular dosage can include nausea, diarrhea, headache, dizziness, drowsiness and constipation. Allergy or sensitivity is rare but may include hives, trouble breathing and dizziness. Symptoms of chest pain, depressed breathing, seizures or rapid heart rate are considered medical emergencies.

Tramadol Dependency, Addiction, and Withdrawals:

People most at risk for tramadol dependency include those who take it on a regular basis and those who have a history of substance abuse. Regular dosage of this medication can create dependency. Dependency is not the same as addiction, particularly when patients take the medication as prescribed. When tramadol is no longer needed, doctors and patients should work together to come up with a plan for safely coming off of the medication.

Signs of addiction include:

* Obsessing over when the next dose can be taken
* Stealing the drug or asking others who take the drug for a few pills
* Asking for refills long before refills are due
* Using several doctors and pharmacies to obtain more of the drug
* Reporting lost medication in order to obtain more
* Taking more of the medication than prescribed

Withdrawal symptoms can vary. They include an increase in pain, sweating, anxiety, tremors, diarrhea, insomnia and hallucinations. Those suffering from tramadol addiction are most likely to experience withdrawal symptoms.

Cost of Tramadol

Availability (generic available)
Tablets: 50 mg. Price: Generic- /30, /100.
Extended-release tablets: Price: 100mg /30, 200mg 8/30, 300mg 5/30.

Tramadol comes in many forms. It comes in capsules, tablets, suppositories, and in injectables. Some preparations of the medication include other analgesics like acetaminophen or anti-inflammatory agents like aspirin. Recommended dose is usually no more than 400 mg per day. It is especially important to use this medication exactly as prescribed, for the length of time prescribed. It should never be shared with others or used in a manner other than advised by a physician. If you believe you or someone else is having an adverse reaction to tramadol, overdose, or a drug interaction Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A tramadol overdose can be fatal!



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