Tramadol

What is Tramadol and what is it used for?

Tramadol is a medicine used to treat pain called an analgesic.
Among the different types of pain relievers, it is counted among the so-called opiates.

The best-known representative of the opiates is morphine. Tramadol (Tramundin®) is less effective than morphine and is used for moderate to severe pain.
The cause of the pain is irrelevant and so pain during and after operations, chronic pain of various causes or pain caused by tumors can be alleviated. It is also important to keep in mind that tramadol only combats the symptom of pain and does not eliminate the cause of the pain.

Tramadol and its siblings from the opiate family work on so-called opiate receptors. These are located along the pain-conducting nerve pathways in the body, especially in the spinal cord and the brain.
The body itself also produces a type of opiate, the so-called endorphins. In the event of severe injuries, these ensure that the body inhibits its own pain pathways and that the pain does not become too great. Only these endorphins in the body ensure that people do not properly perceive their injuries after serious accidents or that women can survive childbirth without becoming unconscious from pain.

The administration of additional opiates as medication activates this system to the maximum and, on the one hand, the pain no longer reaches the brain or is additionally weakened there. Tramadol is the only opiate that, in addition to the typical opiate effect, also changes the important substance serotonin in the brain. The pain is further alleviated by increasing the serotonin content.

What forms is tramadol available in?

Tramadol (Tramundin®) is in different dosage forms available as a drug.

The most widespread are certainly those Tramadol drops. Likewise, however, are also Tablets available. The tablets are often in the so-called Retard form submitted.
Retard form means that the tablet comes with a Protective layer against the Stomach acid is coated and the active ingredient only slowly im Small intestine is released. This ensures a long-lasting effect of tramadol.
The normal tablet form, however, is very effective fast, but only for that very short and is therefore often used against so-called "Peaks of pain“Used for sudden severe attacks of pain. For children but adults too are Effervescent tablets or Suppositories available. In an acute emergency, Tramadol can also be used directly in the vein or in the muscle be injected.

How and how much tramadol should I take?

Tramadol should always Taken as directed by the doctor to avoid unwanted overdosing. Of the Need varies very strong and can through the Getting used to, the tolerance, also increase many times over in the course of the treatment.
The Maximum dose of 400mg per day should not, however, be exceeded. In order to optimally treat the pain, the doctor will often use a Scheme created in the various Combination with other types of pain relievers be used to use all the different points of attack of pain development for the prevention and relief of pain.

By the compelling Breakdown in the liver and the Elimination through the kidneys it is essential to reduce and adjust the dose if the function of one of the two organs is restricted. Will despite one Function restriction the amount is calculated for a healthy patient so it quickly comes to accumulation and overdose of the drug and it can be the signs of a Opiate overdose up to life-threatening coma with respiratory failure occur, even if this is extremely high when taking tramadol Rare are.
An overdose of opiates is a very serious incident caused by the administration of the Antidote (med. = antidote) Naloxone or Naltrexone however it is easy to fix. Typical signs of an overdose are small pupils, so-called "Pinhead pupils“, deep unconsciousness, Drops in blood pressure, Slowing your heart rate as well as a Slowing breathing up to the complete Apnea and consequent insufficient supply of oxygen to the body.

Use in children

For children does the Admission of tramadol from the first birthday.
Recommended However, it is only ingestion from the age of 12. The cause lies in the fact that many drugs, including tramadol and other opiates, are used in children get to the brain easier and faster than in adults and have a strong effect there.
The reason for this is the so-called Blood-brain barrier, a layer of cells that controls and limits the transfer of drugs into the brain in adults. With children this is not yet fully functional. From the age of 12, however, it is primarily used in a form that is very pleasant for children as Effervescent tablets very straightforward. Suppositories should first after the age of 14 are used.

Use during pregnancy and breastfeeding

During pregnancy and breastfeeding, tramadol (Tramundin®) not absolutely forbidden:
Individual gifts at urgent need According to many references in the literature, they do not have a harmful effect on the unborn child.
Only that permanent use should be urgent avoided and up to the 30th week of pregnancy Ibuprofen and Paracetamol be evaded.
The reason is the Tramadol effect, which over the Plaster cake is also transmitted to the child.

Long-term use of tramadol can cause sudden effects on the baby after the birth withdrawal with all the effects of opiate withdrawal and through the opiates it can be the same as with an adult Overdose to the Apnea come.
Even during the Lactation The following applies: Experience has shown that isolated doses do not pose a problem, long-term use should be avoided, even if only small amounts of tramadol are in the Breast milk pass over.

When should I not take Tramadol?

As with all other drugs, tramadol must not be used if you are known to be hypersensitive to tramadol or any of the other ingredients.
Tramadol should be used with caution if the active ingredient cannot work properly in the body or cannot be broken down sufficiently. For example, in order to be able to guarantee the breakdown of tramadol in the liver and its excretion via the kidneys, tramadol should only be used if the kidneys and liver are functional, or the dose should be adjusted according to the function of the organ. Alternatively, the period between taking Tramadol can be changed accordingly. If these organs are not functioning properly, a lot of tramadol will otherwise quickly accumulate in the body and overdosing with all its side effects such as respiratory failure can occur.
Tramadol plays an important role in many types of pain. The only types of pain that cannot be treated with tramadol are colic pain and abdominal pain that originate in the intestine, because the cramping of the intestinal muscles caused by tramadol does not make this pain go away and in the case of colic the course would even worsen.

It is also important to know about potential interactions with other drugs and to be aware of them and, if necessary, to avoid tramadol.
Important drugs that interact well are, for example, the so-called MAO inhibitors, the selective serotonin reuptake inhibitors, tricyclic antidepressants and mirtazapine, all of which are used in depression and other mental illnesses. These must not be combined with tramadol, as all drugs have a great influence on the signaling substances in the brain and in combination with tramadol and other opiates there is an excess of the substance serotonin.
This excess manifests itself in the so-called serotonin syndrome with fever, sweating, coordination disorders and confusion. In order to trigger the serotonin syndrome, the MAO inhibitors must be taken within the last two weeks before taking tramadol.
You can find much more information under our topic: Serotonin Syndrome

If one of these drugs is taken against a mental illness, all opiates such as tramadol, morphine, pethidine, fentanyl or oxycodone should be avoided and pain relievers from other groups such as metamizole (Novalgin®) or naproxen can be used.

The same applies to other drugs that affect our brain, including sleeping pills and, above all, alcohol. These drugs can lead to a mutual reinforcement of the effects with sometimes life-threatening side effects or they can promote the development of seizures in the context of an epileptic seizure. It is particularly important to pay attention to this with epileptics and, if possible, another pain reliever from the group of non-opiates such as metamizole (Novalgin®) to take.
Caution should also be exercised when using blood thinners such as the widespread phenprocoumon (Marcumar®), as tramadol also affects blood clotting and thus the risk of bleeding is greatly increased by taking it at the same time.

Side effects

Tramadol, like all drugs, possesses Side effectswhich may or may not appear after ingestion. Tramadol's side effects are similar to those of all opiates.
One of the most common side effects that affects many patients is nausea and dizziness. Both of you are due to the effects of Tramadol im brain conditionally. This effect also causes a headache and in rare cases one Drowsiness.
Next occurs frequently constipation on. This is through a kind Cramp in the bowel (Spasticity) conditioned and felt lack of bowel movements. Help is provided by a prescription laxative, a so-called laxative. If none has been prescribed by prescription, this should be done as soon as possible when the constipation occurs.
Many other side effects like Changes in appetite, Mood changes, Kidney dysfunction, Seizures, confusion, nightmares, changed Sensory perceptions, Voiding disorders are due to the diverse effects of tramadol on various parts of the body. These and many other side effects are there very rare and can be found in the package insert. Even the dreaded one Respiratory paralysis is taking tramadol very rare, but the risk increases with careless combinations with Sleeping pills or alcohol.

What else should you watch out for?

Tramadol falls Not how many others opiate how Morphine or Fentanyl under that Narcotics Act. This means that it is available from the pharmacy with a prescription after a prescription by the doctor and does not require the so-called narcotic prescription like the other opiates. Nevertheless, as with all opiates, a Dependency arise even if the risk is lower than with the other opiates. In addition to the dependency, there is the so-called Tolerance development. This means that more and more tramadol must be taken for the same pain relieving effect.
At the end of the therapy, a Opiate inflammation syndrome With confusion, weakness, nausea, insomnia, fever, sweat and other very diverse physical symptoms occur. However, the physical signs of withdrawal can be prevented by tapering off and taking appropriate medication, and only one sudden withdrawal may possibly use the Symptoms of withdrawal trigger. Tramadol is also not to be regarded as a substitute for morphine and so can opiate addiction not as a substitute drug For heroin and the same symptoms of inflammation arise when not using tramadol as when not using opiates. Tramadol can also be used in high doses applied that Responsiveness of the person concerned so far that the Operate machines or that drive can no longer be carried out safely!