Tramadol
Tramal, Tramagesic, Tramol, Tramazac, Doreta, Tramak, Trapam, Tonoflex-P
Opioid Analgesic (Centrally Acting)
Tramadol is a synthetic opioid analgesic used to treat moderate to moderately severe pain. It acts on the central nervous system (CNS) by binding to μ-opioid receptors and inhibiting the reuptake of serotonin and norepinephrine, producing analgesia similar to that of codeine or morphine but with a lower potential for dependence and respiratory depression.
Moderate to severe acute pain (e.g. postoperative, injury-related) Chronic pain conditions (e.g. osteoarthritis, neuropathic pain) Cancer-related pain Dental pain
Hypersensitivity to tramadol or other opioids Acute intoxication with alcohol, hypnotics, or other CNS depressants Severe respiratory depression Epilepsy or seizure disorders not adequately controlled MAO inhibitors (within 14 days of use) Children under 12 years of age
Immediate-release tablets: 50–100 mg every 4–6 hours as needed Maximum daily dose: 400 mg Extended-release tablets: 100 mg once daily; may increase gradually to 300 mg/day if required Swallow whole (do not crush or chew) Geriatric / Renal or Hepatic impairment: Start with lower doses and increase cautiously Avoid in severe hepatic impairment
Moderate to severe acute pain (e.g. postoperative, injury-related) Chronic pain conditions (e.g. osteoarthritis, neuropathic pain) Cancer-related pain Dental pain
Common: Nausea, vomiting, dizziness, headache, constipation, dry mouth, drowsiness, sweating Serious: Seizures, respiratory depression, serotonin syndrome (when combined with SSRIs/SNRIs), dependency, withdrawal symptoms
Use with caution
Not recommended for breastfeeding mothers
Caution in patients with renal/hepatic impairment, head injury, seizure disorders, drug or alcohol dependence, or respiratory disorders. Avoid combining with CNS depressants, alcohol, or MAO inhibitors. Risk of addiction, tolerance, and withdrawal on prolonged use. Warn patients about operating machinery or driving due to drowsiness.
Tramadol is a dual-action analgesic: 1. μ-opioid receptor agonist → decreases pain transmission in the CNS. 2. Inhibits reuptake of serotonin and norepinephrine → enhances inhibitory pathways in the spinal cord that modulate pain perception. The combined opioid and monoaminergic effects provide analgesia with a lower risk of respiratory depression than traditional opioids.
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