General
Description & Use
Used to relieve moderate to moderately severe pain. It also may
be used to treat pain caused by surgery and chronic conditions
such as cancer or joint pain. Tramadol also known as Ultram and
Tramacip is an atypical opioid which is a centrally acting analgesic,
used for treating moderate to severe pain. It is a synthetic agent,
and appears to have actions on the µ-opioid receptor as
well as the noradrenergic and serotonergic systems.
Tramadol is usually marketed as the hydrochloride
salt (tramadol hydrochloride) and is available in both injectable
(intravenous and/or intramuscular) and oral preparations. It is
also available in conjunction with paracetamol (acetaminophen).
Specifically,
tramadol comes in capsules, tablets, extended-release tablets,
low-residue and/or uncoated tablets which can be taken by the
sublingual and buccal routes, suppositories, effervescent tablets
and powders, ampoules of sterile solution for SC, IM, and IV injection,
powders for compounding, liquid for oral and sublingual administration
- in regular phials and bottles, dropper bottles, bottles with
a pump similar to those used with liquid soap and phials with
droppers built into the cap - as well as tablets and capsules
containing paracetamol and aspirin. Tramadol has a characteristic
taste which is mildly bitter but much less so than morphine and
codeine. Oral and sublingual drops and liquid preparations come
with and without added flavouring. Its relative effectivness via
transmucousal routes (sublingual, buccal, rectal) is around that
of codeine and like codeine it is also metabolised in the liver
to stronger metabolites.
Doses
Doses range from 50–400 mg daily, maximum dose of 400 mg
a day, with up to 600 mg daily when given IV/IM. The formulation
containing APAP contains 37.5 mg of tramadol and 325 mg of paracetamol,
intended for oral administration with a common dosing recommendation
of one or two tabs every four to six hours.
Unlike
most other opioids, Tramadol is not considered a controlled substance
in many countries (including the USA, among others). Tramadol
is available over the counter without prescription in a few countries.
Tramadol is sometimes mistakenly classified as a non-opioid analgesic,
because its abuse liability is lower than that of other opioids
and because it has multiple mechanisms of action (including, but
not limited to mu-opioid activity).
Uses
Tramadol is used to treat moderate and severe pain and most types
of neuralgia, including trigeminal neuralgia. It has been suggested
that tramadol could be effective for alleviating symptoms of depression
and anxiety because of its action on the noradrenergic and serotonergic
systems, the involvement of which appear to play a part in its
ability to alleviate the perception of pain.
