HOW DOES Tramadol (Ultram) WORK?
Tramadol (Ultram) acts on the central nervous system and unlike codeine and its
derivative medications is a totally synthetic analgesic compound. Although
its mode of action is not completely understood, from animal tests,
at least two complementary mechanisms appear applicable: the binding
of parent compound and its metabolite to opioid receptors and weak inhibition
of reuptake of norepinephrine and serotonin by nerves located within
the central nervous system. Tramadol (Ultram)-induced analgesia is only partially
reversed by the opiate antagonist naloxone in several animal tests.
Tramadol (Ultram) has been shown to inhibit reuptake of norepinephrine and serotonin
in vitro. These mechanisms may contribute independently to the overall
analgesic profile of Tramadol (Ultram). Analgesia in humans begins approximately
within one hour after administration and reaches a peak in approximately
two to three hours.
HOW EFFECTIVE IS Tramadol (Ultram)?
Tramadol (Ultram) has been given in single oral doses of 50, 75, 100, 150 and 200
mg to patients with pain following surgical procedures and pain following
oral surgery (extraction of impacted molars). In single-dose models
of pain following oral surgery, pain relief was demonstrated in some
patients at doses of 50 mg and 75 mg. A dose of 100 mg of Tramadol (Ultram) tended
to provide analgesia superior to codeine sulfate 60 mg, but it was not
effective as the combination of aspirin 650 mg with codeine phosphate
60 mg. In single-dose models of pain following surgical procedures,
150 mg provided analgesia generally comparable to the combination of
acetaminophen 650 mg with propoxyphene napsylate 100 mg, with a tendency
toward later peak effect. Tramadol (Ultram) has been studied in three long-term
controlled trials involving a total of 820 patients, with 530 patients
receiving Tramadol (Ultram). Patients with a variety of chronic painful conditions
were studied in double-blind trials of one to three months duration.
Average daily doses of approximately 250 mg of Tramadol (Ultram) in divided doses
were generally comparable with five doses of acetaminophen 300 mg with
codeine phosphate 30 mg (Tylenol with Codeine #3) daily, five doses
of aspirin 325 mg with codeine phosphate 30 mg daily, or two to three
doses of acetaminophen 500 mg with oxycodone hydrochloride 5 mg (Tylox)
daily.
HOW DO I USE Tramadol (Ultram)?
For the treatment of painful conditions Tramadol (Ultram) 50 mg to 100 mg can be
administered as needed for relief every four to six hours, not to exceed
400 mg per day. For moderate pain Tramadol (Ultram) 50 mg may be adequate as the
initial dose, and for more severe pain, Tramadol (Ultram) 100 mg is usually more
effective as the initial dose.
Individualization of Dose:
Patients 65 to 75 years of age: No dose adjustment is necessary.
Patients over 75 years old: No more then 300 mg/day in divided doses.
Patients with kidney impairment: The dosing interval of Tramadol (Ultram) should
be increased to 12 hours with a maximum daily dose of 200 mg.
Dialysis patients: These patients can receive their regular dose on
the day of dialysis.
Patients with cirrhosis: Recommended dosage is 50 mg every 12 hours.
Patients receiving chronic carbamazepine: Doses up to 800 mg daily may
be required, this is up to twice the recommended dose of Tramadol (Ultram).
DRUG ABUSE AND DEPENDENCE:
Tramadol (Ultram) has a potential to cause psychic and physical dependence of the
morphone-type. The drug has been associated with craving, drug-seeking
behavior and tolerance development. Cases of abuse and dependence on
Tramadol (Ultram) have been reported.
Tramadol (Ultram) should not be used in opioid-dependent patients. Tramadol (Ultram) can reinitiate
physical dependence in patients that have been previously dependent
or chronically using other opioids. In patients with a tendency to drug
abuse, a history of drug dependence, or are chronically using opioids,
treatment with Tramadol (Ultram) is not recommended.
Tramadol (Ultram) AND SEIZURES:
Seizure Risk: Seizures have been reported in patients receiving Tramadol (Ultram)
within the recommended dosage range. Concomitant use of Tramadol (Ultram) increases
the seizure risk in patients taking:
Selective serotonin reuptake inhibitors (SSRI antidepressants or anoretics
-phentermine),
Tricyclic antidepressants and other tricyclic compounds (e.g., cyclobenzaprine,
promethazine, etc.),
Opioids,
MAO inhibitors,
Neuroleptics,
Any drugs that reduce the seizure threshold,
Epilepsy.
Tramadol (Ultram) AND DROWZINESS:
Tramadol (Ultram) may impair mental or physical abilities required for the performance
of potentially hazardous tasks such as driving a car or operating machinery.
Tramadol (Ultram) should not be taken with alcohol containing beverages.
Tramadol (Ultram) should be used with caution when taking medications such as tranquilizers,
hypnotics or other opiate containing analgesics.
Tramadol (Ultram) AND PREGNANCY:
Tramadol (Ultram) should not be used in pregnant women or nursing mothers,
safe use in pregnancy has not been established.
Chronic use during pregnancy may lead to physical dependence and post-pregnancy
withdrawal symptoms in the newborn.
Tramadol (Ultram) has been shown to cross the placenta. Nonetheless,
the effect of Tramadol (Ultram), if any, on the later growth, development,
and functional maturation of the child is unknown.
OVERDOSAGE:
Serious potential consequences of over dosage are respiratory depression
and seizure.
Ultram
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