Tramadol - instructions for use, reviews, analogs and forms of release (capsules and tablets 50 mg and 100 mg, injections in ampoules for injection in solution) drug for the treatment of pain and analgesia in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Tramadol. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Tramadol in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Tramadol in the presence of existing structural analogues.Use for the treatment of pain and analgesia in adults, children, as well as during pregnancy and lactation.

Tramadol - opioid synthetic analgesic, which has a central effect and action on the spinal cord (promotes the opening of K + and Ca2 + channels, causes hyperpolarization of membranes and inhibits pain impulses), enhances the action of sedatives.

Activates opioid receptors (mu, delta, kappa) on the pre- and postsynaptic membranes of the afferent fibers of the nociceptive system in the brain and GI tract.

The drug belongs to the list of No. 1 potent substances of the Standing Committee on Drug Control of the Ministry of Health of the Russian Federation.

Composition

Tramadol hydrochloride + excipients.

Pharmacokinetics

Absorption - 90%, bioavailability - 68% (increases with repeated use). Penetrates through blood-brain and placental barriers, 0.1% is excreted in breast milk. It is excreted by the kidneys (25-35% unchanged).

Indications

• pain syndrome of medium and strong intensity of different etiology (postoperative period, trauma, pain in cancer patients);
• anesthesia in the conduct of painful diagnostic or therapeutic manipulations.

Forms of release

Capsules 50 mg and 100 mg.

Tablets of 50 mg and 100 mg.

Candles for rectal administration 100 mg.

Solution or drops for oral administration.

Solution for injections (injections in ampoules).

Instructions for use and dosing regimen

The dose of the drug is selected by the doctor individually, depending on the intensity and nature of the pain.

Pills

Adults and adolescents over the age of 14: initial dose - 1 tablet (50 mg) orally with a small amount of liquid, regardless of food intake; if there is no effect for 30-60 min, one more tablet can be taken; with severe pain, a single dose can immediately amount to 100 mg (2 tablets). The effect, depending on the severity of the pain, persists for 4-8 hours. Do not exceed the daily dose of Tramadol 400 mg (8 tablets).

Do not prescribe this dosage form to children weighing less than 25 kg and aged less than 14 years.

Elderly patients, patients with impaired liver and kidney function, if necessary, should increase the interval between doses of the drug.

Duration and schedule of application are determined by the attending physician

Tablets can be swallowed without chewing, squeezed the necessary amount of liquid, regardless of food intake, or pre-dissolve in 1/2 cup of water.

Capsules

The dose of the drug is selected by the doctor individually, depending on the intensity and nature of the pain.

Adults and adolescents over the age of 14: the initial dose is 1 capsule (50 mg) orally with a small amount of liquid, regardless of food intake; in the absence of effect within 30-60 minutes, one more capsule can be taken; with severe pain, a single dose can immediately amount to 100 mg (2 capsules). The effect, depending on the severity of the pain, persists for 4-8 hours. Do not exceed the daily dose of tramadol 400 mg (8 capsules).

Do not prescribe this dosage form to children weighing less than 25 kg and aged less than 14 years.

Elderly patients, patients with impaired liver and kidney function, if necessary, should increase the interval between doses of the drug.

Duration and schedule of application are determined by the attending physician.

Capsules should be swallowed without chewing, washing down with the necessary amount of liquid, regardless of food intake.

Solution for oral administration

The dose of the drug is selected by the doctor individually, depending on the intensity and nature of the pain.

Adults and adolescents over the age of 14 years: the dose is 50 mg (20 drops).In the absence of the desired effect, another 20 drops can be taken after 30-60 minutes. If necessary, the drug can be taken again after 4-6 hours. The daily dose should not exceed 400 mg (160 drops).

For children aged 1 to 14 years, a single dose is 1-2 mg / kg body weight.

Ampoules

Tramadol is used according to the doctor's prescription, the dosage regimen is selected individually depending on the severity of the pain syndrome and the sensitivity of the patient. Duration of treatment is determined individually, do not prescribe the drug beyond the term justified from a therapeutic point of view.

Tramadol is intended for intravenous (to inject slowly), intramuscularly or subcutaneously. In the absence of other prescriptions, Tramadol should be administered in the following dosages:

For adults and adolescents older than 14 years, single-dose 50-100 mg of tramadol hydrochloride (1-2 ml of injection solution). If there is no satisfactory analgesia, after 30-60 minutes a repeated single dose of 50 mg (1 ml) may be prescribed. In severe pain, a higher dose (100 mg of tramadol hydrochloride) can be prescribed as the initial dose.Typically, 400 mg of tramadol hydrochloride per day is usually sufficient to relieve pain.

To treat pain with cancer and severe pain in the postoperative period, higher doses may be used.

In elderly patients (at the age of 75 and over), the interval between injections of the drug may be increased in accordance with individual characteristics due to the possibility of delayed excretion.

Rectal Candles

The dose is determined by the doctor individually, depending on the intensity and nature of the pain.

Adults and adolescents over the age of 14 years are prescribed 1 suppository (100 mg of tramadol hydrochloride).

The effect of the drug persists for 4-8 hours. The daily dose should not exceed 400 mg of tramadol hydrochloride (4 suppositories).

In the presence of pain in tumors, higher dosages of the drug are required, for which other dosage forms are available.

Side effect

• sweating;
• dizziness;
• headache;
• weakness;
• increased fatigue;
• retardation;
• paradoxical stimulation of the central nervous system (nervousness, agitation, anxiety, tremor, muscle spasms, euphoria, emotional lability, hallucinations);
• drowsiness;
• sleep disturbance;
• confusion of consciousness;
• violation of coordination of movement;
• depression;
• amnesia;
• unsteadiness of gait;
• dry mouth;
• nausea, vomiting;
• flatulence;
• constipation;
• diarrhea;
• difficulty in swallowing;
• tachycardia;
• orthostatic hypotension;
• hives;
• itching;
• exanthema;
• difficulty urinating;
• dysuria;
• retention of urine;
• impaired vision, taste;
• violation of the menstrual cycle;
• with long-term use - the development of drug dependence (narcotic drug).

Contraindications

• conditions accompanied by respiratory depression or severe CNS depression (alcohol poisoning, hypnotics, opioid analgesics, psychotropic drugs);
• severe hepatic and / or renal failure (CC less than 10 ml / min);
• simultaneous use of MAO inhibitors (and 2 weeks after their withdrawal);
• children's age (up to 14 years);
• hypersensitivity to the drug and other opioids.

Application in pregnancy and lactation

When pregnancy should be avoided long-term use of Tramadol because of the risk of developing addiction in the fetus and the occurrence of withdrawal syndrome in the neonatal period.

If you need to take during lactation, it should be borne in mind that Tramadol in a small amount stands out with breast milk.

special instructions

In elderly patients, Tramadol is used at extended intervals.

With caution and under the supervision of a physician, the drug should be used for patients with impaired renal and hepatic function, with craniocerebral trauma, increased intracranial pressure, epilepsy, and people with drug dependence for opioids.

Under careful medical supervision and in reduced doses should be used Tramadol against the background of the means for anesthesia, hypnotics and psychotropic drugs.

The drug should not be combined with narcotic analgesics due to poor predictability of the interaction effect.

Against the background of long-term use of carbamazepine, the effect of Tramadol may be weaker.

It is not recommended to drink alcohol when treated with Tramadol.

Impact on the ability to drive vehicles and manage mechanisms

When using tramadol, you should not drive a car or perform other work that requires special attention.

Drug Interactions

With the simultaneous use of Tramadol with Carbamazepine and other inducers of metabolic enzymes, the analgesic effect of Tramadol may be weakened.

With the systematic administration of barbiturates, especially phenobarbital, there is a likelihood of reducing the analgesic effect of opioid analgesics.

Long-term use of opioid analgesics or barbiturates stimulates the development of cross tolerance.

Naloxone activates breathing, eliminating analgesia after the use of opioid analgesics.

Strengthens the effect of drugs that have a depressing effect on the central nervous system, and ethanol (alcohol).

Quinidine increases the plasma concentration of Tramadol.

Analogues of the drug Tramadol

Structural analogs for the active substance:

• Protradon;
• Sintradon;
• Tramadol Lannacher;
• Tramadol retard;
• Tramadol Stade;
• Tramadol Acry;
• Tramadol GR;
• Tramadol Plethiko;
• Tramadol ratopharm;
• Tramadol of Slovakia;
• Tramadol hydrochloride;
• Tramaclosidol;
• Tramal;
• Tramal 50;
• Tramped retard;
• Tramped retard 100;
• Tram retard 150;
• Tired Retard 200;
• Tremolin;
• Tramundine retard.

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