Tramadol is an analgesic used to combat moderate and severe pain. The active ingredient fights only the symptoms, but not the cause of the pain. Tramadol is available in the form of tablets, drops and suppositories, as well as injections and infusions. Like other painkillers, Tramadol has side effects: It is important to remember that - although this side effect is relatively rare - regular use of Tramadol may cause dependence.
Tramadol: action against pain
Tramadol belongs to the group of opioid analgesics. The main active ingredient of this group is morphine. Opioid painkillers are used to treat moderate and severe pain - while weaker pain is treated with non-opioid analgesics such as acetaminophen or acetylsalicylic acid.
For moderate pain, weaker opioid agents such as tramadol or tilidine are used. In severe pain, however, stronger opioids such as morphine, burprenorphine and fentanyl are used. Compared to morphine, the effect of tramadol is about four times weaker - but the mode of action of the two substances is very similar.
Once ingested, tramadol unfolds its effect in the brain by docking there with the opioid receptors. These receptors normally act on the body's own messengers, which inhibit the perception of pain. Tramadol resembles in its structure these messenger substances and can thereby also bind to the opioid receptors. Therefore, after taking even relatively severe pain is perceived as low.
Influence on pain perception
In addition, tramadol still has a second mechanism of action: the active substance inhibits the reuptake of serotonin and norepinephrine in the brain, thus influencing pain perception. In this regard, tramadol is similar to some antidepressants, such as tricyclic antidepressants.
The effect of tramadol begins about 30 minutes after taking the analgesic. Depending on the dose taken and the severity of the pain, the analgesic effect lasts between two and seven hours. The individual dose of tramadol will be calculated by the treating physician depending on factors such as the degree of the disease, the level of pain experienced and the age and weight.
Side effects of Tramadol
As with the other drugs from the group of opioid analgesics, the intake of tramadol is associated with side effects. The most common side effects include nausea and dizziness. Likewise, it can often lead to headache, dizziness, dry mouth, vomiting, constipation and sweating after taking it.
Occasionally the analgesic also has effects on the cardiovascular system: Side effects such as palpitations, accelerated heartbeat, circulatory fluctuations or circulatory collapse may occur. It can also occasionally cause diarrhea, rash and itching. On the other hand, tramadol rarely causes side effects such as respiratory disorders, increased blood pressure, delusions, confusion and changes in appetite.
Risk of dependence low
Also rare are the cases in which the intake of tramadol leads to dependence. A dependency occurs especially when the active ingredient is taken over a longer period of time. However, even after prolonged use, the risk of becoming dependent is relatively low. If there is a dependency, withdrawal symptoms such as sweating and freezing as well as gastrointestinal complaints may occur after the end of the treatment.
Before taking the analgesic, you should always consult your doctor or pharmacist for possible side effects and read the package leaflet carefully.
Tramadol: Contraindications and Interactions
Like all other active substances, tramadol must not be used if it is hypersensitive to the substance. In addition, the pesticide may not be used even if previously taken alcohol, psychotropic drugs, sleeping pills or other painkillers, since the substances in their mode of action can reinforce each other. Another contraindication is the intake of MAO inhibitors within the past two weeks, since otherwise life-threatening side effects can occur.
In epilepsy, especially if the disease is not under control, it should be avoided to take tramadol. Because taken regularly and in higher doses, the drug may increase the risk of epileptic seizure. In addition, it should be noted that the epilepsy drug carbamazepine reduces the effectiveness of tramadol.
In addition, tramadol should not be combined with drugs that lower the threshold for epileptic seizures. These drugs include tricyclic antidepressants and selective serotonin reuptake inhibitors. In rare cases a serotonin syndrome can occur in combination with the latter.
Caution in case of impaired liver or kidney function
Likewise, tramadol should not be used when taking blood thinning medication, because the drug also has an effect on blood clotting. Also, when taking the fungus Ketoconazole and the macrolide antibiotic erythromycin should be dispensed with the intake of tramadol.
If there is a limited liver or kidney function, Tramadol should only be taken after consultation with the attending physician. The same applies to disorders of consciousness, respiratory disorders, shock states, brain diseases and increased intracranial pressure.
In patients who are hypersensitive to opioids or who are prone to abuse of medication, Tramadol should also be used after extensive consultation with the physician. The analgesic is not suitable as a substitute drug for persons who are dependent on opiates because it can not cover the withdrawal syndromes.
Tramadol in pregnancy
During pregnancy, tramadol should not be used if possible. Above all, if the analgesic is taken regularly, it can come in the newborn to withdrawal symptoms. Should treatment with opioid analgesics be unavoidable during pregnancy, it should be limited to a single dose of tramadol.
Even during lactation, the active ingredient should not be taken if possible. However, since only very small amounts of the analgesic pass into breast milk, it can still be breastfed after a single dose of tramadol.
In children under the age of twelve, tramadol should only be used in the form of drops, as it may be used in this form as a low dose. Tablets are only recommended for children over the age of twelve, suppositories are only suitable for children over the age of 14 years.