Does tramadol cause constipation. How common is constipation with tramadol use. What are other common side effects of tramadol. How can tramadol-induced constipation be managed. Are there alternatives to tramadol that cause less constipation.

The Link Between Tramadol and Constipation

Tramadol, a prescription opioid medication used to treat moderate to moderately severe pain, is known to cause constipation as one of its most common side effects. But how prevalent is this issue among tramadol users?

Studies have shown that constipation occurs in 9% to 46% of patients taking tramadol. This wide range suggests that individual responses to the medication can vary significantly. For some users, constipation may be mild and manageable, while for others, it can become severe enough to necessitate discontinuation of the treatment.

Why does tramadol cause constipation? Like other opioids, tramadol affects the digestive system by slowing down gut motility and reducing fluid secretion in the intestines. This leads to harder, drier stools that are more difficult to pass.

Risk Factors for Tramadol-Induced Constipation

Certain factors can increase the likelihood or severity of constipation when taking tramadol:

• Age: Older adults, particularly those over 75, are more susceptible to severe constipation.
• Dosage: Higher doses of tramadol generally correlate with an increased risk of constipation.
• Duration of use: Long-term tramadol use may exacerbate constipation symptoms.
• Concurrent medications: Taking other drugs that can cause constipation, such as anticholinergics, may compound the effect.
• Pre-existing digestive issues: Individuals with a history of constipation or other gastrointestinal problems may be more prone to tramadol-induced constipation.

Is tramadol-induced constipation more common in certain populations? Studies indicate that older adults are particularly vulnerable. In clinical trials, constipation led to treatment discontinuation in 10% of patients over 75 years of age. This highlights the importance of close monitoring and proactive management in elderly tramadol users.

Other Common Side Effects of Tramadol

While constipation is a significant concern, tramadol can cause various other side effects. Understanding these potential reactions can help patients and healthcare providers make informed decisions about pain management strategies.

Common gastrointestinal side effects of tramadol include:

• Nausea (reported in 16% to 40% of patients)
• Vomiting (5% to 17%)
• Dry mouth (5% to 13%)
• Heartburn (1% to 13%)

Beyond digestive issues, tramadol can also cause:

• Dizziness
• Headache
• Drowsiness
• Sweating
• Itching

Do these side effects typically subside over time? Many patients find that some side effects, such as nausea and dizziness, may improve as their body adjusts to the medication. However, constipation often persists and requires ongoing management.

Managing Tramadol-Induced Constipation

Addressing constipation promptly is crucial to prevent complications and ensure patient comfort. Several strategies can help manage this side effect:

1. Increase fluid intake: Drinking plenty of water and other non-caffeinated beverages can help soften stools.
2. Dietary changes: Consuming more fiber-rich foods like fruits, vegetables, and whole grains can promote regular bowel movements.
3. Regular exercise: Physical activity can stimulate bowel function and alleviate constipation.
4. Over-the-counter laxatives: Stool softeners, osmotic laxatives, or stimulant laxatives may be recommended by healthcare providers.
5. Prescription medications: For severe cases, doctors may prescribe specific medications designed to treat opioid-induced constipation.

How effective are these management strategies? While individual responses vary, a combination of lifestyle changes and appropriate medications can significantly improve constipation symptoms for many tramadol users. However, it’s essential to consult with a healthcare provider before starting any new treatment regimen.

Alternatives to Tramadol for Pain Management

For patients experiencing severe constipation or other intolerable side effects, exploring alternative pain management options may be necessary. Some potential alternatives include:

• Non-opioid analgesics: Acetaminophen, NSAIDs (like ibuprofen or naproxen)
• Topical pain relievers: Creams, gels, or patches containing ingredients like lidocaine or capsaicin
• Antidepressants: Certain types, such as SNRIs, can help manage chronic pain
• Anticonvulsants: Medications like gabapentin or pregabalin may be effective for neuropathic pain
• Non-pharmacological approaches: Physical therapy, acupuncture, cognitive behavioral therapy

Can these alternatives provide effective pain relief without the constipation risk? Many patients find that a combination of non-opioid treatments can offer significant pain relief with fewer side effects. However, the effectiveness varies depending on the type and severity of pain being treated.

The Importance of Monitoring and Communication

Regular monitoring and open communication between patients and healthcare providers are crucial when using tramadol or any opioid medication. This helps ensure prompt identification and management of side effects like constipation.

Patients should be encouraged to:

• Keep a symptom diary to track bowel movements and any changes in digestive function
• Report any new or worsening side effects to their healthcare provider immediately
• Discuss any concerns about their pain management regimen openly
• Follow up regularly with their healthcare team to assess the effectiveness of their treatment plan

How often should patients on tramadol be monitored for constipation? While there’s no one-size-fits-all answer, many healthcare providers recommend weekly check-ins during the initial treatment period, with frequency adjusted based on individual patient needs and responses.

Long-Term Considerations for Tramadol Use

For patients who require long-term pain management with tramadol, it’s important to consider the potential impacts of chronic constipation and other side effects. Long-term opioid-induced constipation can lead to complications such as:

• Hemorrhoids
• Anal fissures
• Rectal prolapse
• Bowel obstruction

Additionally, prolonged use of tramadol carries risks of tolerance, dependence, and addiction. Healthcare providers must carefully weigh these risks against the benefits of pain relief when considering long-term tramadol use.

Is it possible to use tramadol long-term without developing severe constipation? With proper management and regular monitoring, many patients can use tramadol for extended periods without experiencing debilitating constipation. However, this requires a proactive approach to side effect management and a willingness to adjust treatment strategies as needed.

The Role of Patient Education in Tramadol Use

Educating patients about the potential side effects of tramadol, including constipation, is crucial for ensuring safe and effective use of the medication. Patients who are well-informed about what to expect and how to manage side effects are better equipped to adhere to their treatment plan and communicate effectively with their healthcare providers.

Key points to cover in patient education include:

• The importance of taking tramadol exactly as prescribed
• Common side effects and how to manage them
• Signs of severe side effects that require immediate medical attention
• Strategies for preventing and managing constipation
• The risks of long-term opioid use, including tolerance and dependence
• Safe storage and disposal of tramadol to prevent misuse

How can healthcare providers ensure effective patient education about tramadol? Utilizing a combination of verbal instruction, written materials, and follow-up discussions can help reinforce key information. Some providers also use teach-back methods, asking patients to explain what they’ve learned, to ensure comprehension.

Innovative Approaches to Managing Opioid-Induced Constipation

As the prevalence of opioid-induced constipation (OIC) has become more widely recognized, researchers and pharmaceutical companies have developed new treatments specifically targeting this side effect. Some innovative approaches include:

• Peripherally acting mu-opioid receptor antagonists (PAMORAs): These medications block opioid receptors in the gut without interfering with pain relief in the central nervous system.
• Probiotic supplements: Some studies suggest that certain probiotics may help alleviate OIC by promoting healthy gut function.
• Gut-focused hypnotherapy: This psychological approach has shown promise in managing various gastrointestinal disorders, including OIC.
• Acupuncture: Traditional Chinese medicine techniques may offer relief for some patients experiencing OIC.

Are these new approaches effective in managing tramadol-induced constipation? While research is ongoing, early results for some of these treatments, particularly PAMORAs, have been promising. However, their effectiveness can vary among individuals, and they should be used under medical supervision.

The Economic Impact of Tramadol-Induced Constipation

Beyond its physical and emotional toll on patients, tramadol-induced constipation can have significant economic implications. These may include:

• Increased healthcare costs due to additional medications, treatments, or hospitalizations
• Lost productivity from work absences or reduced efficiency due to discomfort
• Potential costs associated with switching to alternative pain management strategies if tramadol must be discontinued

How substantial is the economic burden of opioid-induced constipation? Studies have estimated that OIC can increase healthcare costs by thousands of dollars per patient annually, highlighting the importance of effective prevention and management strategies.

Future Directions in Pain Management and Constipation Prevention

As research in pain management and pharmacology continues to advance, several promising areas may lead to improved treatments with fewer side effects:

• Development of opioids with reduced constipation risk
• Advanced drug delivery systems that minimize systemic exposure and side effects
• Personalized medicine approaches that tailor pain management strategies to individual patient profiles
• Integration of artificial intelligence in predicting and managing medication side effects

What potential do these advancements hold for reducing tramadol-induced constipation? While it’s difficult to predict specific outcomes, ongoing research in these areas offers hope for more effective and better-tolerated pain management options in the future.

The Role of Genetic Factors in Tramadol Response and Side Effects

Emerging research suggests that genetic variations may influence an individual’s response to tramadol, including their likelihood of experiencing side effects like constipation. Key areas of investigation include:

• Cytochrome P450 2D6 (CYP2D6) enzyme variations: This enzyme is crucial for metabolizing tramadol, and genetic differences can affect drug efficacy and side effect profiles.
• Opioid receptor gene polymorphisms: Variations in genes coding for opioid receptors may influence individual responses to tramadol.
• Genetic factors affecting gut motility: Some genetic variations may predispose individuals to constipation, potentially exacerbating tramadol’s effects.

Could genetic testing help predict and prevent tramadol-induced constipation? While genetic testing shows promise in personalizing pain management, more research is needed before it can be routinely used to predict side effects like constipation. However, this remains an active area of investigation with potential future clinical applications.

Balancing Pain Relief and Side Effect Management

For many patients and healthcare providers, managing tramadol use involves a delicate balance between achieving adequate pain relief and minimizing side effects like constipation. Strategies for striking this balance may include:

• Dose titration: Carefully adjusting the tramadol dose to find the lowest effective amount
• Combination therapy: Using tramadol alongside non-opioid pain relievers to allow for lower opioid doses
• Scheduled dosing vs. as-needed use: Determining the most appropriate dosing regimen based on pain patterns and side effect occurrence
• Regular reassessment: Continuously evaluating the benefits and drawbacks of tramadol use

How can patients and providers work together to achieve optimal pain management with minimal side effects? Open, ongoing communication is key. Patients should be encouraged to keep detailed records of their pain levels, medication use, and side effects, which can inform treatment decisions during follow-up appointments.

The Psychological Impact of Chronic Pain and Medication Side Effects

Living with chronic pain and managing medication side effects like constipation can take a significant toll on a patient’s mental health. Important considerations include:

• The relationship between chronic pain, depression, and anxiety
• The impact of persistent side effects on quality of life and treatment adherence
• The role of psychological support in comprehensive pain management
• Strategies for coping with the emotional challenges of long-term medication use

How can healthcare providers address the psychological aspects of tramadol use and its side effects? Integrating mental health screening and support into pain management protocols can help identify and address psychological challenges. This may include referrals to mental health professionals, support groups, or pain management programs that incorporate psychological techniques like cognitive-behavioral therapy.

Tramadol Use in Special Populations

While tramadol can be an effective pain management tool for many patients, special considerations are necessary for certain populations:

• Elderly patients: Increased risk of side effects, including severe constipation
• Pregnant women: Potential risks to fetal development and neonatal opioid withdrawal syndrome
• Patients with renal or hepatic impairment: May require dose adjustments due to altered drug metabolism
• Individuals with a history of substance abuse: Higher risk of developing tramadol dependence or addiction

How should tramadol use be approached in these special populations? Careful assessment of risks and benefits, close monitoring, and individualized treatment plans are essential. In some cases, alternative pain management strategies may be preferable to tramadol use.

The Future of Pain Management: Beyond Tramadol

As our understanding of pain mechanisms and pharmacology evolves, new approaches to pain management are emerging that may offer alternatives to traditional opioids like tramadol. Some promising areas of research include:

• Targeted pain therapies that act on specific pain pathways
• Novel non-opioid analgesics with improved side effect profiles
• Advanced neuromodulation techniques for pain control
• Gene therapy approaches to chronic pain management
• Regenerative medicine strategies to address underlying causes of pain

What potential do these emerging therapies hold for reducing reliance on opioids like tramadol? While many of these approaches are still in early stages of development, they offer hope for more effective, targeted pain management with fewer systemic side effects like constipation. Continued research in these areas may lead to significant advancements in pain treatment options in the coming years.

Does tramadol cause constipation?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 7, 2022.

Yes, tramadol can cause constipation and is one of the most common side effects with this drug. In studies, constipation was reported in 9% to 46% of patients. In some cases it may be severe. Call your healthcare provider if you have any tramadol symptoms and they are severe.

• Constipation is a well-known and expected side effect of opioid use. It should be addressed quickly to prevent further complications.
• Use extra caution in older patients and monitor more closely. In studies, constipation resulted in discontinuation of treatment in 10% of those over 75 years of age.
• The use of other drug therapies that lead to constipation, such as anticholinergic drugs, can worsen the constipating effect of tramadol. If you are not sure if you are taking other medicines that may worsen constipation, ask your doctor or pharmacist.

To learn more: Treatment of Opioid-Induced Constipation: The Hard Facts

Tramadol (Ultram) is commonly associated with other stomach (gastrointestinal) side effects such as:

• nausea (16% to 40%)
• vomiting (5% to 17%)
• dry mouth (5% to 13%)
• heartburn (1% to 13%)

Tramadol side effects (in more detail)

Bottom Line

• Tramadol can cause constipation in 9% to 46% of patients. Stomach side effects in general are common with tramadol.
• Constipation is a well-known side effect of opioid pain treatment, and it should be addressed quickly to prevent further complications. Call your doctor if you have constipation with opioid treatment.

This is not all the information you need to know about tramadol for safe and effective use. Review the full tramadol information here, and discuss this information and any questions with your doctor or other health care provider.

References

• Tramadol monograph. Drugs.com. Accessed Nov. 16, 2020 at https://www.drugs.com/ppa/tramadol.html
• Ultram [product information]. Janssen Pharmaceuticals, Inc. Updated July 16, 2020. Accessed Nov. 16, 2020 at https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=45f59e6f-1794-40a4-8f8b-3a9415924468

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Medical Disclaimer

Tramadol Side Effects: Nausea, Constipation, and More

Tramadol is an opioid painkiller used to treat chronic pain. When taken as prescribed, this medication is ingested every 4-6 hours; however, people who struggle with tramadol addiction may take it more often and at higher doses. Doctors adjust prescription doses so their patients do not consume more than 400 mg of tramadol per day.

More than this amount can cause severe side effects, including addiction, tolerance, and dependence.

While a person who takes tramadol as prescribed may develop some side effects, they are more likely to develop in people who struggle with addiction. General side effects from tramadol include:

• Flushing
• Dizziness
• Fatigue or sleepiness
• Sore throat
• Congestion
• Headache
• Itching
• Constipation
• Appetite changes or stomach upset
• Nausea or vomiting
• Physical weakness

Per the National Library of Medicine, in a double-blind study regarding the general side effects from tramadol, about 26 percent of people taking the medicine as directed developed diarrhea; 24 percent experienced nausea and vomiting; 18 percent had headaches; and 16 percent experienced excessive fatigue. Other side effects, like vomiting, itching, and sweating, occurred in less than 10 percent of study participants; dry mouth, indigestion, and diarrhea occurred in about 5 percent of study participants.

Tramadol can cause changes in the central nervous system, which could be disturbing or detrimental. These include:

• Anxiety
• Physical tremors
• Muscle spasms
• Emotional changes
• Hallucinations

These are very rare when tramadol is taken as directed; however, people who struggle with addiction to this narcotic may experience these side effects.

Some people may develop an allergy to tramadol, and this can cause symptoms like hives, difficulty breathing, mouth sores, rash, itchy eyes, and even convulsions. While this is rare, symptoms should be reported to doctors for emergency treatment immediately.

Other rare side effects include:

• Excess gas
• Urinary retention
• Frequent urination
• Bloating
• Blurry vision
• Trouble performing routine tasks
• Numbness or tingling, especially in the hands or feet
• Changes to physical sensations, especially decreased sensation
• Chest pain or discomfort
• Loss of balance
• Fainting
• Pain in the arms, jaw, legs, or back
• Trembling or shaking in the hands and feet
• Severe cramping
• Hallucinations, typically auditory
• Lack of oxygen to the extremities, leading to blue or clammy hands, feet, or nose
• Menstrual irregularities
• Vasodilation

If too much vasodilation occurs, blood pressure will drop, and the person may faint, suffer damage to the heart and blood vessels, and potentially experience organ damage, including brain damage from lack of oxygen.

People who abuse tramadol are at risk of suffering an opioid overdose. If a person survives opioid overdose, they may suffer liver failure, although this could be associated with taking acetaminophen at the same time as the narcotic. It is rare for opioid painkillers like tramadol to cause liver damage, but it has occurred in a small percent of cases.

Tramadol may also increase the risk of serotonin syndrome in people who take antidepressants, including SSRIs. It is unclear how this occurs, but it appears that tramadol enhances the effects of the antidepressant on releasing serotonin and preventing it from being reabsorbed. This causes serotonin to remain in the brain for too long. Many cases of serotonin syndrome clear up on their own, but very serious instances can cause high fever, irregular heartbeat, unconsciousness, or seizures.

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Last Updated on Jul 10, 2023

Tramadol for osteoarthritis | Cochrane

This translation is out of date. Please click here for the latest English version of this review.

This summary of the Cochrane Review presents what we know from research on the effects of tramadol on osteoarthritis. The review shows that:

There is gold level evidence that for the treatment of osteoarthritis, taking tramadol for up to three months can reduce pain, stiffness, and improve function and overall well-being. Tramadol can cause side effects such as nausea, vomiting, dizziness, constipation, fatigue and headache.

The benefits of tramadol are negligible and the side effects may cause people to stop taking it, which may limit the benefit of tramadol in the treatment of osteoarthritis.

What is osteoarthritis and what drugs are used to treat it?

Osteoarthritis (OA) is the most common form of arthritis and can affect the hands, hips, shoulders, and knees. In OA, the cartilage that protects the ends of bones breaks down and causes pain and swelling. There are two main types of drug treatment for OA. Painkillers (such as acetaminophen/paracetamol and opioids) are used to relieve pain, but they do not affect swelling. Non-steroidal anti-inflammatory drugs (NSAIDs such as ibuprofen and COX-II inhibitors) are used to reduce pain and swelling. Tramadol is one of the opioids most used in OA. It does not cause bleeding from the stomach and intestines, and does not cause kidney problems that can occur with other painkillers. It also does not affect the cartilage at the ends of bones. But tramadol does not reduce swelling and may not be effective with long-term use. Therefore, it is important to know the benefits and harms of tramadol.

What are the results of this review?

People in the studies took about 200 mg of tramadol per day, or a placebo (fake pill or powder), or an NSAID, or other pain medication. People took the medicines for one week to three months.

Benefits of tramadol

in people with osteoarthritis:

tramadol can reduce pain more than placebo

– tramadol can reduce pain by more than 8. 5 points on a scale of 0 to 100

tramadol may improve overall well-being more than placebo

– 50 out of 100 people may improve with placebo
– 69 out of 100 people may improve with tramadol

tramadol may reduce stiffness somewhat and improve function more than placebo

– function may improve by 0.32 points on a scale of 0 to 10 with tramadol

It is not known whether tramadol improves osteoarthritis symptoms more than other drugs. It is also unknown if tramadol is still effective with long-term use. This is due to the fact that the observations in the studies were short.

Harm of tramadol

in people with osteoarthritis:

tramadol may cause minor side effects in more people than placebo, such as nausea, vomiting, dizziness, constipation, fatigue, and headache

– 18 out of 100 people may have minor side effects when placebo
– 39 out of 100 people may have minor side effects when taking tramadol

tramadol can cause serious side effects that would cause people to stop taking it

– 8 out of 100 people had serious side effects with placebo
– 21 out of 100 people had serious side effects with tramadol

It is not known if tramadol causes more side effects than other osteoarthritis medications.

If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions.

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Translation notes:

Translation notes: Translation: Aleksandrova Elvira Grigoryevna. Editing: Gamirova Rimma Gabdulbarovna, Ziganshina Lilia Evgenievna. Russian translation project coordination: Kazan Federal University. For questions related to this transfer, please contact us at: [email protected]

Tramadol tablets for oncology – instructions for use, reviews, reaction in cancer patients to the drug

Tramadol is an effective pain reliever that belongs to soft drugs. It is difficult to get a prescription for it, but it is often impossible for cancer patients to do without this drug.

Oncology and pain syndrome

Drug therapy of pain syndrome in oncology is carried out in accordance with some fundamental principles: pain in 90% of patients;

Oral: Oral (swallowed) dosage forms are preferred, as are other non-injectable forms.

Description and pharmacological effects of Tramadol

Tramadol is a weak opioid analgesic similar to morphine, only weaker. This compound is a derivative of cyclohexanol. Once in the body, it binds to opioid prescriptions and blocks the transmission of pain impulses to the spinal cord. In addition, this drug has a sedative (sedative) and antitussive effect. Thus, after the introduction of Tramadol, the patient not only ceases to experience pain, but also calms down, can sleep normally.

Indications for the use of Tramadol

Tramadol is prescribed for various conditions that are accompanied by very severe pain, with the ineffectiveness of drugs from the NSAID group:

• injuries;
• oncological diseases;
• myocardial infarction;
• postoperative period;
• neuralgia.

Tramadol in oncological practice

Tramadol according to the rules of the “anaesthesia ladder” recommended by WHO, is prescribed in the second line – after the use of nonsteroidal drugs (NSAIDs).

Long-term use of opiates is addictive. But cancer patients should not be afraid of this side effect – provided that they are used strictly according to indications, adequate dosage and regimen.

Pharmacokinetics

Tramadol enters the body in an inactive form and only in the liver is converted into ten inactive metabolites and one active, which reduces pain intensity and disrupts the transmission of pain impulses in the spinal cord.

Of the tablets and drops taken, 68% of the medicine reaches the “sore spot”, all 100% are delivered by blood when injected. The disintegrated drug is excreted by 90% by the kidneys and 10% through the intestines, therefore, with renal failure, it can linger in the blood and tissues for a long time.

After taking a tablet or drops, the analgesic effect will appear after a quarter of an hour, after a maximum of half an hour, and will last almost 6 hours, Tramadol-retard acts up to 12 hours. The drug is highly effective, but over time the body decomposes it more actively, which requires an increase in the dose. If tramadol does not help at all, then a transition to stronger narcotic analgesics is required.

How to use the medicine?

Unlike most narcotic analgesics, Tramadol has several dosage forms. You can swallow capsules and tablets, and two types of solutions are also available: in drops for oral administration and in ampoules for injection.

In all cases, oral forms are preferred: injections are painful and, in patients weakened by a long illness, are associated with the possibility of developing an abscess even if complete sterility is observed – immunity works at half strength.

Tramadol drops begin to work very quickly, but they are easy to overdose. It is necessary to drip 20 drops onto a piece of sugar or into water – this is a dose for one dose. The second 20 drops are taken in the absence of pain relief within an hour after the first dose.

Capsule and tablet contains a full single dose. They are taken regardless of food. With unbearable pain syndrome, it is allowed to swallow two at once.

Long-acting tablet – Tramadol retard contains a doubled, tripled dose, and the largest one contains 4 single doses at once, which last up to 12 hours, but in especially difficult situations can be taken after 6 hours.

Ampoules contain 1 or 2 ml of solution, i.e. 50 mg or 100 mg of the drug. How often can you inject tramadol? Injections under the skin, into a muscle or vein are repeated no earlier than 4 hours later.

Contraindications

Stop using tramadol:

• if allergic to it;
• in case of alcohol and drug intoxication, overdose of psychotropic drugs;
• is incompatible with antidepressants from the group of MAO inhibitors due to the possibility of developing a severe serotonin syndrome;
• in severe renal failure, when the drug remains in the blood for a long time at a high concentration and an overdose may occur;
• in liver failure, the formation of the active metabolite is impaired.

Oncology and pain syndrome

90% of cancer patients experience pain of varying intensity, but it is not necessarily unbearable. Intolerable excruciating pain usually accompanies metastatic cancer, again, not in everyone, but with severe complications.

Duration of use

How long tramadol can be taken depends on the purpose for which it is prescribed. For example, after injuries and operations, it is used in a short course for several days, a maximum of weeks. In oncological diseases, the drug is used for a long time. It is important to strictly follow the instructions of the attending physician and immediately report all side effects.

Special instructions

During pregnancy Tramadol is prescribed only in short courses. Otherwise, the fetus may become addictive, and then the newborn child may experience a withdrawal syndrome. During breastfeeding, it is also necessary to take into account that a certain amount of the drug passes into breast milk.

Tramadol should be used with caution in case of impaired liver and kidney function .

Do not use the drug in children under 1 year of age. At the age of 1-14 years, dosages of 1 to 2 mg/kg are used. At the same time, prolonged forms of Tramadol should not be used in children under 14 years of age.

Tramadol should be used with caution in case of hypersensitivity to other opioid analgesics, confusion, drug dependence, convulsions.

The drug is incompatible with alcohol, drugs from the group of MAO inhibitors.

Tramadol reduces attention and reaction speed, therefore, during the course of treatment, you can not drive a car and engage in certain activities.

Side effects

Tramadol at therapeutic doses is well tolerated but may cause nausea , which is usually treated with conventional antiemetics – antiemetics.

In long-term treatment, especially in bedridden patients, constipation is possible , which is fought with enemas and laxatives.

Drowsiness and drowsiness are not always unfavorable for severe patients, they even help to some extent, however, this is a side effect.

The drug is characterized by excitation due to changes in the metabolism of serotonin – the “hormone of joy”.

Some patients find over time that this medicine no longer helps them effectively relieve pain and ask the doctor: “why doesn’t tramadol work?”. First, it is one of the weakest opioids. Secondly, as we mentioned above, with prolonged use, the body “gets used” to it and does not respond as well. If the pain syndrome can no longer be effectively controlled, this is an occasion to reconsider the treatment regimen, to include more powerful drugs in it.

Overdose

The maximum dose of Tramadol per day is not more than 400 mg, that is, four times 40 drops, or 8 capsules and regular tablets, 4 suppositories or 4 painkillers injections of tramadol, 2 ml each.

Exceeding the dose is accompanied by a change in consciousness – workload and even coma, convulsions, respiratory depression against the background of a strong heartbeat and a decrease in blood pressure are not excluded. To stop the condition, naloxone is used, convulsions are relieved by an injection of diazepam. Serotonin syndrome is treated with cyproheptadine.

Tramadol analogues

Tramadol and Tramal are the same drug from different manufacturers.

The combination of Tramadol with paracetamol from the group of NSAIDs is available under the names zaldiar, ramleps, tramaceta and forsodol.

How to replace tramadol in oncology? This question is best answered by the attending physician, who knows how the disease proceeds in a particular individual patient.

Only a doctor knows what needs to be done to make the painkiller Tramadol work in full force and with minimal risk to the patient’s health. But it is also important for the patient himself to have information about the drug in order to better understand the goals of treatment, follow the doctor’s prescriptions correctly, and notice side effects in time. Euroonco clinics use only original drugs with proven efficacy, and they are always in stock. Our doctors prescribe treatment in accordance with modern international recommendations.

Appointment for a consultation around the clock

+7 (495) 668-82-28

References:

1. Abuzarova G.R. /The role of tramadol in oncology and surgery// Abstracts X Ross. National congress “Man and medicine”; M.; 2003.
2. Abuzarova G.R., Gallinger E.Yu. Pchelintsev M.V. / Algorithm for pharmacotherapy of chronic pain syndrome in an oncological clinic // Vrach; 2011.-№ 6.
3. Pain ed. Yakhno N.N. / Guide for doctors / / Ed. Medpress info; 2009
4. Kogonia L.M., Voloshin A.G., Novikov G.A., Sidorov A.V. /Practical recommendations for the treatment of chronic pain syndrome in cancer patients // Malignant tumors: Practical recommendations RUSSCO #3s2, 2018 (vol. 8 ).
5. Osipova N.A., Abuzarova G.R. /Treatment of chronic pain in incurable patients at home// Doctor; 2002.-№ 4.
6. Novikov G.A., Osipova N.A. /Treatment of chronic pain of oncological genesis//Ed.