What is tramadol and how does it work. How is tramadol prescribed and what are its potential side effects. What are the risks of tramadol abuse and addiction. How does tramadol compare to other pain medications. What precautions should be taken when using tramadol.

Understanding Tramadol: A Synthetic Opioid for Pain Management

Tramadol is a synthetic opioid analgesic used to treat moderate to severe pain. It was first introduced in 1978 and has since become a widely prescribed medication for various pain conditions. But what exactly is tramadol, and how does it work?

Tramadol, with the chemical formula C16H25NO2·HCl, is a centrally acting analgesic that affects the brain’s perception of pain. It works by binding to mu-opioid receptors and inhibiting the reuptake of norepinephrine and serotonin. This dual mechanism of action sets it apart from other opioids and contributes to its effectiveness in pain management.

Key Features of Tramadol

• Synthetic opioid analgesic
• Treats moderate to severe pain
• Available in oral formulations
• Dual mechanism of action
• Less potent than traditional opioids

Medical Uses and Prescription Guidelines for Tramadol

Tramadol is primarily prescribed for the management of moderate to severe pain. But in what specific situations is it commonly used? Healthcare providers may prescribe tramadol for various conditions, including:

• Post-surgical pain
• Chronic lower back pain
• Osteoarthritis
• Fibromyalgia
• Neuropathic pain

When prescribing tramadol, doctors consider several factors, including the patient’s medical history, the severity of pain, and potential drug interactions. The typical dosage ranges from 50 to 100 mg every 4-6 hours, with a maximum daily dose of 400 mg. However, dosages may vary depending on individual patient needs and responses.

Tramadol Formulations

Tramadol is available in various formulations to suit different patient needs and pain management strategies. What are the common forms of tramadol? Here’s a breakdown:

• Immediate-release tablets
• Extended-release tablets
• Capsules
• Oral solutions
• Suppositories (in some countries)

Side Effects and Potential Risks of Tramadol Use

Like all medications, tramadol can cause side effects. While many people tolerate the drug well, it’s essential to be aware of potential adverse reactions. What are the most common side effects of tramadol?

• Nausea and vomiting
• Constipation
• Dizziness
• Headache
• Drowsiness
• Dry mouth
• Sweating

In rare cases, more severe side effects may occur. These can include seizures, serotonin syndrome, and respiratory depression. It’s crucial for patients to report any unusual symptoms to their healthcare provider promptly.

Tramadol and Serotonin Syndrome

One of the unique risks associated with tramadol is its potential to cause serotonin syndrome, especially when combined with other medications that affect serotonin levels. What is serotonin syndrome, and why is it a concern with tramadol use?

Serotonin syndrome is a potentially life-threatening condition characterized by excessive serotonin activity in the nervous system. Symptoms can include agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, and in severe cases, seizures and loss of consciousness. The risk increases when tramadol is combined with other serotonergic drugs, such as selective serotonin reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MAOIs).

Tramadol Abuse and Addiction: Understanding the Risks

While tramadol is considered less addictive than traditional opioids, it still carries a risk of abuse and dependence. What factors contribute to tramadol’s potential for abuse?

• Opioid-like effects
• Potential for euphoria
• Development of tolerance
• Withdrawal symptoms upon discontinuation

The risk of addiction is particularly high in individuals with a history of substance abuse or those who use the medication for prolonged periods. Healthcare providers must carefully assess patients’ risk factors before prescribing tramadol and monitor for signs of misuse or dependence during treatment.

Signs of Tramadol Abuse

Recognizing the signs of tramadol abuse is crucial for early intervention. What are some common indicators that someone may be misusing tramadol?

• Taking higher doses than prescribed
• Obtaining tramadol from multiple doctors or illegal sources
• Using tramadol for non-medical purposes
• Experiencing cravings for the drug
• Neglecting responsibilities due to drug use
• Continuing use despite negative consequences

Tramadol vs. Other Pain Medications: A Comparative Analysis

How does tramadol compare to other pain medications in terms of efficacy and safety? Let’s examine its standing among various analgesics:

Tramadol vs. Traditional Opioids

Compared to traditional opioids like morphine or oxycodone, tramadol is generally considered less potent and has a lower risk of respiratory depression. However, it still carries a risk of dependence and should be used with caution.

Tramadol vs. NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen work differently from tramadol, primarily by reducing inflammation. While NSAIDs are effective for mild to moderate pain, tramadol may be more suitable for moderate to severe pain that doesn’t respond to NSAIDs alone.

Tramadol vs. Acetaminophen

Acetaminophen (paracetamol) is a common over-the-counter pain reliever. While it’s effective for mild pain and fever, tramadol is typically reserved for more severe pain conditions. Some formulations combine tramadol with acetaminophen for enhanced pain relief.

Precautions and Contraindications for Tramadol Use

While tramadol can be an effective pain management tool, it’s not suitable for everyone. What precautions should be taken when using tramadol, and who should avoid its use?

Contraindications

Tramadol is contraindicated in certain situations. Who should not use tramadol?

• Individuals with a history of drug or alcohol abuse
• Those with severe respiratory depression
• Patients with a history of seizures
• Individuals taking MAOIs or who have used them within the past 14 days
• Patients with severe liver or kidney disease

Special Populations

Certain groups require special consideration when it comes to tramadol use. How should tramadol be approached in these populations?

• Elderly patients: May require lower doses due to increased sensitivity
• Pregnant women: Should be used only if the potential benefit outweighs the risk to the fetus
• Breastfeeding mothers: Tramadol can pass into breast milk and may affect the infant
• Children: Use in children under 12 is not recommended, and use in adolescents 12-18 with certain risk factors is contraindicated

Tramadol Interactions: Medications and Substances to Avoid

Tramadol can interact with various medications and substances, potentially leading to adverse effects or reduced efficacy. What are some key interactions to be aware of?

Drug Interactions

• Antidepressants: Particularly SSRIs and SNRIs, due to increased risk of serotonin syndrome
• Benzodiazepines: Can increase the risk of respiratory depression
• Carbamazepine: May reduce tramadol’s effectiveness
• Warfarin: Tramadol may increase the anticoagulant effect
• Digoxin: Tramadol may increase digoxin levels

Substance Interactions

What substances should be avoided while taking tramadol?

• Alcohol: Can increase the risk of side effects and respiratory depression
• Other opioids: Combining opioids can lead to severe respiratory depression
• Illicit drugs: Can increase the risk of overdose and other adverse effects

It’s crucial for patients to inform their healthcare providers about all medications, supplements, and substances they use to prevent potentially dangerous interactions.

Tramadol in Pain Management: Current Trends and Future Perspectives

As our understanding of pain management evolves, so does the role of tramadol in clinical practice. What are the current trends in tramadol use, and what might the future hold for this medication?

Current Trends

In recent years, there has been increased scrutiny of opioid prescribing practices due to the ongoing opioid crisis. How has this affected tramadol use?

• Stricter prescribing guidelines
• Increased monitoring of patient use
• Greater emphasis on multimodal pain management approaches
• Exploration of alternative pain management strategies

Future Perspectives

What might the future hold for tramadol and pain management in general?

• Development of abuse-deterrent formulations
• Research into personalized pain management strategies
• Exploration of new drug combinations to enhance efficacy and reduce side effects
• Increased focus on non-pharmacological pain management techniques

As research continues, our understanding of tramadol’s place in pain management will likely evolve, potentially leading to more targeted and effective use of this medication.

Tramadol and Environmental Concerns: An Emerging Issue

Recent studies have raised concerns about the environmental impact of pharmaceutical residues, including tramadol. What are the implications of tramadol presence in aquatic ecosystems?

A study reported in the Sun Sentinel found that more than 50% of sampled redfish were contaminated with both flecainide and tramadol. This contamination raises questions about the potential effects on marine life and the broader ecosystem. How does tramadol end up in aquatic environments?

• Excretion of unmetabolized drug by humans
• Improper disposal of unused medications
• Wastewater treatment plants unable to fully remove pharmaceutical residues

Potential Environmental Impacts

What are the potential consequences of tramadol contamination in aquatic ecosystems?

• Behavioral changes in fish and other aquatic organisms
• Potential bioaccumulation in the food chain
• Alterations in ecosystem dynamics
• Possible development of drug resistance in bacteria

This emerging issue highlights the need for further research into the environmental fate of pharmaceuticals and the development of strategies to mitigate their impact on ecosystems.

Legal and Regulatory Aspects of Tramadol

The legal status and regulation of tramadol vary across different countries and jurisdictions. What are some key aspects of tramadol’s legal and regulatory landscape?

Scheduling and Classification

In the United States, tramadol is classified as a Schedule IV controlled substance under the Controlled Substances Act. This classification reflects its potential for abuse and dependence, albeit lower than that of Schedule II opioids like oxycodone or morphine. What does this classification mean for prescribing and dispensing practices?

• Stricter prescribing regulations
• Limitations on refills
• Requirements for secure storage and record-keeping
• Restrictions on prescribing via telemedicine in some cases

International Regulations

How does tramadol regulation differ internationally?

The regulation of tramadol varies significantly across countries. In some nations, it’s available over-the-counter, while in others, it’s strictly controlled or even banned. This variability in regulation can lead to challenges in global pain management practices and potential issues with cross-border travel for patients using tramadol.

Prescription Fraud and Diversion

Like other controlled substances, tramadol can be subject to prescription fraud and diversion. What measures are in place to prevent these issues?

• Prescription drug monitoring programs
• Tamper-resistant prescription forms
• Limits on prescription quantities
• Education programs for healthcare providers on identifying potential abuse

These measures aim to ensure that tramadol is used appropriately while minimizing the risk of misuse and diversion.

Tramadol Definition & Meaning – Merriam-Webster

tram·​a·​dol

ˈtra-mə-ˌdȯl 

: a synthetic opioid analgesic administered orally in the form of its hydrochloride C₁₆H₂₅NO₂·HCl to treat moderate to severe pain

Example Sentences

Recent Examples on the Web

More than 50% of the redfish sampled were contaminated with both flecainide, which in humans slows electrical signals in the heart to stabilize heart rhythms, and the habit-forming opioid pain reliever tramadol.

—Bill Kearney, Sun Sentinel, 4 Apr. 2023

The three most common in muscle tissue were opioid pain reliever tramadol, the heart medicine flecainide and haloperidol.

—Bill Kearney, Sun Sentinel, 4 Apr. 2023

Over 50 percent of fish tested had the opioid tramadol and the antiarrhythmic medication flecainide in their systems.

—Matthew Every, Field & Stream, 4 Apr. 2023

Chisholm illegally wrote more than 20,000 prescription’s including oxycodone, methadone, hydrocodone, morphine, tramadol, fentanyl, hydromorphone and buprenorphine to about 350 patients between January 2014 and October 2019, prosecutors said Tuesday in a news release.

—Aya Elamroussi And Michelle Watson, CNN, 20 Jan. 2022

In addition to the alcohol in her blood, there were traces of strong medications in her system, including oxycodone and tramadol, and anti-depressants, including citalopram, the report said.

—courant.com, 9 Aug. 2021

The complaint also alleges Richey unlawfully possessed three prescription drugs — hydrocodone, tramadol and alprazolam — on Dec. 28.

—San Diego Union-Tribune, 10 Jan. 2023

Some people take tramadol, a narcotic analgesic, or Vicodin, which is a combination of acetaminophen and hydrocodone.

—Sandee Lamotte, CNN, 6 Jan. 2023

The 38-year-old civil rights activist, who lives in Columbia, takes the prescription opioid tramadol and several other drugs to keep her chronic severe lower back pain in check.

—Michelle Andrews, CBS News, 4 Jan. 2023

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These examples are programmatically compiled from various online sources to illustrate current usage of the word ‘tramadol.’ Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Word History

First Known Use

1978, in the meaning defined above

Time Traveler

The first known use of tramadol was
in 1978

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Medical Definition

tramadol

noun

tram·​a·​dol

ˈtram-ə-ˌdȯl 

: a synthetic opioid analgesic administered orally in the form of its hydrochloride C₁₆H₂₅NO₂·HCl to treat moderate to severe pain

see ultram

Last Updated:
29 Apr 2023
– Updated example sentences

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Merriam-Webster unabridged

Tramadol Pill Images – What does tramadol look like?

What does Tramadol hydrochloride look like?

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Tramadol on which prescription form is issued – Telegraph

Tramadol on which prescription form is issued

Buy Here

If you have a question where to buy medicine? Set as home Add to favorites Login Login: Pharmacy reference Home Registration Contacts Rules. Find out the prices and availability of medicines in pharmacies in Novokuznetsk and the Kemerovo region. Call or – free of charge from cellular. What orders currently regulate the release of tramadol? If you do not know how to spell the drug, put spaces instead of letters para tamol Search and sorting settings Search for a word at the beginning of the name Search for all matches Search by active ingredient INN Sort by price. Smallest first Sort by name Group by pharmacy. Nadja by , How is the maximum number of 2ml ampoules and 50mg tablets per prescription calculated? In accordance with this, according to subparagraph 2 of paragraph 9approved by Order of the Ministry of Health of the Russian Federation dated No restrictions on the maximum amount of Tramadol Tramal per prescription have been established by the current legislation. Therefore, the specified drug can be dispensed from pharmacies in the quantities indicated in the prescription by a medical professional. It should be noted that in accordance with the Decree of the Government of the Russian Federation approved above, ‘Large size of potent substances for the purposes of the article of the Criminal Code of the Russian Federation’, the amount of Tramadol Tramal is set at 10 grams. However, this size is established for the purposes of an article of the Criminal Code of the Russian Federation, which provides for sanctions for the illegal circulation of potent or toxic substances for the purpose of sale. The release of potent drugs by a pharmacy organization according to a properly executed doctor’s prescription cannot be considered illegal trafficking in potent substances, therefore, the above large amount for Tramadol Tramal has nothing to do with prescription drugs. Director of the legal company ‘Unico’ M. Download mp3 Movies online TV shows online Movies online, TV shows for free. Dear visitor, you have entered the site as an unregistered user. We recommend that you register or enter the site under your name. News archive As a calendar As a list. If you do not know the correct spelling of the remedy, put spaces instead of the letters para tamol. Search and sorting settings Search for a word at the beginning of the name Search for all matches Search by active substance INN Sort by price.

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Question: What orders currently regulate the release of tramadol?

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Tramadol on which prescription form is issued

Ramp link 50mg tablets per prescription? In accordance with this, according to subparagraph 2 of paragraph 9 approved by the Order of the Ministry of Health of the Russian Federation dated Therefore, the specified drug can be dispensed from pharmacy organizations in the quantities indicated in the prescription by a medical worker. However, this size is established for the purposes of an article of the Criminal Code of the Russian Federation, which provides for sanctions for the illegal circulation of potent or toxic substances for the purpose of sale. The preparations indicated in the text of the question contain codeine codeine phosphate, caffeine, metamizole sodium, paracetamol and phenobarbital. The maximum and recommended dispensing rates for individual medicinal products are established, respectively, by Annexes 1 and 2 approved by the Order of the Ministry of Health of the Russian Federation dated In accordance with paragraph 13 of the said Procedure, when prescribing combined medicinal products containing codeine or its salts indicated in the text of the question, it is not recommended to exceed the value of 0, 2 g. Thus, the pharmacy organization is obliged to dispense these drugs in the amount indicated in the doctor’s prescription. Responsibility for the prescribed amount of the drug in this case lies with the medical worker who wrote the prescription. Which point of the order to focus on? In accordance with subparagraph 2 of paragraph 9approved by Order of the Ministry of Health of the Russian Federation dated The release of these drugs is carried out by a pharmacy organization in the amount indicated in the prescription. We also emphasize that the Ministry of Health and Social Development of the Russian Federation in its Letter dated In our opinion, this statement of the Ministry of Health should equally apply to all other documents of the PKKN, which was a Russian interdepartmental expert body working on a voluntary basis, actually ceased its activities in the city. , despite the fact that the documents issued by the PCKN have not been officially canceled by anyone, their application cannot be considered mandatory for pharmaceutical market entities. According to paragraph 9order of the Ministry of Health of the Russian Federation from the Prescription for such drugs is valid for ten days? They are not subject to PKU, but prescriptions are kept in the pharmacy for three years? All the preparations listed in the text of the question contain either testosterone or a mixture of testosterone esters as the only active substance. One of the isomers of testosterone 1-Testosterone is included in the approved Decree of the Government of the Russian Federation dated According to the notes to this List, potent substances also include all isomers of the substances listed in the list in all cases where the existence of such isomers is possible, as well as complex and simple ethers listed in this list substances. Therefore, all the drugs indicated in the text of the question are potent substances. In approved by the Order of the Ministry of Health and Social Development of the Russian Federation dated However, testosterone and substances synthesized on its basis, which are anabolic steroids, have increased anabolic activity, therefore, prescriptions for the drugs indicated in the text of the question in accordance with subparagraph 3 of paragraph 9approved by the Order of the Ministry of Health of the Russian Federation dated In accordance with paragraph 2. At the same time, in accordance with paragraph 2. In accordance with paragraph 8 approved by the Order of the Ministry of Health of the Russian Federation dated In the absence of an international non-proprietary name and a grouping name of the drug, the drug is prescribed and dispensed by a medical worker by trade name. This rule is duplicated in paragraph 9 approved by the Order of the Ministry of Health of the Russian Federation dated 1. Information about all incorrectly written prescriptions is brought to the attention of the head of the relevant medical institution.

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3. Forms of prescription forms and rules for their execution registration of these forms, their accounting and storage – The current latest version of 04/21/2016 – Registered with the Ministry of Justice of the Russian Federation on 06/25/2013 N 28883 – The beginning of the revision on 01/01/2017 , dated 06/30/2015 N 386 n, dated 04/21/2016 N 254 ​​n)

The following prescription forms are in force in the Russian Federation:

Form No. 107/u-NP – a special prescription form for a narcotic and psychotropic drug of List II of the List

Form No. 148-1/u-88 “Prescription Form”

Form No. 107-1/u “Prescription Form”

Form No. 148-1/y-04 (l) “Recipe”

Form No. 148-1/y-06 (l) “Recipe” fields for a barcode)

The form of these forms, as well as instructions for filling them out, are specified in the appendices to the Order of the Ministry of Health of the Russian Federation of December 20, 2012 N 1175 n.

Instructions on the procedure for prescribing drugs and issuing prescriptions

Prescription rules are now regulated by Order of the Ministry of Health of the Russian Federation of December 20, 2012 N 1175 n.

The main requirements of this Order can be summarized as follows:

.

2. Health care workers write prescriptions for medicines with their signature and their position.

Prescribing and prescribing drugs is carried out by a medical worker according to the international non-proprietary name (INN), and in its absence, the grouping name.

In the absence of an INN and a grouping name, the medicinal product is prescribed and dispensed according to the trade name.

3. A prescription issued in violation of the established requirements is considered invalid.

4. Information about the prescribed and prescribed drug is indicated in the patient’s medical record.

A prescription for a drug is written in the name of the patient for whom the drug is intended.

5. It is forbidden to issue prescriptions for medicines:

a) medical workers:

– in the absence of medical indications;

— for medicinal products not registered in the Russian Federation;

– for medicinal products that, in accordance with the instructions for medical use, are used only in medical organizations;

– for narcotic drugs and psychotropic substances included in List II of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, approved by a decree of the Government of the Russian Federation (hereinafter referred to as the List), registered as drugs for the treatment of drug addiction;

b) individual entrepreneurs engaged in medical activities – for medicinal products containing narcotic drugs and psychotropic substances included in Lists II and III of the List.

6. Prescriptions for medicines are issued on prescription forms according to forms No. 148-1/y-88, No. 148-1/y-04 (l), No. 148-1/y-06 (l) and No. 107- 1/y.

Narcotic and psychotropic drugs of List II of the List are issued on a special prescription form (Form No. 107/u-NP).

7. Prescription form No. 148-1/u-88 is intended for prescribing psychotropic substances included in List III of the List; other medicinal products subject to subject-quantitative accounting; drugs with anabolic activity; medicines containing, in addition to small amounts of narcotic drugs or psychotropic substances and their precursors (substances and doses are specified in clause 5 of the appendix to the Order), other pharmacologically active substances.

8. Prescription forms No. 148-1/y-04 (k) and 148-1/y-06 (l) are intended for prescribing medicines to citizens who have the right to receive medicines free of charge or receive medicines at a discount.

9. Prescription form No. 107-1/y is intended for prescribing medicines containing, in addition to small amounts of narcotic drugs, psychotropic substances and their precursors (substances and doses are specified in clause 4 of the appendix to the Order), other pharmacologically active substances ; other medicinal products not specified in paragraphs 7 and 8 of the basic requirements.

10. When prescribing narcotic and psychotropic drugs of Lists II and III of the List, other drugs subject to quantitative accounting, the dose of which exceeds the highest single dose, the medical worker writes the dose of this drug in words and puts an exclamation mark.

It is allowed to use only prescription abbreviations provided for in the Order, which do not allow double interpretation.

11. The composition of the combined medicinal product, the designation of the dosage form and the medical worker’s request to the pharmaceutical worker about the manufacture and dispensing of the medicinal product are written in Latin.

12. The route of administration of the medicinal product is indicated indicating the dose, frequency, time of administration relative to sleep (morning, at night) and its duration, and for drugs that interact with food, the time of their use relative to food intake (before meals, during mealtime, after meals).

13. If the patient needs immediate or urgent dispensing of a medicinal product, the words “cito” (urgently) or “statim” (immediately) are put at the top of the prescription.

14. When writing a prescription for a medicinal product of individual manufacture, the amount of liquid pharmaceutical substances is indicated in milliliters, grams or drops, and other pharmaceutical substances – in grams.

15. Prescriptions written on prescription form No. 148-1/у-88 are valid for 15 days.

16. Prescriptions for drugs written out on prescription forms No. 148-1/y-04 (k) and forms No. 148-1/y-06 (l) are valid for 30 days from the date of issuance.

For citizens who have reached retirement age, disabled people of the first group and disabled children – within 90 days from the date of issue.

For the treatment of chronic diseases of these categories of citizens, prescriptions for drugs can be issued for a course of treatment up to 90 days.

17. Prescriptions for medicines written out on prescription forms No. 107-1/y are valid for 60 days from the date of issuance.

Patients with chronic diseases may have a validity period of up to 1 year and exceed the recommended amount of the drug to be filled per prescription.

When writing out such prescriptions, the medical worker makes a note “For a patient with a chronic disease”, indicates the validity period of the prescription and the frequency of dispensing drugs from the pharmacy, certifies this indication with his signature and personal seal, as well as the seal of the medical organization “For Prescriptions”.

Further, the Order of the Ministry of Health of the Russian Federation of December 20, 2012 N 1175 n provides a number of special instructions for prescribing and prescribing drugs to patients who are in hospitals, when providing emergency medical care, as well as to citizens who have the right to receive medicines free of charge or purchase medicines at a discount, as part of their primary health care.