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Tramadol is a synthetic (man-made) pain reliever (analgesic). Researchers and doctors do not know the exact mechanism of action of tramadol, but it is similar to morphine. Like morphine, tramadol binds to receptors in the brain (narcotic or opioid receptors) that are important for transmitting the sensation of pain from throughout the body to the brain.
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Like other narcotics used to treat pain, patients taking tramadol may abuse the drug and become addicted to it.
Tramadol is not a nonsteroidal anti-inflammatory drug (NSAID), therefore, it does not have the increased risk of stomach ulcers and internal bleeding that can occur with NSAIDs.
Tramadol, a centrally acting synthetic opioid analgesic. Although its
mode of action is not completely understood, from animal tests, at least two complementary mechanisms appear applicable: binding of parent and M1 metabolite to μ-opioid receptors and weak inhibition of re-uptake of norepinephrine and serotonin.
Tramadol has been shown to inhibit reuptake of norepinephrine and serotonin in vitro, as have some other opioid analgesics. These mechanisms may contribute independently to the overall analgesic profile of ULTRAM®. Analgesia in humans begins approximately within one hour after administration and reaches a peak in approximately two to three hours.
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Apart from analgesia, ULTRAM® administration may produce a constellation of symptoms (including dizziness, somnolence, nausea, constipation, sweating and pruritus) similar to that of other opioids. In contrast to morphine, tramadol has not been shown to cause histamine release. At therapeutic doses, ULTRAM® has no effect on heart rate, left-ventricular function or cardiac index. Orthostatic hypotension has been observed.
This is a typical dosing schedule for someone just starting to take tramadol regular-release tablets:
- Your doctor will most likely start with 25 milligrams (mg) each morning.
- That may increase by separate doses of 25 mg every three days to reach a maximum dose of 100 mg a day (25 mg, four times a day), depending on how much the medication is relieving your pain.
- If necessary, your doctor may increase by separate doses of 50 mg every three days to reach a maximum of 200 mg a day (50 mg, four times a day).
- A normal adult dose should not go above 400 mg a day.
- For someone with cirrhosis (liver damage), the daily dose should not be above 100 mg in a 24-hour period.
- For someone with kidney disease, the daily dose should not be above 200 mg.
- For someone older than 75, the daily dose should not be above 200 mg.
Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, or headache may occur. Some of these side effects may decrease after you have been using this medication for a while. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise. Ask your pharmacist for help in selecting a laxative (such as a stimulant type with stool softener).
To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.