What's in Tramadol
TramadolDrug groupsOpioideTramadol is a pain reliever from the group of opioids for the treatment of moderate to severe pain of various causes. It is not a pure and typical opioid and also has noradrenergic and serotonergic effects like some antidepressants. Tramadol has a high potential for drug-drug interactions due to its mechanism of action and biotransformation via CYP3A4 and CYP2D6. The numerous precautionary measures must be observed. The most common adverse effects include nausea, headache, drowsiness, vomiting, constipation, dry mouth, sweating, and exhaustion. The risk of respiratory depression and the development of addiction is considered to be low.
synonymous: Tramadolum, Tramadoli hydrochloridumPhEur, TramadolhydrochloridProducts
Tramadol is available in the form of tablets, capsules, orodispersible tablets, drops, effervescent tablets, suppositories and as a solution for injection. (Tramal®, generics). Fixed combinations with paracetamol are also available (Zaldiar®, generics).
Tramadol was developed by Grünenthal in Germany in 1962 and has been approved in Switzerland since 1977 and in the USA since 1995.Structure and properties
Tramadol (C.16H25NO2, Mr = 263.38 g / mol) is a cyclohexanolamine and is present in medicinal products as tramadol hydrochloride, a white, crystalline powder that is easily soluble in water. It is a racemate and both enantiomers and a metabolite are involved in the effect. Tramadol is structurally closely related to SSNRIVenlafaxine.
Tramadol (ATC N02AX02) has central analgesic properties. It is an opioid with a dual mechanism of action. On the one hand, tramadol binds to opioid receptors. On the other hand, it is noradrenergic and serotonergic in that it inhibits the reuptake of neurotransmitters and thus influences the perception of pain. So it can be seen as a combination of an opioid and a reuptake inhibitor such as venlafaxine. For the opioid effect, the O-Desmethyl metabolite M1 and not the parent compound blamed.
Tramadol is used to treat moderate to severe, persistent pain when non-opioid pain relievers such as the non-steroidal anti-inflammatory drugs NSAID and paracetamol are not effective enough.
According to a Cochrane review, like some antidepressants, it is also suitable for treating neuropathic pain. It is also used for pain relief in fibromyalgia.abuse
Like other opioids, tramadol can also be abused as an intoxicant, be addictive and trigger withdrawal symptoms.Contraindications
The full precautionary measures can be found in the product information.Interactions
Tramadol is made up of CYP3A4 and CYP2D6 too N- and O-Desmethyl metabolites biotransformed and glucuronidated. O-Desmethyltramadol (M1), which is formed via CYP2D6, is active as an opioid. Interactions with CYP inducers such as carbamazepine and CYP inhibitors such as azole antimycotics or macrolides are therefore possible.
The combination with MAOIs is contraindicated and potentially life threatening.
Since Tramadol is serotonergic, the combination with other serotonergic drugs can lead to serotonin syndrome (see under Serotonin syndrome).
Centrally depressant drugs such as sleeping pills, sedatives and alcohol can increase the depressant effect of tramadol.
When using vitamin K antagonists such as phenprocoumon, the bleeding time should be monitored. Since tramadol can cause seizures, it should not be given at the same time as medicines that lower the seizure threshold. Opioid antagonists can make tramadol less effective. The full information on interactions can be found in the information for healthcare professionals.unwanted effects
The most common adverse effect is nausea. Headache, drowsiness, vomiting, constipation, dry mouth, sweating, and exhaustion are common. Occasionally there are disorders of the circulatory regulation with palpitations, low blood pressure and collapse, as well as skin reactions. Withdrawal symptoms may occur after discontinuation.see also
Opioids, serotonin syndrome, venlafaxine, tapentadol, tramadol and paracetamolliterature
- Medicinal product information (CH, EMA)
- Cepeda M.S., Camargo F., Zea C., Valencia L. Tramadol for osteoarthritis: a systematic review and metaanalysis. J Rheumatol, 2007, 34 (3), 543-55 Pubmed
- Cepeda M.S., Camargo F., Zea C., Valencia L. Tramadol for osteoarthritis. Cochrane Database Syst Rev, 2006, CD005522 Pubmed
- European Pharmacopoeia PhEur
- Grond S., Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet, 2004, 43 (13), 879-923 Pubmed
- Hollingshead J., Dühmke R.M., Cornblath D.R. Tramadol for neuropathic pain. Cochrane Database Syst Rev, 2006, CD003726 Pubmed
- Keating G.M. Tramadol sustained-release capsules. Drugs, 2006, 66 (2), 223-30 Pubmed
- Langley P.C., Patkar A.D., Boswell K.A., Benson C.J., Schein J.R. Adverse event profile of tramadol in recent clinical studies of chronic osteoarthritis pain. Curr Med Res Opin, 2010, 26 (1), 239-51 Pubmed
- Leppert W. Tramadol as an analgesic for mild to moderate cancer pain. Pharmacol Rep. 2009, 61 (6), 978-92 Pubmed
- Raffa R.B. Basic pharmacology relevant to drug abuse assessment: tramadol as example. J Clin Pharm Ther, 2008, 33 (2), 101-8 Pubmed
Conflicts of Interest: None / Independent. The author has no relationships with the manufacturers and is not involved in the sale of the products mentioned.additional Information
Support PharmaWiki with a donation!
© PharmaWiki 2007-2021 - PharmaWiki provides independent and reliable information about medication and health.
This article was last changed on April 15, 2020.
Imprint and data protection declaration
Show products for this page
- Who inherited Steve Jobs' estate
- Was Babylon powerful in ancient times
- Is the WhatsApp calling function officially activated
- What are the cons of NIT Durgapur
- What is Al Shahada
- Adaptive cruise control can be added aftermarket
- What is spiritual enlightenment
- What is a valence electron
- Who is Grandma Kvach
- American state governments can indict their governors
- Can Nigeria belong to the world powers
- Why do atoms combine to form molecules
- What is the reservoir for human malaria
- What is an unexpected danger in Honduras
- What's the story of IPL
- How do you deal with being unattractive?
- You have to choose a name
- How is Vistaprint doing financially
- Where do people live in Palo Alto
- How does Li Fi affect internet speed
- What are some facts about mental disorders
- Failure of students in APT at VIT
- How does the Note 8 work
- What is the Conservative antonyms of SJWs