Tramal® tablets

Active ingredient

Tramadol

introduction

Tramal® is a medicine that contains the active substance tramadol.
It is one of the opioids, which are among the strongest painkillers and largely fall under the Narcotics Act. Tramadol, however, is not subject to this.
Opioids are measured in their potency by the potency of morphine, the potency of morphine is set as 1. Tramadol has about 0.1 times the effectiveness of morphine, so it is one of the low-potency opioids.

According to the World Health Organization (WHO), low-potency opioids such as tramadol should be used in the 3-stage scheme for pain treatment from stage 2. These can also be combined with pain relievers from the group of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or mediaments such as paracetamol and metamizol (Novalgin ®).
A combination of low and high potency opioids such as fentanyl should be avoided as they mutually inhibit each other's effectiveness. From WHO level 3, highly potent opioids should be used for pain relief.

Side effects

Opioids are - compared to the weaker painkillers such as NSAIDs - relatively gentle as far as their effects on the organism are concerned, they also contribute permanent ingestion so less permanent organ damage than ibuprofen and others.
One problem with opioids, however, is the risk of one Dependency development with long-term therapy. As a result, after discontinuation of the medication it can too Withdrawal symptoms come. Take the drug as an example heroin called, which also belongs to the group of opioids. your Dependency potential is due to the pharmacological behavior significantly higher than with the opioids used in everyday clinical practice.

Furthermore, too many opioids can sometimes be very unpleasant for those affected Side effects to lead. When taking Tramadol, nausea and often occur Vomit, dizziness, Dry mouth such as a headache and Drowsiness.
Another common side effect of opioids are Constipation (Constipation). In patients who are treated with opioids over a longer period of time, an additional one is therefore usually used laxative (laxative) drug prescribed so that the bowel movement does not come to a standstill.
Also sweat and skin symptoms like Redness or a Rash (Rash) can occur during opioid therapy. It happens less often Difficulty urinating (Micturition disorders). Other rare side effects are Muscle weaknessRespiratory depression, seizures, Hallucinations and States of confusion, Mood changes both in terms of a euphoria as well as one Dysphoria (irritable mood), Slowing of the heartbeat (Bradycardia), Increase in blood pressure (hypertension) such as allergic reaction.
Tramal® can be one Impairment of the ability to react to lead. The patient should therefore independently assess whether he feels able to do the Road traffic to actively attend or Machines to operate and avoid doing this as much as possible if symptoms such as drowsiness or depression occur.

Interactions

The attending physician should always be informed about any additional medication taken, including those not available on prescription from the pharmacy or drugstore, as there may be interactions between the medications that must be observed.

When taking Tramal® and drugs from the group of Sleeping pills, Cough suppressants (especially Codeine, as this drug also belongs to the group of opioids), Antidepressants of the sedating type as well as drugs for Replacement therapy when treating a Drug addiction (for example Methadoneas this is also an opioid) it can be an aggravated one damping (Sedation) and Inhibition of the respiratory drive (Respiratory depression) up to Apnea come.
Combination therapy should therefore only be carried out carefully and under medical supervision.

Also alcohol During Tramal® therapy it can lead to increased damping and inhibition of the respiratory drive, so alcohol consumption should be avoided as far as possible. When combining Tramal® with Medicationwho the Lower the seizure threshold, the risk of seizures may increase. These drugs include those from the group of Antipsychotics (for example Haloperidol) and Antidepressants.
When taking Tramal® and certain drugs from the group of antidepressants (in particular Serotonin reuptake inhibitors and MAOIs) it can be life-threatening Serotonin Syndrome With Muscle twitching (Myoclonia), Sweating, tremors, fever, restlessness, increased reflexes (hyperreflexia) and other symptoms.

When taking Tramal® and Blood thinners from the group of coumarins (for example Marcumar®) it may be necessary to adjust the dose of the blood thinners in the sense of a dose reduction, as otherwise there may be a significantly increased risk of bleeding. When taking the anti-nausea (antiemetic) Drug Ondansetron and tramadol, the pain reliever effect of tramadol may be decreased. The same applies to parallel therapy with the drug Carbamazepinethat is mainly used to treat the epilepsy as well as for the therapy of neuropathic pain and manic episodes is applied.

dosage

Tramal® in Tablet form on the one hand as Hard capsules, on the other hand as tablets in Retard form, so with longer effectiveness.
The Tramal® hard capsules contain 50 mg Tramadol.
Children over 12 years and Adults can one Single dose from 1-2 tablets take that Maximum daily dose amounts to a maximum 8 hard capsules, i.e. 400 mg tramadol.
Tramal® in Retard form as a tablet there is a dose of 50 mg, 100 mg, 150 mg and 200 mg, this dosage form is called Tramal Long® designated. The Single dose for Tramal Long® is 50 mg and 100 mg 1-2 tablets, for Tramal Long® 150 mg and 200 mg 1 tablet. The Maximum daily dose also amounts to here 400 mg per day equivalent to 8 tablets Tramal Long® 50 mg, 4 tablets Tramal Long® 100 mg, 2-3 tablets Tramal Long® 150 mg and 2 tablets Tramal Long® 200 mg.

Application / indications

Tramal® is used for the therapy of moderate to severe pain, it will be at Level 2 of the three-stage WHO level schemes applied and possibly with medication like Ibuprofen, Diclofenac, Indomethacin, Paracetamol and Metamizole combined.

Contraindications

Tramal® must not be taken if you already know Hypersensitivity against the Active ingredient tramadol and at one Overdose With Sleeping pills, Psychotropic drugs, other drugs from the group of Opioids such as alcohol.

During therapy with MAO inhibitors for treatment depressive moods Simultaneous therapy with Tramal® is prohibited.
It must be at least 14 days between the last time you took the MAOIs and the first time you took Tramal®.
Even with one epilepsy which is not well controlled therapeutically, Tramal® must not be used as a pain reliever as it Can lower the seizure threshold.
In patients with a tendency to Dependency development The use of Tramal® should be carefully considered, the treatment should then only take place over a very limited period of time in order to keep the risk of developing addiction as low as possible.

For patients who already have a Opiate addiction experience, the use of Tramal ® should - if possible - be avoided completely.
Furthermore, caution should be exercised when taking Tramal® Impaired consciousness, Disruptions of Respiratory center or the Respiratory function, Conditions with increased Intracranial pressure as well as strong impaired liver or Kidney function.

In the pregnancy If the indication for therapy with Tramal® should be made strictly, if the use of Tramal® comes into question, this should not be done over a longer period of time but in Single doses happen since it was used to Getting used to the child what can come in Withdrawal symptoms can show after birth.

The same goes for them Lactation, here too, no permanent therapy with Tramal ® should take place, one Single dose however, can be held responsible. In patients over 75 years the elimination of Tramal ® can be slowed down, so that a lower dose should be used.

costs

Tramal® Hard capsules with a dose of 50 mg per capsule cost up Private prescription in a pack with 10 hard capsules 11.94 euros, with 30 hard capsules 13.86 euros and with 50 hard capsules 15.90 euros.
Upon presentation of a Till prescription only the prescription fee falls from 5 euros on.

Tramal Long® Tablets at a dose of 50 mg cost on Private prescription 13.11 euros for 20 tablets, 16.02 euros for 50 tablets and 20.73 euros for 100 tablets. Tramal Long® tablets in a dose of 100 mg cost 15.90 euros in a pack of 20 tablets, 22.67 euros with 50 tablets and 33.32 euros with 100 tablets. 20 tablets Tramal Long® tablets in a dose of 150 mg cost 19.09 euros, 50 tablets 30.07 euros and 100 tablets 47.23. 200 mg Tramal Long® tablets cost € 22.36 in a pack size of 20, € 37.72 for 50, € 60.81 for 100. At all versions of Tramal Long® the price is reduced when one is presented Prescription to 5 euros.