Tramundin® is a drug from the group of opioids and is used due to its pain-relieving effect to treat moderate to severe pain of various causes. It is not a pure opioid, as it also unfolds its pain-relieving effect via a further mechanism that corresponds to that of antidepressants.

Tramadol is the active ingredient of the drug, which is sold under the trade name Tramundin®. The active ingredient is available in the form of tablets, capsules, meltable or effervescent tablets and drops, although the dosages may differ depending on the dosage form. Chemically, the active ingredient is usually in salt form as tramadol hydrochloride, a white, crystalline powder that is easily soluble in water. Tramundin® requires a prescription in Germany and may only be taken on medical advice.

Mode of action

Tramundin® works on a central level. As usual with opiates, the drug binds special receptors in the brain and spinal cord and reduces the transmission of pain stimuli within the nervous system. In this way, weakened pain signals arrive in the brain and the person affected perceives less or even no pain. For this, the electrical flow of information is partially interrupted at the contact point between two nerve endings.

Another way of action also leads to pain inhibition. The otherwise very sparse The release of endogenous opioids is stimulated. This happens as a result of an increase in the concentration of the messenger substance Norepinephrine in the gap between two nerve endings (synapse), which leads to an amplification of the signal. Normally, the signals are regulated by the nerve cells themselves taking up the messenger substances again. Tramundin® attacks here and prevents norepinephrine from being reabsorbed.

As a result, many antidepressants have a pain-relieving effect in addition to their actual mood-enhancing effect.


Tramundin® is used for moderate to severe, persistent pain. The prerequisite for prescribing the drug should be that other non-opioid pain relievers have been tried before and insufficient pain relief could be achieved. A treatment with more tolerable active ingredients such as Aspirin® or Paracetamol should always be preferred.

Due to its dual mechanism of action, Tramundin® is particularly suitable for Treatment of nerve pain (Neuralgia) and diseases associated with them because they affect central or peripheral nerves. These include neuropathic painhow to look for a Shingles may occur. This is also known as post-therapeutic zoster neuralgia. This leads to a reactivation of a herpes virus (Varicella zoster virus) in nerve cords of the spinal cord. This late complication becomes more common with age and very severe, permanent pain can occur in the affected area, which persists even after the skin has healed.

Another clinical picture for which Tramundin® is more often used as a pain medication is Fibromyalgia (Soft tissue rheumatism). It is a non-inflammatory diseasewhich manifests itself in chronic pain all over the body, exhaustion and numerous other complaints. Many non-opioid substances have proven to be ineffective in reducing pain in fibromyalgia and are therefore ruled out for therapy. The reason for this lies in the different points of attack of the drugs. The group of so-called non-steroidal anti-inflammatory drugs, as the name suggests, tackles the inflammation and inhibits pain by intervening in the inflammatory process.

Side effects

The opioid receptors as the target of Tramundin® are localized in some organs in the body, from which the diverse and sometimes serious side effects which should be observed before taking. The influence on the above-mentioned quantities of messenger substances additionally expands the spectrum of possible undesirable side effects.

To the most common adverse effects count Nausea, vomiting, headache, dizziness, constipation, drowsiness, dry mouth, sweating and exhaustion. Occasionally kick Circulatory disorders which can manifest as palpitations, increased heart rate, faintness attacks, and circulatory collapse. Also can Diarrhea and skin reactions occur as a side effect.

Effects that are rarely observed can and should be taken from the package insert discussed immediately with the responsible doctor become. Like other opioids, Tramundin® abused as an intoxicant become dependent and trigger typical withdrawal symptoms after discontinuation.


Tramundin® must not be used if the person concerned has Hypersensitivity to individual components of the drug, a acute poisoning from alcohol, Sleeping pills, pain relievers, opioids or other psychotropic drugs, at the same time or 14 days before Treatment with MAO inhibitors (Antidepressants) and at Presence of epilepsythat cannot be adequately controlled despite treatment.

In addition, there is always the risk of Interactions when taking different drugs at the same time. An example is Carbamazepine, an active ingredient in epilepsy therapy. It accelerates the breakdown of Tramundin® in the liver, consequently the effect is shortened and thus reduced.
The reverse effect is often found in the Presence of certain antibiotics or antifungal drugs observed. The inhibition of the degradation of tramaundin results in a longer duration of action and ultimately a stronger effect with the same dosage.

Furthermore, the simultaneous use of depressant substances like sleeping pills, sedatives and alcohol waived become. These can increase the already dampening effect of Tramundin® life threatening conditions to lead.

It's just as dangerous Serotonin syndrome, which threatens if drugs are consumed at the same time that cause a further increase in the messenger substance serotonin, as do many antidepressants. The possibly fatal symptoms are due to an increased effect of serotonin.

A Overdose from Tramundin® can with opioid opponents be weakened.