Tramadol
Tramadol hydrochloride tablet is a centrally acting analgesic. It works in certain areas of the brain and nervous system to decrease pain.
How to use Tramadol:
Check the label on the medicine for exact dosing instructions.
* Take Tramadol by mouth with or without food.
* If you miss a dose of Tramadol and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Individualization of Dose
Good pain management practice dictates that the dose be individualized according to patient need using the lowest beneficial dose. Studies with tramadol in adults have shown that starting at the lowest possible dose and titrating upward will result in fewer discontinuations and increased tolerability.
* In all patients with creatinine clearance less than 30 mL/min, it is recommended that the dosing interval of tramadol hydrochloride be increased to 12 hours, with a maximum daily dose of 200 mg. Since only 7% of an administered dose is removed by hemodialysis, dialysis patients can receive their regular dose on the day of dialysis.
* The recommended dose for adult patients with cirrhosis is 50 mg every 12 hours.
* In general, dose selection for an elderly patient over 65 years old should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function and of concomitant disease or other drug therapy. For elderly patients over 75 years old, total dose should not exceed 300 mg/day.
Drug Abuse and Dependence
Tramadol may induce psychic and physical dependence of the morphine-type (µ-opioid). Dependence and abuse, including drug-seeking behaviour and taking illicit actions to obtain the drug are not limited to those patients with prior history of opioid dependence. The risk in patients with substance abuse has been observed to be higher. Tramadol is associated with craving and tolerance development. Withdrawal symptoms may occur if tramadol is discontinued abruptly. These symptoms may include: anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, piloerection and rarely hallucinations. Clinical experience suggests that withdraw alsymptoms may be relieved by reinstitution of opioid therapy followed by gradual, tapered dose reduction of the medication combined with symptomatic support.
