Application Indications
Tramal® is used for the treatment of moderate to severe pain. It is applied at level 2 of the WHO three-step regimen and is combined with drugs such as ibuprofen, diclofenac, indomethacin, paracetamol and metamizole as appropriate.
Contraindications
Tramal® must not be taken in the case of a previously known hypersensitivity to the active substance tramadol and in the case of an overdose with sleeping pills, psychotropic drugs, other drugs from the group of opioids and alcohol. In the case of therapy with MAO inhibitors for the treatment of depressive moods, simultaneous therapy with Tramal® is prohibited. There must be at least 14 days between the last intake of MAO inhibitors and the first intake of Tramal®.
Even in the case of epilepsy which is not well controlled therapeutically, Tramal® must not be used as an analgesic, as it can lower the seizure threshold. In patients with a tendency to develop dependency, the use of Tramal® should be carefully considered, and treatment should only be given for a very limited period of time to minimize the risk of developing dependency. In patients who have already experienced an opiate dependency, the use of Tramal® should be avoided completely if possible.
Furthermore, caution should be exercised when taking Tramal ® in cases of impaired consciousness, disturbances of the respiratory center or respiratory function, conditions with increased intracranial pressure and severely impaired liver or kidney function. During pregnancy, the indication for therapy with Tramal® should be strictly defined. If Tramal® is to be used, it should not be taken over a longer period of time but in single doses, as the child may become accustomed to it, which may result in withdrawal symptoms after birth.
The same applies to the breastfeeding period. Here, too, no permanent therapy with Tramal® should take place, but a single dose can be justified. In patients over 75 years of age the elimination of Tramal ® may be slower, so that a lower dose should be used.
