Interactions | Tramal® tablets

Interactions

The attending physician should always be informed about any additional medications taken, including non-prescription drugs from the pharmacy or drugstore, as there may be interactions between the medications that must be taken into account. If 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, and drugs used as substitutes in the treatment of a drug addiction (e.g. methadone, as this also belongs to the group of opioids) are taken in parallel, there may be an increased attenuation (sedation) and inhibition of the respiratory drive (respiratory depression) up to respiratory arrest. A combination therapy should therefore only be carried out carefully and under medical supervision.

Alcohol during Tramal® therapy can also lead to increased damping and inhibition of the respiratory drive, so alcohol consumption should be avoided as far as possible. When Tramal® is combined with drugs that lower the seizure threshold, the risk of seizures can increase. These drugs include those from the group of antipsychotics (for example Haloperidol) and antidepressants.

The parallel use of Tramal® and certain antidepressants (especially serotonin reuptake inhibitors and MAO inhibitors) can lead to a life-threatening serotonin syndrome with muscle twitching (myoclonia), sweating, trembling, fever, agitation, increased reflexes (hyperreflexia) and other symptoms.When taking Tramal® and blood thinners from the group of coumarins (e.g. Marcumar®) at the same time, the dose of the blood thinners may have to be adjusted in the sense of a dose reduction, as otherwise there may be a significantly increased risk of bleeding. If the nausea-reducing (antiemetic) drug ondansetron and tramadol are taken simultaneously, the analgesic effect of tramadol may be reduced. The same applies to parallel therapy with the drug carbamazepine, which is mainly used to treat epilepsy and to treat neuropathic pain and manic episodes.

Dosage

Tramal® in tablet form is available on the one hand as hard capsules and on the other hand as tablets in retard form, i.e. with longer efficacy. The Tramal® hard capsules contain 50 mg tramadol. Children over 12 years of age and adults can take a single dose of 1-2 tablets.

The maximum daily dose is 8 hard capsules, i.e. 400 mg tramadol. Tramal® in sustained release form as a tablet is available in a dose of 50 mg, 100 mg, 150 mg and 200 mg, this dosage form is called Tramal Long®. 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 is also 400 mg per day, corresponding 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.