Tramadol is an analgesic used to fight moderate and severe pain. However, the active ingredient only combats the symptoms, not the cause of the pain. Tramadol comes in the form of tablets, drops, and suppositories, as well as injections and infusions. Just like other painkillers, tramadol has side effects: It should be especially noted – even though this side effect is relatively rare – that regular use of tramadol can lead to dependence.
Tramadol: effect against pain
Tramadol belongs to the group of opioid painkillers. The main active ingredient in this group is morphine. Opioid pain relievers are used to treat moderate and severe pain – weaker pain, on the other hand, is treated with non-opioid pain relievers such as acetaminophen or acetylsalicylic acid. For moderate pain, weaker opioid agents such as tramadol or tilidine are used. For severe pain, on the other hand, stronger opioids such as morphine, burprenorphine and fentanyl are used. Compared to morphine, the effect of tramadol is about four times weaker – however, the mode of action of the two substances is very similar. After ingestion, tramadol exerts its effect in the brain by docking there at the opioid receptors. The body’s own messenger substances normally act at these receptors to inhibit the perception of pain. Tramadol is similar in structure to these messenger substances and can therefore also bind to the opioid receptors. For this reason, even relatively severe pain is only perceived as slight after taking the drug. Painkillers: which one, when and for what?
Influence on pain perception
In addition, however, tramadol has a second mechanism of action: namely, the active ingredient also inhibits the reuptake of serotonin and norepinephrine in the brain and in this way influences the perception of pain. In this respect, tramadol is similar to some antidepressants, such as the tricyclic antidepressants. The effect of tramadol begins approximately 30 minutes after taking the analgesic. Depending on the dose taken and the severity of the pain, the analgesic effect lasts between two and seven hours. The individual dosage of tramadol is calculated by the attending physician depending on factors such as the degree of illness, the perceived intensity of pain, and age and weight.
Side effects of tramadol
As with other agents in the opioid painkiller group, taking tramadol is associated with side effects. The most common side effects include nausea and dizziness. Likewise, headache, drowsiness, dry mouth, vomiting, constipation, and sweating may occur more often after taking the drug. Occasionally, the painkiller also has effects on the cardiovascular system: side effects such as palpitations, accelerated heartbeat, circulatory fluctuations or circulatory collapse may occur. Similarly, diarrhea, skin rash, and itching may occasionally occur. Rarely, on the other hand, side effects such as respiratory disturbances, increase in blood pressure, delusions, confusion, as well as changes in appetite occur after the use of tramadol.
Risk of dependence low
Also rare are cases in which taking tramadol leads to dependence. Dependence occurs primarily when the active ingredient is taken over a long period of time. However, even after a longer period of use, the risk of becoming dependent is relatively low. If dependence is present, withdrawal symptoms such as sweating and freezing as well as gastrointestinal complaints may occur after the end of treatment. Before taking the painkiller, you should in any case ask your attending physician or a pharmacist about possible side effects and read the package insert carefully.
Tramadol: contraindications and drug interactions.
Like all other active ingredients, tramadol must not be used if there is hypersensitivity to the substance. In addition, the shmermittel must also not be used if alcohol, psychotropic drugs, sleeping pills or other painkillers were previously taken, as the substances can reinforce each other in their mode of action. Another contraindication is the use of MAO inhibitors within the past two weeks, as otherwise life-threatening side effects may occur.In epilepsy – especially if the disease is not under control – tramadol should not be taken. This is because taken regularly and in higher doses, the active ingredient can increase the risk of an epileptic seizure. In addition, it should be noted that the epilepsy drug carbamazepine reduces the effectiveness of tramadol. In addition, tramadol should also not be combined with agents that lower the threshold for epileptic seizures. These drugs include tricyclic antidepressants and selective serotonin reuptake inhibitors. In combination with the latter, serotonin syndrome may also occur in rare cases.
Caution with impaired hepatic or renal function.
Similarly, tramadol should not be used when taking blood-thinning medications, because the active ingredient also has an effect on blood clotting. Tramadol should also be avoided when taking the antifungal drug ketoconazole and the macrolide antibiotic erythromycin. If liver or kidney function is impaired, tramadol should only be taken after consultation with the attending physician. The same applies in cases of impaired consciousness, respiratory disorders, shock conditions as well as brain diseases and increased intracranial pressure. In patients with hypersensitivity to opioids or who are prone to drug abuse, tramadol should also only be used after detailed consultation with the attending physician. The analgesic is not suitable as a substitute drug for individuals addicted to opioids because it cannot mask withdrawal syndromes.
Tramadol in pregnancy
Tramadol should not be used during pregnancy if possible. Especially if the pain reliever is taken regularly, the newborn may experience withdrawal symptoms. If treatment with opioid analgesics is unavoidable during pregnancy, it should be limited to single doses of tramadol. The active substance should also be avoided if possible during breastfeeding. However, since only very small amounts of the analgesic pass into breast milk, breastfeeding can still continue after a single dose of tramadol. For children under twelve years of age, tramadol should only be used in the form of drops, as a low dose can be administered in this form. Tablets are not recommended until children are twelve years of age or older, and suppositories are not even suitable until children are 14 years of age or older.
