How tramadol works
Tramadol is a pain-relieving (analgesic) substance from the opioid group.
Humans have an endogenous analgesic system that is activated in stressful situations, among other things. For example, after serious accidents, injured people are often initially able to help others without even noticing their own injury.
In addition, the analgesic prevents the reuptake of certain nerve messengers (norepinephrine, serotonin) into their storage location. The amount of free neurotransmitters in the tissues thus increases, which supports the analgesic effect and may have antidepressant effects.
Absorption, degradation and excretion
After about four to six hours, half of the active substance is excreted (half-life). This excretion takes place via the kidneys (together with the urine).
When is tramadol used?
Tramadol belongs to the opioid painkillers and is used for moderately severe to severe pain. Off-label uses of tramadol include neuropathic pain (nerve pain).
How tramadol is used
However, for severe pain such as tumor pain, the requirement may be higher. For children, adolescents and patients with renal dysfunction, on the other hand, the dosage must be reduced.
Tramadol is also frequently combined with other painkillers (for example paracetamol) – the different points of attack can reduce the development of pain and the sensation of pain even better.
What are the side effects of tramadol?
Less commonly, there are appetite changes, tremors, blurred vision, hallucinations, allergic reactions, or muscle weakness.
What should be considered when taking tramadol?
Contraindications
The active substance tramadol must not be taken by:
- poisoning with centrally acting substances (alcohol, psychotropic drugs, sleeping pills, painkillers)
- concomitant use of certain antidepressants (MAO inhibitors such as tranylcypromine, moclobemide or selegiline)
- inadequately controlled epilepsy (seizure disorder)
Drug interactions
The simultaneous intake of drugs that are also degraded via the CYP2D6 and CYP3A4 enzymes may enhance or weaken the effect of tramadol. People with a congenital CYP2D6 deficiency are not able to convert tramadol into its active form (only this has an analgesic effect).
The blood-thinning effect of coumarin derivatives such as warfarin (anticoagulants) may be increased by tramadol, so blood coagulation levels should be monitored more closely during use.
Trafficability and operation of machines
Age restriction
Tramadol is approved for the treatment of moderately severe to severe pain conditions from the age of one year. Slow-release dosage forms (release tramadol with a delay, thus providing a longer duration of action) are only suitable from the age of twelve years.
Pregnancy and lactation
If therapy with other painkillers such as paracetamol and ibuprofen does not work sufficiently, short-term treatment with tramadol is possible during breastfeeding. Caution is advised for infants who suffer from breathing problems – tramadol can make them worse.
How to obtain medication with tramadol
How long has tramadol been known?
The active ingredient tramadol is a derivative of the opium component morphine. The active ingredient was introduced to the German market in 1977 and has been used successfully in pain therapy ever since.
Initially, drugs containing tramadol were more widely used in pain therapy for cancer. In the meantime, they are increasingly used in demand therapy for chronic pain.
