Introduction
Tramundin® is a drug from the group of opioids and is used for the treatment of moderate to severe pain of various causes due to its analgesic effect. It is not a pure opioid, as it also exerts its analgesic effect via another mechanism similar to that of antidepressants. Tramadol is the active ingredient of the drug, which is marketed under the trade name Tramundin®.
The active ingredient is available in the form of tablets, capsules, fused or effervescent tablets and drops, although the dosages may vary depending on the dosage form. Chemically, the active ingredient is usually present in salt form as tramadol hydrochloride, a white, crystalline powder that is readily soluble in water. Tramundin® is available only on prescription in Germany and may only be taken on a doctor’s prescription.
Mode of action
Tramundin® acts on a central level. As is usual with opiates, the drug binds to specific receptors in the brain and spinal cord and reduces the transmission of pain stimuli within the nervous system. As a result, weakened pain signals reach the brain and the patient perceives less or no pain.
Instead, the flow of electrical information is partially interrupted at the contact point between two nerve endings. Another mode of action also leads to pain inhibition. This stimulates the otherwise very sparse release of the body’s own opioids.
This occurs as a result of an increase in the concentration of the messenger substance noradrenalin in the gap between two nerve endings (synapse), which leads to an amplification of the signal. Normally, the regulation of the signals takes place through a resumption of the messenger substances by the nerve cells themselves. Tramundin® attacks here and prevents the reabsorption of noradrenalin. Therefore, many antidepressants have an additional pain-inhibiting effect in addition to the actual mood-lifting effect.
Application
Tramundin® is used for moderate to severe, persistent pain. The prescription of the drug should be subject to the condition that other non-opioid analgesics have been tried before and that no sufficient pain relief could be achieved. Treatment with more tolerable active ingredients such as Aspirin® or paracetamol should always be preferred.
Due to its dual mechanism of action, Tramundin® is particularly suitable for the treatment of nerve pain (neuralgia) and related disorders because they affect central or peripheral nerves. These include neuropathic pain such as that which can occur after shingles. This is also known as post-herpetic zoster neuralgia.
It involves reactivation of a herpes virus (varicella zoster virus) in nerve cords of the spinal cord. This late complication occurs more frequently with increasing age and very severe, permanent pain can occur in the affected area, which remains even after the skin condition has healed. Fibromyalgia (soft tissue rheumatism) is another clinical picture for which Tramundin® is more frequently used as a pain medication.
It is a non-inflammatory disease which manifests itself in chronic pain all over the body, exhaustion and numerous other complaints. Many non-opioid substances have been shown to be ineffective in inhibiting the pain of fibromyalgia and are therefore excluded from the therapy. The reason for this lies in the different targets of the drugs. The group of so-called non-steroidal anti-inflammatory drugs, as the name suggests, target the inflammation and inhibit the pain by intervening in the inflammatory process.
