Sometimes we experience unbearable pain. There are times when ordinary painkillers cannot control the pain. That is when doctors prescribe a stronger painkiller like Tramadol. If you use this medicine, it is very important to be fully aware of it and use it very carefully. So today, let's talk about Tramadol.
What is Tramadol?
Simply put, tramadol is a medication that is used to control severe pain . Doctors usually prescribe it when other painkillers have failed or when the body cannot tolerate the medication.
It works by blocking pain signals to our brain. That is, it stops the message from the source of the pain to the brain. This reduces the amount of pain we feel. Tramadol belongs to a class of drugs called opioids . Since these are very strong painkillers, they should only be used with caution and under medical supervision.
Things you need to tell your doctor before taking this medicine
Before you start using tramadol, it is important to give your doctor a complete description of your health condition. Be sure to tell them if you have any of the following conditions:
- If you have a brain tumor.
- If you are a regular drinker.
- If there is a head injury.
- If you have kidney disease.
- If you have liver disease.
- If you have a lung or respiratory disease such as asthma.
- If you have epilepsy or seizures.
- If you have any problems with your stomach or intestines.
- If you have a substance use disorder.
- If you or a family member has a history of suicidal thoughts, plans, or attempts.
- If you have used an MAOI (e.g. Marplan, Nardil, Parnate) medication within the past 14 days.
- If you have an allergic reaction to tramadol or any other medicine, food, or dye.
- If you are pregnant or trying to get pregnant.
- If you are a mother who is breastfeeding your child.
Do not hide this information from your doctor, as this information is very important in deciding whether this medication is right for you or not, and if so, in what dosage.
How exactly do you use this medicine?
This medicine comes in the form of a solution. Therefore, it is to be taken orally. Be aware of these points when using this.
- Accurate measurement: Measure and drink the exact amount your doctor has prescribed. You will receive a special measuring cup, oral syringe, or spoon with the medicine. Do not measure with teaspoons or tablespoons at home. They are not accurate. If you do not have access to such a measuring device, ask your doctor about it.
- Taking with food: This medicine can be taken before or after meals. However, if you experience stomach upset, it is best to take it with food.
- Dosage: Do not take more than the prescribed dosage as prescribed by your doctor. Take the prescribed dosage at the prescribed time.
- Stopping: Continue taking the medicine for as long as your doctor tells you to. Do not stop taking the medicine suddenly. If you do stop, there is a way to do it. Your doctor will advise you about this.
- Special Instructions: You will receive a special instructions leaflet (MedGuide) when you are given the medicine. Read it carefully every time.
What if there is an emergency? - Overdosage
If you think you have taken more than the prescribed dose, it is an emergency. Do not delay. Immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Most importantly: This medicine has been prescribed for you only. Never give this medicine to anyone else, not even a friend. It could cause serious harm.
What to do if you miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at the same time to make up for a missed dose.
Other medications that may interact with tramadol
Tramadol is a drug that can interact with other medications and substances, so it is very important to tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
| Drugs that should never be taken together with tramadol | |
|---|---|
| Linezolid | Methylene blue |
| MAOIs (e.g. Marplan, Nardil, Parnate) | Ozanimod |
| What can be reacted to? | Examples |
|---|---|
| Alcohol | Any type of alcohol. |
| Medicines for allergies, coughs, and colds (Antihistamines) | Like Piriton, Cetirizine. |
| Medication for anxiety or sleep | Such as Diazepam, Alprazolam. |
| Some medications for depression | Such as Amitriptyline, Fluoxetine, Sertraline. |
| Some antibiotics and antifungals | Such as Erythromycin, Ketoconazole. |
| Some medications for migraines | Such as sumatriptan. |
| Some medications for seizures | Such as Carbamazepine, Phenobarbital. |
| General anesthetics for surgery | Like Propofol. |
| Other opioid painkillers | Like Morphine, Pethidine. |
| Warfarin (a blood thinner) | This can increase the risk of bleeding. |
This list is not complete, so tell your doctor about all the medications you are taking.
Things to keep in mind when taking this medicine
It is very important to pay attention to your body while using tramadol.
Pain and tolerance
When you use this medicine for a long time, your body may get used to it. This is called tolerance . Then, the previous dose may not be enough to relieve your pain. This is normal. If your pain does not go away, gets worse, or you have a different type of pain, do not increase the dose on your own and tell your doctor.
Sleepiness and other things
Tramadol can cause drowsiness and dizziness. Taking tramadol with alcohol, sleeping pills, or other opioids can increase drowsiness and even cause shortness of breath, which can be serious. Therefore, avoid drinking alcohol completely while taking this medication.
If you have difficulty breathing or are so sleepy that you can't wake up, it's an emergency. Go to a hospital immediately.
Drug addiction and withdrawal
When used for a long time, the body can become dependent on this medicine. This can happen even if you take it as prescribed by your doctor. This is why it is advised not to stop taking the medicine suddenly. If you do, you may experience withdrawal symptoms such as restlessness, body aches, and sweating. If your doctor decides to stop taking the medicine, the dose will be gradually reduced.
Overdose and Naloxone
An opioid overdose can be life-threatening. It can cause things like breathing problems and loss of consciousness. Naloxone is a medicine used as an emergency treatment for an opioid overdose. Be aware of the symptoms of an overdose (difficulty breathing, extreme sleepiness, inability to wake up).
Driving and operating machinery
This medicine may reduce your concentration and ability to make decisions. Therefore, avoid driving or operating dangerous machinery while taking tramadol. Get up slowly, as you may feel dizzy when you stand up suddenly from a sitting position.
Possible serious skin reactions
Rarely, some people may develop a serious skin reaction to tramadol. This can happen weeks after starting the medication. If you have a red rash, blisters, or peeling skin along with fever, body aches, or swollen lymph nodes in your face, lips, neck, or armpits , see your doctor right away.
Constipation and dry mouth
A common side effect of tramadol is constipation. If you have not had a bowel movement for 3 days, tell your doctor. To treat this , drink plenty of water and eat more fiber-rich foods (fruits and vegetables).
Chewing sugar-free gum and drinking plenty of water can help with dry mouth.
Pregnancy, breastfeeding and fertility
Taking tramadol for a long time during pregnancy may cause temporary withdrawal symptoms in the unborn baby. If a breastfeeding mother is taking this medicine, watch the baby closely for excessive sleepiness and difficulty breathing. Talk to your doctor about all of these.
What are the possible side effects?
Like any medication, tramadol can cause side effects. Some are serious, while others are common.
| Side effect | Description |
|---|---|
| Side effects that should be reported to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS depression) | Slow or shallow breathing, excessive sleepiness, difficulty waking up, loss of consciousness. |
| Low adrenal gland function | Nausea, vomiting, loss of appetite, unusual weakness, dizziness. |
| Low blood pressure | Dizziness, fainting, blurred vision. |
| Blistering or peeling of the skin | Redness, blistering, or peeling of the skin, including inside the mouth. |
| Seizures | A sudden seizure. |
| Side effects that should be reported to the doctor if they persist or are bothersome | |
| Constipation | Dizziness |
| Drowsiness | Dry mouth |
| Headache | Nausea and vomiting |
How to store and dispose of medicine safely?
Because this is a very powerful medicine, special care must be taken to store and dispose of it safely.
- Keep away from children and pets. Store in a safe place where they cannot see or touch it.
- Throw away expired or no longer needed medicine. This medicine can be fatal if taken by another adult, child, or pet.
- The best way to get rid of medication is to hand it over to the drug take-back programs available at government hospitals or some pharmacies.
- If that's not possible, take the medicine out of the bottle, mix it with something like used coffee grounds, soil, or cat litter, put it in a tightly sealed plastic bag, and throw it in the trash.
- Never flush anything down the toilet without consulting your doctor.
Take-Home Message
- Tramadol is a powerful painkiller, so use it only as directed by your doctor, in the amount prescribed.
- This medicine is for you only. Never share it with anyone else.
- Inform your doctor about all other medications, vitamins, and supplements you are taking.
- Seek immediate medical attention if you experience serious side effects such as excessive drowsiness, difficulty breathing, or skin rash.
- Store the medicine in a safe place out of the reach of children and pets , and dispose of it properly when not needed.
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