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This medicine contains the active ingredient tramadol hydrochloride, which is a type of medicine called an opioid analgesic or painkiller. Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.
Tramadol mimicks the action of our natural endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain. Therefore, even though the cause of the pain may remain, less pain is actually felt.
Tramadol also works by enhancing the activity of neurotransmitters in the brain and spinal cord. Neurotransmitters are chemical compounds that act as chemical messengers between the nerve cells. Tramadol enhances the effect of the neurotransmitters serotonin and noradrenaline, and this action also helps relieve pain.
Tramadol is a fairly strong painkiller that is used in the management of moderate to severe pain.
What is it used for?
- Treatment and prevention of moderate to severe pain.
Warning!
- This medicine may cause drowsiness. If affected do not drive or operate machinery. Alcohol should be avoided.
- Some people may rarely experience withdrawal symptoms when they stop taking this medicine. These may include feeling agitated, anxious, nervous or shaky, or having difficulty sleeping. Tell your doctor if you experience any of these symptoms after stopping this medicine. These effects usually disappear after a few days.
- This medicine is not recommended for children under 12 years of age.
- This medicine is not recommended for people with severely decreased kidney function.
Use with caution in
- Asthma
- Decreased kidney function
- Elderly people
- Head injury
- History of convulsions, eg epilepsy
- History of drug dependence or abuse
- Increased pressure in the brain (raised intracranial pressure)
- Reduced blood flow to vital internal organs (shock)
- Severely decreased liver function
- Slow, shallow breathing (respiratory depression)
Not to be used in
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine during pregnancy has not been established. The manufacturer therefore advises that it should be avoided during pregnancy. Seek medical advice from your doctor.
- This medicine passes into breast milk. Women who are breastfeeding should not use this medicine. Seek medical advice from your doctor.
Label warnings
- This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Headache
- Blurred vision
- Dry mouth
- Changes in mood
- Slow, shallow breathing (respiratory depression)
- Confusion
- Sweating
- Nightmares
- Muscle weakness
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- False perceptions of things that are not really there (hallucinations)
- Awareness of your heartbeat (palpitations)
- Dizziness
- Problems with urinating
- A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension)
- Skin reactions such as rash and itch
- Increased heart rate (tachycardia)
- Drowsiness
The side effects listed above may not include all of the side effects reported by the drugs manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
You should tell your doctor or pharmacist what medicines you are using, particularly those listed below, before you start treatment with this medicine. This includes those bought without a prescription and herbal medicines. Likewise, check with your doctor or pharmacist before starting any new medicines while you are taking this medicine.
The manufacturer states that this medicine should not be taken at the same time as, or within two weeks of, MAOI antidepressants such as phenelzine or tranylcypromine.
There may be an increased risk of convulsions or seizures if this medicine is taken with SSRI antidepressants (eg fluoxetine) or tricyclic antidepressants (eg amitriptyline).
If this medicine is taken with SSRI antidepressants such as fluoxetine, or triptans for migraine such as sumatripitan, there may also be an increased risk of other side effects, as both medicines enhance the activity of serotonin in the brain.
There is an increased risk of drowsiness and sedation if this medicine is taken with other medicines that can cause drowsiness, such as the following:
- tricyclic antidepressants, eg amitriptyline
- other opioids, eg codeine, morphine
- benzodiazepines, eg diazepam
- sedating antihistamines, eg chlorpheniramine
- sleeping tablets.
Carbamazepine may decrease the blood level of tramadol, which may make it less effective at relieving pain. If you are taking carbamazepine your doctor may therefore need to prescribe you a larger dose of tramadol.
Tramadol may enhance the anti-blood-clotting effect of anticoagulant medicines such as warfarin. If you are taking warfarin your blood clotting ti
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