Tramadol fights severe pain

Tramadol is a pain reliever used to combat moderate to severe pain. However, the active ingredient only combats the symptoms, not the cause of the pain. Tramadol is available in the form of tablets, drops and suppositories, but also as injections and infusions. Just like other painkillers, tramadol also has side effects: It should be noted in particular – even if this side effect is relatively rare – that taking tramadol regularly can lead to addiction.

Tramadol: anti-pain effect

Tramadol belongs to the group of opioid painkillers. The main active ingredient in this group is morphine. Opioid painkillers are used to treat moderate and severe pain – milder pain, on the other hand, is treated with non-opioid painkillers such as  paracetamol  or  acetylsalicylic acid  .

For moderate pain, weaker opioid drugs 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 around four times weaker – however, the mode of action of the two substances is very similar.

After ingestion, tramadol unfolds its effect in the brain by docking to the opioid receptors there. The body’s own messenger substances, which inhibit the perception of pain, normally act on these receptors. 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 felt to be minor after ingestion.

influence on pain perception

In addition, tramadol has a second mechanism of action: the active ingredient also inhibits the reuptake of  serotonin  and noradrenaline in the brain and in this way influences pain perception. In this respect, tramadol is similar to some antidepressants, such as tricyclic antidepressants.

Tramadol takes effect about 30 minutes after taking the painkiller. 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 doctor treating you, depending on factors such as the degree of illness, the perceived pain level, as well as age and weight.

Side effects of tramadol

As with the other active ingredients from the group of opioid painkillers, taking tramadol is also associated with side effects. The most common side effects include  nausea  and dizziness. Likewise, headaches, drowsiness , dry mouth, vomiting,  constipation  and sweating can often occur after ingestion  .

Occasionally, the painkiller also has an effect on the cardiovascular system: Side effects such as palpitations, accelerated heartbeat, circulatory fluctuations or circulatory collapse can occur. Diarrhea , skin rash and  itching can also occasionally   occur. On the other hand, side effects such as breathing disorders, rise in blood pressure, delusions, confusion and changes in appetite occur only rarely after using tramadol.

Risk of dependency low

Also rare are the cases in which taking tramadol leads to dependence. Dependence occurs especially when the active ingredient is taken over a longer period of time. However, even after prolonged use, the risk of becoming dependent is relatively low. If there is a dependency,  withdrawal symptoms  such as sweating and freezing as well as gastrointestinal problems can occur after the end of the treatment.

Before taking the painkiller, you should always ask your doctor or pharmacist about possible side effects and read the package leaflet carefully.

Tramadol: contraindications and interactions

Like all other active ingredients, tramadol should not be used if there is hypersensitivity to the substance. In addition, the painkiller must not be used if you have previously taken alcohol, psychotropic drugs,  sleeping pills  or other painkillers, as the substances can mutually reinforce their mode of action. Another contraindication is taking MAO inhibitors within the past two weeks, as otherwise life-threatening side effects can occur.

In  the case of epilepsy  , tramadol should be avoided, especially if the disease is not under control. Because taken regularly and in higher doses, the active ingredient can increase the risk of an epilepsy attack. It should also be noted that the epilepsy drug carbamazepine reduces the effectiveness of tramadol.

In addition, tramadol should not be combined with active substances that lower the threshold for epileptic seizures. These drugs include tricyclic antidepressants and selective serotonin reuptake inhibitors. In combination with the latter, serotonin syndrome can also occur in rare cases.

Caution with impaired liver or kidney function

Likewise, tramadol should not be used if blood-thinning medication is being taken, because the active ingredient also has an effect on blood clotting. Tramadol should also be avoided when taking the antifungal agent ketoconazole and the macrolide antibiotic erythromycin.

If there is impaired liver or kidney function, tramadol should only be taken after consultation with the doctor treating you. The same applies to disturbances of consciousness, breathing disorders, states of shock and diseases of the brain and increased intracranial pressure.

In patients who are hypersensitive to opioids or who are prone to drug abuse, tramadol should also only be used after detailed advice from the treating physician. The painkiller is not suitable as a substitute drug for people who are dependent on opiates, as it cannot mask the withdrawal syndrome.

Tramadol during pregnancy

If possible, tramadol should not be used during pregnancy. Especially if the painkiller is taken regularly, the newborn can experience withdrawal symptoms. If treatment with opioid painkillers is unavoidable during pregnancy, this should be limited to single doses of tramadol.

If possible, the active ingredient should also not be taken during breastfeeding. However, since only very small amounts of the painkiller pass into breast milk, breastfeeding can still continue after taking tramadol once.

In children under the age of twelve, tramadol should only be used in the form of drops, since a low dose can also be administered in this form. Tablets are only recommended for children over the age of twelve, suppositories are only suitable for children over the age of 14.


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