When is caution required in the administration of Tramadol?
- If you think you are over-taking other pain relievers
- if you suffer from disturbances of consciousness (if you feel faint);
- if you are in a state of shock (cold sweats may be a sign);
- if you have increased pressure in the brain (possible after head injury or brain disease);
- if you have difficulty breathing;
- if you have a tendency to epilepsy or seizures;
- if you suffer from liver or kidney disease;
in these cases, discuss this with your doctor before taking.
Patients who react with particular sensitivity (for example with seizures) to potent analgesics of the so-called opioid type should use Tramadol only with caution.
Seizures have been reported in patients taking tramadol at recommended dosages. The risk may increase when tramadol dosages exceed those recommended, beyond the daily limit dose of 400 mg.
Remember that Tramadol can cause psychic and physical dependence. When Tramadol is administered for a long time, its effect may decrease, therefore higher doses should be administered (tolerance development). In patients with a tendency to drug abuse or drug dependence, treatment with Tramadol should be performed quickly and under very close medical supervision.
Tell your doctor if any of these problems occur during treatment with Tramadol or have occurred previously.
How to use Tramadol?
Tramadol is available in Tramadol in the form of two-layer tablets with prolonged release of the active ingredient. This means that the active ingredient tramadol reaches the body slowly but continuously, so its effect lasts longer. Therefore, as a rule, Tramadol two-layer tablets are taken only twice a day (in the morning and in the evening).
Always take Tramadol according to the doctor's instruction. If you are unsure, consult your doctor or pharmacist.
The dosage should be adapted to the intensity and its perception of pain. In principle it is recommended to always choose the lowest effective dose. Do not take more than 4 two-layer tablets of Tramadol 100 mg or 2 two-layer tablets of Tramadol 200 mg per day (corresponding to 400 mg tramadol hydrochloride), unless your doctor has instructed you otherwise. .
Unless otherwise prescribed by the doctor Tramadol - regardless of meals - should be taken as follows:
Adults and adolescents over 14 years of age
Take 1 double-layer tablet Tramadol 100 mg or 1 double-layer tablet Tramadol 150 mg or 1 double-layer tablet Tramadol 200 mg as a single dose with a sufficient amount of liquid, in the morning and evening.
Based on this recommended normal dosage, the intervals between administrations can be adapted to individual needs, but with a minimum interval of not less than 6 hours.
If your doctor has prescribed a fixed dosing schedule, please adhere to it exactly.
Children under the age of 14
Tramadol is not recommended for children under 14 years of age.
In older people (over 75 years) the elimination of tramadol may be delayed. If this applies to you, your doctor may advise you to lengthen the interval between doses.
Patients with severe hepatic or renal insufficiency/dialysis
In case of hepatic and / or renal insufficiency your doctor may advise you to lengthen the interval between one dose and another.
Duration of employment
Tramadol should not be taken longer than necessary. In the case of long-term therapy with Tramadol, your doctor will check at short intervals (possibly including breaks in the therapy) whether, and to what extent, the administration of Tramadol is still necessary.
If you take more Tramadol than you should
If you accidentally take an extra dose of Tramadol, no negative consequences are normally expected. Take the next dose of Tramadol as prescribed.
In case of very high doses, the following effects may appear: narrowing of the pupils, nausea, drop in blood pressure, rapid heartbeat, cardiovascular collapse, disturbed state of consciousness up to coma (profound loss of consciousness), seizures epileptic type and impaired respiration up to respiratory arrest. If these signs appear, call a doctor immediately!
If you forget to take Tramadol
If you forgot to take Tramadol, the pains may return. Do not take a double dose to make up for a forgotten dose, just take the next doses as planned.
Do not change the prescribed dosage on your own initiative. If you think that the action of the medicine is too weak or too strong, talk to your doctor or pharmacist.
What side effects can Tramadol have?
Nausea and dizziness.
Lightheadedness, headache, vomiting, constipation, dry mouth, sweating and fatigue.
Influence on circulation (palpitations, paroxysmal tachycardia, tendency to collapse up to actual collapse).
These side effects may occur especially when standing and in physically stressed patients. In addition, retching, gastrointestinal irritation (e.g. stomach weight, fullness, diarrhea), and skin phenomena (e.g. itching, rash, sudden redness) may occasionally occur.
Slow heart beat (bradycardia), increased blood pressure, muscle weakness, involuntary muscle spasms, coordination disturbances, changes in appetite, urination disturbances, changes in skin sensation (e.g. tingling, pricking, numbness), tremor, speech disorders, dilation of the pupils (mydriasis), narrowing of the pupil (miosis) and blurred vision.
If the recommended dosage is exceeded and at the same time other medications are used that have a depressing effect on certain brain functions (for example sedatives and sleeping pills, psychotropic drugs) a depressing effect on breathing may appear. Epileptic seizures have been reported, mainly when high doses of tramadol are taken or when combined with medications which, in turn, can cause seizures (e.g. antidepressants) or lower the seizure threshold.
Also rare are: psychic effects such as hallucinations, mental confusion, delirium, apprehension, sleep disturbances and nightmares.
Psychic disorders can differ from one person to another in type and intensity (depending on the personality and duration of treatment). These may be changes in mood (generally euphoric, occasionally irritated), changes in activity (generally decreasing, occasionally increasing) and changes in decision-making behavior or perception disturbances.
Addiction may appear. Withdrawal symptoms may occur at the end of treatment, see also section 'When is caution required in the administration of Tramadol?'.
Cases of worsening of asthma have been reported.
Very rare allergic reactions have appeared, eg. skin rashes, breathlessness, "whistling" sounds when breathing, swelling of the skin and mucous membranes (angioneurotic edema) and shock. Consult a doctor immediately if you notice any problems such as swelling of the face, tongue and / or throat and / or difficulty in swallowing or skin rashes and, at the same time, difficulty in breathing.
Very rare increases in liver enzyme values which can signal liver problems.
Frequency not known : decrease in blood glucose level.
If you notice any side effects, please contact your doctor or pharmacist, especially if they are side effects not described in this leaflet.