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Updated by secure pharmacare on Mar 11, 2020
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Uses. This combination medication is used to relieve moderate to severe pain. It contains an opioid (narcotic) pain reliever (hydrocodone) and a non-opioid pain reliever (acetaminophen). Hydrocodone works in the brain to change how your body feels and responds to pain. Acetaminophen can also reduce a fever.


Tramadol For Back Pain Dosage

Tramadol For Back Pain Dosage

Generic Name: tramadol (TRAM a dol)
Brand Names: ConZip, Ultram, Ultram ER

*What is tramadol?

Tramadol is a narcotic analgesic.

Tramadol is used to treat moderate to severe pain in adults.

Tramadol for back pain dosage: Tramadol extended release is almost the treatment of pain. The sustained-release form of tramadol is not intended for use when needed for pain.

How should I take tramadol?

Take tramadol exactly as prescribed. Follow all instructions on your prescription label. Tramadol may slow down or stop your breathing, especially when you start using this medication or whenever your dose changes. Do not take this medicine in case of overdose or longer than expected. Tell your doctor if the medication stops working while relieving your pain.

Tramadol can cause addiction, even at regular doses. Never share this drug with anyone, especially with a history of addiction or addiction. Pain, treatment, death or death may occur in a particular child or other person using the drug without medication. Selling or giving this medicine is illegal.

When you start taking tramadol, stop taking all other analgesics.

Tramadol can be taken with or without food, but take it in the same way every time.

Do not crush, break, or open tablets or prolonged-release capsules (Conzip, Ultram ER). Swallow it to avoid exposure to a potentially lethal dose. (tramadol for back pain dosage)

Never inject the powder or mix it in liquid or fluid to inject the drug. This practice resulted in death.

If you are using tramadol extended-release tablets, the tablet shell may enter your stool (stool). This is normal and does not mean that you do not get enough medicine.

Do not stop using this medication abruptly or you may have unpleasant withdrawal symptoms. Ask your doctor how to use this medicine safely.

Store at room temperature. Keep away from moisture and heat. Keep an eye on your medications. Tramadol is an abusive drug and you need to know if someone is using your medicine inappropriately or without a prescription.

Do not take any other opioid medication. Accidental or improper use of this medication may result in death in one dose. Ask your pharmacist where to locate the drug elimination program. If there is no salvage program, mix the remaining medications with cat litter or coffee grounds in a closed plastic bag and dispose of the bag in the trash. (tramadol for back pain dosage)

What happens if I miss a dose?

Because tramadol is used to relieve pain, you probably won't miss a dose. Ignore any missed dose if it is almost time for your next scheduled dose. Do not take additional medicine
Forget to make up for the dose.

What happens if I overdose?

Consult an emergency physician or call the poison helpline at 1-850-253-7137. An overdose of tramadol can be fatal, especially in using a child or other person.
Non prescription medicine. Symptoms of an overdose may include slowing of heart rate, severe drowsiness, cold, clammy skin, very slow breathing, or coma.

What should I do while taking tramadol?

Do not drink alcohol Dangerous side effects or death may occur.

This medicine may change your thinking or your reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Tramadol side effects

If you have an allergic reaction to tramadol (hives, difficulty breathing, swelling of face or throat) or if you have severe skin reaction (fever, sore throat, eye irritation, skin pain, red skin) Signs are or purple) rash that spreads and causes blisters and peeling).

Like other drugs, tramadol can slow your breathing. If breathing becomes very weak then death can occur.

If you have long breaks, blue lips, or if you have trouble waking up, breathing slowly, then you should consult an emergency doctor.

Call your doctor immediately if you have:

Noise breathing, sighing, shallow breathing, breathing that stops during sleep;

Slow heart rate or weak pulse;

A light-headed spirit, such as you may lose consciousness;

Seizure (cramps);

Missed rules;

Impotence, sexual problems, loss of interest in sex; Or

Nausea, vomiting, loss of appetite, dizziness, fatigue or aggravated weakness.

If you experience symptoms of serotonin syndrome, seek immediate therapy, such as: agitation, hallucinations, fever, sweating, shivering, rapid heartbeat, muscle tightness, muscle contraction, loss of coordination, nausea, Vomiting or diarrhea.

Serious side effects may be greater in the elderly and overweight, undernourished or vulnerable.

Prolonged use of opioid medications may affect fertility (ability to have children) in men or women. It is not known whether the effect of opioids on fertility is permanent.

Common side effects of tramadol may include:

Constipation, nausea, vomiting, abdominal pain;

Dizziness, [drowsiness]([1-850-253-7137](, fatigue

Headache, or


What will be the effect of tramadol?

If you need to start or stop taking other medications, you may have symptoms of shortness of breath or withdrawal. Tell your doctor if you are using an antibiotic, antifungal, heart medication or high blood pressure, antiepileptic drug or a medicine to treat HIV or hepatitis C.

Tramadol may interact with many other drugs and cause dangerous or life-threatening side effects. Make sure your doctor knows if you are also using:

Cold or allergy medications, bronchodilator for asthma / COPD, or diuretic ("water pill");

Drugs for motion sickness, irritable bowel syndrome or overactive bladder;

Other narcotic drugs - prescription opioid analgesics or cough suppressants;

A sedative such as valium - diazepam, alprazolam, lorazepam, Xanax, klonopin, Versed and others;

Drugs that make you sleepy or slow down your breathing - sleeping pills, muscle relaxants, mood and mental health medications Or tramadol for back pain dosage.

Drugs that affect serotonin levels in your body - a stimulant or medication for depression, Parkinson's disease, migraines, serious infections, nausea and vomiting.enter link description here


What is Tramadol used to treat?

What is Tramadol used to treat?

Brand names: Ultram, Ultram ER, Rezolt, Conzip
Generic Name: Tramadol
Drug class: analgesic opioids

What is Tramadol used to treat?

Tramadol is an oral medication that is used to help relieve moderate to severe pain. Tramadol is similar to opioid analgesics (alcoholics). It works in the brain to change the way your body feels and reacts to pain.

Tramadol is a narcotic analgesic oral medication that is used to treat moderate to severe pain in adults.

The extended-release tablet formulation of this medication is used to treat moderate to severe chronic pain when treatment is required throughout the day.

This medication must be prescribed by a doctor and is available only by prescription.

Patients taking this medication should alert their doctors about any problems arising from the use of this medication and about any side effects or unusual side effects of symptoms or discomfort.

Care should be taken to specify that this medication is prescribed at all.

The risk of addiction is generally high for most opioid medications. However, the risk of becoming addicted to tramadol is not high.

Read the Patient Health Information Sheet that completes the prescriptions for this medication, as well as always. There might be new health care data.

Tramadol is available under the following different brands: Ultram, Ultram ER, Rezolt and Conzip.


Oral dosage
- Adulteration: 5-15 drops or 1-3 drops of fluid extract.

Dosage forms for adults and strength

Tablet: Annex IV
- 50mg

Restructured suspension
- 10 mg / ml

Capsules, extended version: Annex IV

  • 100 mg (Conzip, Ultram ER)
  • 150 mg (ConZip)
  • 200 mg (Conzip, Ultram ER)
  • 300 mg (Conzip, Ultram ER)

    Pediatric dosage forms and strengths:
    Tablet: Annex IV
    50 mg oral dose
    Restructured suspension
    10 mg / ml

Dose consideration
Oral extended-release capsules or tablets should not be chewed, crushed, broken or fractured. Also combined with acetaminophen.

Moderate to severe pain
Immediate release

  • Chronic: Initially oral dose of 25 mg every morning; 25–50 mg / day every 3 days orally every 4–6 hours for an increase of 50–100 mg, as needed; Do not exceed 400 mg / day

  • Acute: oral dose of 50–100 mg every 4-6 hours, as required; Do not exceed 400 mg / day

Long continued dose

  • 100 mg once a day initially; Increase of 100 mg / day every 5 days; Not to exceed 300 mg / day
  • Conversion from immediate release to longer release: round the total daily dose to 100 mg
  • Do not chew, crush, split or dissolve

Dose modification

Severe renal impairment (CrCl less than 30 ml / min): immediate release, 50–100 mg orally every 12 hours; Extended release not recommended

Severe liver impairment: immediate release, 50 mg oral tablets every 12 hours; Extended release not recommended

*Pediatric Dosage Considerations

** Immediate release

  • Treatment for patients under 17 years of age: safety and efficacy not established
  • For patients 17 years and older (acute) treatment: oral tablets 50–100 mg every 4-6 hours, as needed; Do not exceed 400 mg / day
  • Treatment for patients 17 years and older (older): Initially 25 mg oral tablets every morning; Increase orally every 4–6 hours as a separate dose to 50–100 mg every 3 days from 25–50 mg / day, as needed; Do not exceed 400 mg / day

Extended release tablets

Treatment for children under 18: Safety and efficacy not established. This can pose a health risk.
Geriatrics dosage forms and strengths:

Treatment for children under 65 years: starting at the lower end of the dose range; It should not exceed 300 mg / day if it is over 75 years old.

Treatment for children under 75 years: should not exceed 300 mg of medication per day; Immediate release; Be very careful with the extended-release formulation of this medicine.

SIDE EFFECTS (What is Tramadol used to treat?)


If your doctor is using this medication to treat your pain, then your doctor or pharmacist can now find out about possible medications and control them. Do not start, stop or change the dose of any medication before checking with your doctor, healthcare provider or pharmacist.

Serious interactions of Tramadol include:

Tramadol has serious interactions with at least 49 different medications.

Tramadol has moderate interactions with at least 269 different medications.

Mild intake of tramadol includes:

This information does not include all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Contact your healthcare professional or doctor for additional medical advice, or if you have or have health questions, concerns or more information about this medicine.

WARNINGS AND PRECAUTIONS( What is Tramadol used to treat? )

This drug contains tramadol. Do not take Ultram, Ultram ER, Rezolt or Conzip if you are allergic to tramadol or any of the ingredients contained in this medicine.

Keep out of reach of children. In case of an overdose, seek medical attention or contact a poison control center immediately.

Contraindications include hypersensitivity to tramadol or opioids. Known or suspected gastrointestinal obstruction, including paralytic ileus. Simultaneous use of monoamine oxidase inhibitors (MAOIs) or use over the past 14 days.

Effects of drug abuse

Potentiating opioid addiction, abuse and risk of misuse, which can cause overdose and death; Evaluate each patient's risk before routinely prescribing and monitoring all patients for the development of these behaviors or conditions.

Short term effect

No one.

long term effects

No one.

Pregnancy and breastfeeding

Pregnancy: Prolonged use of opioid analgesics during pregnancy for medical or non-medical purposes may cause physical dependence in neonatal and neonatal withdrawal syndrome immediately after birth.

Medical professionals should inspect and monitor newborns for signs of neonatal opioid withdrawal.

Neonatal seizures, neonatal withdrawal syndrome, fetal death and fetal death with tramadol have been reported during use after approval of tramadol immediate release products.

Breastfeeding: Excessive sedation through breast milk, monitored children for respiratory depression or other health problems; Maternal administration of an opioid analgesic is suspended or when breastfeeding is suspended, there may be withdrawal symptoms in breastfed babies.

Talk to your doctor if you have any questions about pregnancy and breastfeeding while taking this medicine.


Tramadol Recreational Dosage

Tramadol Recreational Dosage

I have never prescribed tramadol. I have been told that it is a terrible drug for various reasons. In Canada, everyone seemed to agree. But then I moved to New Zealand.

During my orientation in New Zealand, I was told that unlike North America, very few patients were on opioids. However, during my first few days, tramadol was placed on the drug list. It was used to relieve chronic pain, osteoarthritis, headaches and ankle strain. It was used daily by many patients with known epilepsy (which was presented to the emergency department after a seizure). Overall, I do not see any difference in the rate of opioid use, at least compared to Canada. I only use different opioids, with tramadol in mind.

I came to New Zealand to learn. To see how medicine is practiced in a different country. I was hoping to see different practices that could open my eyes to a dogma that I could find in the way I practiced medicine. These differences will likely occur in several blog posts over the next year. However, after reviewing the literature on tramadol, I must say that my initial teaching was correct. Tramadol is a terrible drug that I will probably never prescribe.

A little pharmacology

Tramadol is an opioid, but it does not bind directly to opioid receptors (or at least it binds so weakly that it can not bind at all). Its opioid action is a metabolite (the result of O-demethyltramadol if you really want to know), which means that, like codeine, it must be metabolized via the P450 enzyme before it can act. It is a problem. A significant portion of the population (approximately 3 to 10% among Caucasians) has no activity on the essential enzyme (CYP2D6). As a result, you are prescribing a pain medication that does not relieve pain in some of your patients. On the other hand, there are ultra-metabolisers that reach very high concentrations and high doses of active opioids. (Stammer 2007, Gong 2014, Fortenberry 2019) So, instead of prescribing a known dose of opioid, you play, but your patient is the one who can lose. (That's the only reason that codeine is such a terrible drug.)

To complicate matters, tramadol acts as an inhibitor of serotonin and norepinephrine reuptake (SNRI), although none of its degradation products do. Looking at the side effects of tramadol, it becomes a problem, that I will come back soon.

What you get with tramadol is an unexpected mix of opioid pharmacology and SNRI. Why play? If you want to exercise opioid activity, determine the appropriate dose of morphine. If you think an SNRI is appropriate, write one. Prescribed at least separately, you will get the approximate dose of the drug that you actually want to administer.

The effectiveness

There seems to be a fundamental misconception that determines a lot of tramadol. People seem to want a "weak" opioid without wondering what it really means. Morphine is "weaker" than fentanyl, but clinically, they have the same efficacy because we give 10 mg of morphine, where we can give 100 micrograms of fenenyl. Tramadol is weak in the same way. You need a higher dose to achieve equivalent analgesia. We therefore prescribe 100 mg tramadol when we can use 10 mg of morphine, but at the end of the day they both work on opioid receptors. Both are opioids. Duration If you really want to give a low dose of morphine instead of converting it to tramadol, you can give a lower dose of morphine.

Finally, when medically examined, tramadol is not a very effective analgesic. It has proven to be as effective against acetaminophen against abdominal pain as it is against NSAIDs against biliary colic. (Oguztark 2012, Schmieder 1993) 100 mg tramadol is less than a combination of 5 mg and 500 mg acetaminophen for the relief of acute pain associated with MSK. (Tuturo 1998) for postoperative pain, a meta-analysis showed that the combination of tramadol and acetaminophen was as effective as 400 mg of ibuprofen. (Edwards 2002) A review of 5 RCTs found that tr5 mg tramadol plus 750 mg paracetamol was no more effective than ibuprofen 400 mg. (Priscriere 2003) Several other studies have shown equivalence with ibuprofen. (Romero 2008, Banerjee 2011, Karabayarli 2012)

Overall, tramadol has a limited analgesic effect at commonly prescribed doses (and no analgesic effect for a reasonable percentage of the population due to genetic polymorphisms).


Respiratory depression

Tramadol is an opioid agonist and will therefore have the same opioid-related respiratory depression as all opioids. (2016 Prescriber) However, there is an additional risk due to CYP polymorphisms. Like codeine, some individuals are ultra-metabolisers, resulting in higher doses than expected and respiratory depression, even at normal doses. (Orlyguet 2015, Fortenberry 2019)

Seizures and other neurological disorders

Tramadol is associated with convulsions, both in case of overdose and when taken at normal doses. (2005 2005, Gardner 2012, Ryan 2015) This link seems very clear in case of overdose (although these are always complicated by a possible polypharmacy), but not yet definitive in standard doses. The absolute risk does not seem high, but it is an additional risk that we do not see with morphine, so why take it?

There is also a link between the long-term use of tramadol and neurological disorders such as Alzheimer's disease and Parkinson's disease. (Raj 2019)

Serotonin syndrome

Several cases of tramadol have been reported in serotonin syndrome in combination with other drugs. The absolute risk seems very low.

Drug interaction

Because tramadol requires the CYP2D6 pathway to become an opioid, there may be an unexpected withdrawal of opioids from CYP2D6 inhibitors (among which there are many drugs), while inadvertently increasing IRSN activity.

Hypoglycemia and hyponatremia

Tramadol is associated with hypoglycemia, which is logical given its pharmacological similarity with SNRI (a class of drugs that cause hypoglycaemia). (Fournier 2015) In the subgroup of patients with type 1 diabetes, the rate of hypoglycemia is about 50%. (Golai 2017) Tramadol has also been linked to the risk of hospitalization for hyponatremia. (Fournier 2015)

Relationship with increase in mortality

Although many studies are more pain-relieving than simple NSAIDs, the recently matched correlation of patients treated for osteoarthritis indicated a link between the use of tramadol and increased mortality compared with naproxen, diclofenac. Exhibited. celecoxib and etoricoxib. (Zeng 2019)

Pediatric alert

For the reasons outlined above, the US FDA states that tramadol is contraindicated in patients younger than 12 years of age as well as in patients 12 to 18 years after tonsillectomy. In addition to these severe warnings, the FDA also warns against the use of tramadol in all elderly pediatric patients with obesity or respiratory problems. (Food and Drug Administration 2018)


Although tramadol is often sold as an alternative to non-addictive opioids, this is simply not true. It acts at the level of the opioid receptor like all other opioids and therefore presents a similar risk of dependence and dependence. (Unless you are one of the patients missing the appropriate CYP2D6, in which case you have never actually been given opioids.)

Tramadol is widely misused in the world. At a drug treatment center in Sweden, 95% of patients tested positive for opioids that were positive for tramadol. (Olson 2017) The rate of tramadol use and tramadol-related deaths has been steadily increasing in the UK until the drug is reclassified as a controlled substance. (Chen 2018) In people using tramadol, there are obvious physiological signs of addiction and are assessed in the same way as heroin is used. (Zhang 2013) fMRI evidence that taking tramadol activates areas of the brain that are related to addiction. (Asari 2018) Patients who stop tramadol abruptly also have classic opioid withdrawal symptoms. (Sen 2013) In addition, 1 in 8 patients worsens, with unusual withdrawal symptoms, such as anxiety, panic attacks, insomnia, hallucinations, confusion, paranoia and abnormal sensory changes, likely to be related to the drug's SNRI effects. . (Senay 2013).

Recreational use of tramadol may be better documented in mainstream media than in medical literature. You can read about this mass abuse in Egypt in this article by The Economist. The Wall Street Journal article discusses the abuse of tramadol in Africa and the Middle East.

Overall, abuse and addiction problems with tramadol are probably less important than other opioids. This is likely due to the fact that tramadol has no opioid (or analgesic) effect on a large percentage of the population and other opioids are so readily available. However, tramadol is clearly both addictive and addictive. This is not a reason to choose it over a relatively non-euphoric opioid such as morphine.

The conclusion

There is no logical reason to preserve tramadol. It is an unpredictable drug. Some patients will not get pain relief. There will be higher opioid concentrations than others. This results in addiction, dependence, and misuse like all opioids, but causes more adverse events than other opioids due to its SNRI functions.

If your patient requires an opioid, there is no reason to choose tramadol over morphine.


What is Tramadol Used For in Adults

What is Tramadol Used For in Adults

*About tramadol

Tramadol is a strong analgesic. It is used to treat moderate to severe pain, for example, after an operation or severe injury.
It is also used to treat long-lasting pain when relieving debilitating pain no longer works.
Tramadol is available by prescription only. It comes in pills, capsules and liquid drops that you swallow. It can also be given by injection, but it is usually done in the hospital.

*Key Facts

  • Tramadol works by blocking pain signals that travel along the nerves to the brain.

  • The most common side effects of tramadol are feeling sick and dizzy.

  • It is possible to become addicted to tramadol, but it is rare if you are taking it to relieve pain and your doctor is reviewing your treatment regularly.

  • It is better not to drink alcohol with tramadol, as it is more likely to have side effects such as feeling sleepy.

  • Tramadol is also known as brand Invadol, Larapam, Mabron, Mano, Marol, Maxitrum, Oldaram, Tilodol, Tredorek, Tramquel, Tramulif, Zamadol, Zeridem and Zadol.

*Who can not take tramadol?

Tramadol can be taken by adults and children older than 12 years.
Tramadol is not suitable for some people. If you have, tell your doctor or pharmacist before starting the medicine:

  • Had an allergic reaction to tramadol or any other drug in the past
  • A disease that causes seizures
  • head trauma
  • Addiction to alcohol, strong painkillers or recreational drugs
  • Shortness of breath
  • Kidney or liver problems
  • Other strong pain relievers in the past were reactions

*How and when to take it

It is important to take tramadol as directed by your doctor.
The dosage may vary, but generally you should not take more than 400 mg per day.
Tramadol usually does not cause stomach upset, so you can take it with or without food.

*Different types of tramadol

Tramadol comes in the form of:

  • Rapid functioning pills: contains 50 mg of tramadol
  • Slow-acting pills: Tramadol is 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 300 mg or 400 mg
  • Quick acting capsules: contains 50 mg of tramadol
  • Slow Working Capsules: Contains 50 mg, 100 mg, 150 mg or 200 mg tramadol
  • The drops you swallow contain 100 mg of tramadol in 1 mg of liquid.
  • An injection (usually given in the hospital)
  • Soluble Pills: Contains 50 mg of tramadol
  • Tablets that dissolve in the mouth, contain 50 mg of tramadol.
  • An injection (usually given in the hospital)

Tramadol drops, injections and some pills and capsules are fast acting. They start working within 30 to 60 minutes. They are used for pain that is expected to last a short time. You may only be instructed to take fast-acting tramadol when you need it for pain or regularly. Always follow the instructions given by your doctor.

Some tramadol tablets and capsules are slow release. This means that tramadol is released slowly into your body for 12 or 24 hours. This type of tramadol takes longer to start working, but lasts longer. It is used for prolonged pain.

Your doctor will determine the correct dosage for you, depending on how sensitive your pain is and how strong your pain is. You may have to change your dose several times to find the one that works best for you. In general, you will be prescribed the lowest dose that relieves your pain.

*How much to take

The dosage varies from person to person. Your dose will depend on how strong your pain is, how you have reacted to get relief from previous pain and if you have any side effects.

*How to take it

Fast-acting tramadol comes in capsules, drops and 2 different tablets: soluble and dissolving tablets in the mouth:

  • Capsules: Swallow each capsule with plenty of water.
  • Drops: mix the drops in a glass of water and then drink the entire contents of the glass
  • Soluble tablets: dissolve each tablet in 50 ml (1/2 cup) of water and drink
  • For tablets to dissolve in the mouth: Make sure your hands are dry before handling the tablet. Remove the blister pill and place it on the tongue. Suck the pill, don't chew it. After it melts, drink or drink water. If you want, you can also dissolve the tablet in a glass of water.

Tablets and capsules have a slow release tramadol. It is important to swallow tramadol pills and slow release capsules completely with water.

*When to take it

When to take it depends on the type of tramadol you have been prescribed:

  • Quick-acting pills and capsules, usually 3 to 4 times a day.

  • If you are over 65 or have liver or kidney problems, you may be asked to take tramadol from your doctor.

  • You can take your tramadol at any time of the day, but try to take it at the same time every day and keep the dose even. For example, if you take tramadol twice a day and your first dose is at 8 a.m., take your second dose at 8 p.m.

*What happens if I forget to take it?

This will depend on what type of tramadol you are taking.

If you miss a dose, check the information on the patient information sheet inside the package or ask your pharmacist or doctor about what to do.

Never take 2 doses at the same time to compensate for a mistake.

If you often miss a dose, it may help to set an alarm to remind you. You can consult your pharmacist in other ways to help you remember to take your medicine.

*What happens if I stop taking it?

If you need to take tramadol for a long time, your body may be tolerant of it.

This is not usually a problem, but if you stop taking it suddenly, you may have unpleasant symptoms.

If you want to stop taking tramadol, talk to your doctor first. Usually, your dose will be gradually reduced so that it does not have an unpleasant withdrawal effect.

Tramadol can cause unpleasant withdrawal symptoms if it occurs suddenly, such as:

  • Feel excited
  • Feeling restless
  • Vibration
  • To sweat

*What happens if I drink too much?

Taking too much tramadol can be dangerous.

If you have taken an accidental overdose, you may feel very sleepy, sick or dizzy. You may also have trouble breathing. In severe cases, you may pass out and require emergency treatment in the hospital.

If you have mistakenly taken 1 additional dose, check the information that comes with the medicine packaging or ask your pharmacist or doctor for advice. In general, you should not have any symptoms and can take your next dose as usual.

*Take tramadol with other pain relievers

It is safe to take tramadol with paracetamol, ibuprofen or aspirin (aspirin is suitable for most people 16 years of age or older).

Do not take tramadol with pain relievers that contain codeine that you can buy at the pharmacy. It is LIKE to have side effects.

Some pain relievers that you can buy at pharmacies contain codeine, which is a drug similar to tramadol. Pain relievers that contain codeine that you can buy in pharmacies include co-codamol, Nurofen Plus and Solpidine.

*Side effects

Like all drugs, tramadol can cause side effects, although not everyone receives them. Talk to your doctor or pharmacist if the side effects listed below bother you or do not go away.

*Very common side effects

The most common side effects of tramadol occur in more than 10 people and include:

  • Feeling sick
  • Feel dizzy

*Common side effects

Common side effects of tramadol occur in more than 100 people. Include:

  • Headache
  • Feeling sleepy, tired, dizzy or "flushed"
  • Feeling or getting sick (vomiting)
  • Constipation
  • Dry mouth
  • To sweat
  • Low energy

*Serious side effects

Serious side effects are rare. Call your doctor directly if you meet:

  • Trouble breathing or shallow breathing
  • Dizziness, tiredness and low energy: these can be a sign of low blood pressure
  • Hallucinations (see or hear things that are not there)
  • Confusion
  • A lot of sleep
  • Problems urinating or unable to urinate at all

- Attack (fit)

If you have to go directly to an A&E.

*How to deal with side effects.

What to do about it:

  • Headache: Relax and consume adequate amounts of fluids. It is better not to drink alcohol with tramadol, as it is more likely to have side effects such as feeling sleepy. Ask your pharmacist for painkiller advice. Headaches should usually go away after the first week of taking tramadol. Talk to your doctor if they last more than a week or are severe.

  • Feeling sleepy, tired, dizzy or "spot": These side effects should go away in a week or two as your body gets used to tramadol. Talk to your doctor if they continue for a long time. Do not drink alcohol, as it will make you feel more tired.

  • *Feeling or getting sick (vomiting): *Stay in a normal diet and do not eat garish or spicy food. Taking your tramadol after meals or after meals can help. If you are sick, take small frequent sips of water. If this continues, tell your doctor. They may prescribe an additional medicine to protect your stomach.

  • Constipation: Try to add more fiber to your diet, such as fresh fruits and vegetables and grains. Also try to drink several glasses of water or other soft drinks every day. If you can, it can also help to do some gentle exercise for a swim or a walk. If your symptoms do not go away, talk to your doctor about medications to help prevent or treat constipation caused by tramadol.

  • *Dry mouth: *Try chewing sugar-free gum or sucking sugar-free candy. Your doctor may also prescribe an artificial saliva substitute to keep your mouth moist. It comes in spray, gel or tablet form.

  • Sweat: Try to wear loose clothes, use strong antiperspirant and keep cool using fan if possible. If it does not help and you find it unbearable, talk to your doctor, as you may need to be treated with a different type of painkiller.

  • Low energy: Talk to your doctor, as they can adjust your dose or give you a different painkiller.

*Pregnancy and breastfeeding

Tramadol is not considered completely safe during pregnancy.

At the beginning of pregnancy, it is associated with some problems for your unborn baby. If you take tramadol at the end of pregnancy, there is a risk that your newborn will have withdrawal symptoms.

However, it is important to treat pain in pregnancy. For some pregnant women with severe pain, tramadol may be the best option. Your doctor is the best person to help you decide what is best for you and your child.

*Precautions with other medicines.

Some medications and tramadol interfere with each other and increase the likelihood of side effects.

Tell your doctor if you are taking any medications:

  • To depression
  • For mental health problems
  • To relieve pain
  • To help you sleep
  • To reduce stress or anxiety
  • To treat the symptoms of an allergy
  • To thin the blood (like warfarin)
  • To treat an infection

Some medications may weaken and / or reduce the effects of tramadol. Tell your doctor if you are taking:

  • Carbamazepine (to treat epilepsy)
  • Buprenorphine (an analgesic)
  • ondansetron (to prevent you from feeling ill)
  • Rifampicin (an antibiotic)

*Combining Tramadol with herbal remedies and supplements

It is not known whether it is safe to take complementary medications and herbal teas with tramadol. They are not tested in the same way as pharmacies and prescription drugs. Usually, its effects on other drugs are not proven.