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Is Tramadol A Safe Painkiller?

Updated on June 28, 2009

 Tramadol is also known as tramadol hydrochloride and is an opioid derivative, very similar to such drugs as morphine and methadone.

Tramadol is an analgesic which operates on a centralized basis, and it generally prescribed to treat pain in individuals which can range from moderate to severe, and is usually given to patients for acute and chronic pain. There are a number of surgical and diagnostic procedures which are exceptionally painful and in which Tramadol can be one of the preferred painkiller drugs to prescribe.

Tramadol is a synthetic opioid which was created and manufactured by the pharmaceutical company Grunenthal GmbH, based in Stolberg-am-Rhein, Germany. The drug has been marketed under the names Tramal, Medtrap, Ultram, and Ryzolt.

Doses vary from 50 mg up to a maximum of 400 mg per day, which may be increased up to 600 mg per day when administered via intravenous and or intramuscular forms. In the formulation containing paracetamol, it contains 37.5 mg of tramadol and 325 mg of paracetamol, and is intended for oral administration with a recommended dosage of one or two tablets every four to six hours.

The side effects from this pharmaceutical which are commonly encountered include nausea, vomiting, excessive sweating and constipation. It was also found to cause sleepiness, even if that particular problem is negligible compared with other opioids. Patients who have been prescribed tramadol for the treatment of pain along with other agents, have reported bouts of uncontrollable nervous tremors similar to those of withdrawal from more conventional natural opioids if the interruption of treatment occurs too abruptly. Respiratory depression, a side effect of most opioids, is not clinically significant in normal doses.

In the U.S., after 3 years of monitoring, tramadol resulted in the reporting of possible or documented 283 cases of excessive use, 171 suspected cases, but inadequately documented, of excessive use and 306 cases of withdrawal syndrome, with an incidence monthly (based on sales figures) of about 1 case per 100,000 patients. In 97.3% of the cases were properly reported a previous dependence on opioids, alcohol or drugs.

In another American study lasting 3 years and conducted by 1601 healthcare professionals with a history of dependence on alcohol or other psychoactive drugs, and who were entered into a federal program of opiate therapy, the annual incidence of addiction to tramadol was equal to 0.7%.

The FDA has stated that there have been 912 reported cases of addiction to tramadol between March 1995 and June 2001.

The U.K. Committee on the Safety of Medicine reports that tramadol has the capability to lead into addiction or withdrawal syndromes about 1 patient in 6000. Symptoms occur on average after 3 months of treatment with a range of 10 to 409 days. In 85% of patients the daily dose was the one that was recommended by the prescribing physician (up to 400 mg / day). 94% of patients had a history of alcoholism or dependence on opioids.

Tramadol was number three on the list of active ingredients most frequently implicated in withdrawal syndromes reported by the British Pharmacovigilance Network.


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