Tramadol Hydrochloride (Analgesic)

Question 1

What are the brand names of tramadol hydrochloride?

Answer 1

Ultram & Ultram ER

Question 2

What are the available ODT strengths of tramadol?

Answer 2

50 mg

Question 3

What are the available tablets strengths of tramadol?

Answer 3

50 mg

Question 4

What are the available extended release tablet strengths of tramadol?

Answer 4

100 mg, 200 mg, 300 mg

Question 5

What are the FDA approved indications of tramadol? What are the FDA approved dosages of tramadol?

Answer 5

For the management of moderate to moderately severe pain.

Dosage:

At home use, 50mg-100mg as needed for the relief of pain every four to six hours not to exceed 400mg per day.

Around the clock care (hospital) use, Start with 100mg ER per day. May titrate up 100mg every 5 days to a maximum of 300mg per day.

Question 6

What is the mechanism of action of tramadol?

Answer 6

Tramadol modulates the descending pain pathways within the central nervous system through the binding of parent and M1 metabolite to μ-opioid receptors and the weak inhibition of the reuptake of norepinephrine and serotonin.

Question 7

What are the drug interactions of tramadol?

Answer 7

• Tramadol may potentiate the effects of other CNS depressants including MAO inhibitor’s and tricyclic antidepressants.
• Risk of seizures is increased when given with serotonin reuptake inhibitor’s, TCAs, and opiods.
• Quinidine is a selective inhibitor of the ice assigned metabolizes tramadol to M1 so concomitant administration of quinidine results in increased concentrations of tramadol and reduced concentrations of M1.
• Concomitant use of carbamazepine significantly increases metabolism of tramadol.

Question 8

What are the contraindications of tramadol?

Answer 8

• Tramadol should not be administered to patients who have previously demonstrated hypersensitivity to it or opioids and then cases of acute intoxication with alcohol, hypnotics, centrally acting and analgesics, opioids or psychotropic drugs.
• Do not use in patients with a past or present history of addiction or dependence on opioids.
• Use caution in patients with epilepsy, a history of seizures, and her patients at risk for seizures.
• Tramadol is not recommended for use in obstetrical preoperative medication or post delivery analgesia and nursing mothers.
• Pregnancy Category C.

Question 9

What are the adverse effects of tramadol?

Answer 9

Dizziness, vertigo, nausea, constipation, headache, somnolence, vomiting, pruritus, CNS stimulation, asthenia, sweating, dyspepsia, dry mouth, diarrhea

Question 10

What should the pharmacist tell the patient when counseling them on the use of tramadol?

Answer 10

• May cause drowsiness. Use caution while operating machinery or when mental alertness is required.
• Avoid alcohol while taking this medication.
• Do not split, crush, or chew extended-release tablets.
• May take with food or milk to avoid GI upset although analgesia may be delayed.
• Continous use may produce psychic and physical dependence of the morphine-type.
• Do not exceed prescribed dosage.
• If a dose is missed, skip it and return to normal dosing schedule.