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FUN Facts regarding medication Tramadol
For the Consumer
Applies to tramadol: oral capsule extended release, oral suspension, oral tablet, oral tablet disintegrating, oral tablet extended release
Tramadol (marketed as Ultram, and as generics) is an opiod pain medication which is used to treat moderate to moderately severe pain. When taken as an immediate-release oral formulation, the onset of pain relief usually occurs within about an hour. It has two different mechanisms. First, it binds to the μ-opioid receptor. Second, it inhibits the reuptake of serotonin and norepinephrine. (a hormone that is released by the adrenal medulla and by the sympathetic nerves and functions as a neurotransmitter. It is also used as a drug to raise blood pressure.)
As well as its needed effects, tramadol may cause unwanted side effects that require medical attention.
If any of the following side effects occur while taking tramadol, check with your doctor immediately:
You may experience some of these side effects if you discontinue use of Tramadol.
Abdominal or stomach pain
feeling of warmth
feeling sad or empty
feeling unusually cold
general feeling of discomfort or illness
itching of the skin
loss of appetite
loss of interest or pleasure
loss of strength or weakness
muscle aches and pains
redness of the face, neck, arms, and occasionally, upper chest
sleepiness or unusual drowsiness
unusual feeling of excitement
blistering, crusting, irritation, itching, or reddening of the skin
bloody or cloudy urine
body aches or pain
change in hearing
cold flu-like symptoms
cough producing mucus
cracked, dry, or scaly skin
decreased interest in sexual intercourse
difficult, burning, or painful urination
difficulty with moving
disturbance in attention
earache or pain in ear
false or unusual sense of well-being
flushing or redness of the skin
general feeling of bodily discomfort
headache, severe and throbbing
inability to have or keep an erection
itching, pain, redness, swelling, tenderness, or warmth on the skin
loss in sexual ability, desire, drive, or performance
loss of voice
lower back or side pain
muscle aching or cramping
muscle pain or stiffness
muscle spasms or twitching
pain in the limbs
pain or tenderness around the eyes and cheekbones
pain, swelling, or redness in the joints
swelling of the hands, ankles, feet, or lower legs
tightness of the chest
trouble in holding or releasing urine
trouble with sleeping
weight increased or decreased
Tramadol - You Need to Know (READ THIS)
Generic Name: tramadol (TRAM a dol)
Brand Names: ConZip, Rybix ODT, Ryzolt, Ultram
Tramadol is a centrally-acting, oral narcotic analgesic and is approved for the treatment of moderate to moderately severe pain in adults. The extended-release form of tramadol is for around-the-clock treatment of pain and not for use on an as-needed basis for pain. A combination product of tramadol and acetaminophen (Ultracet) is also available by prescription. In 2013, over 43 million tramadol prescriptions were written in the U.S, according to IMS.
In 1995, tramadol was originally approved by the U.S. Food and Drug Administration (FDA) as a non-controlled analgesic. However, since 1995, changes to the controlled substance status of tramadol have been made due to reports of drug abuse and diversion. The Drug Abuse Warning Network (DAWN) reported that roughly 20,000 emergency department visits were related to tramadol non-medical use in 2011. According to the National Survey on Drug Use and Health (NSDUH) in 2012, 3.2 million people in the U.S. aged 12 or used tramadol for nonmedical purposes.
1. ****Tramadol is now a controlled substance in all 50 U.S. states.****
On July 7, 2014 the U.S. Drug Enforcement Administration (DEA) announced that tramadol has been placed into schedule IV of the Controlled Substances Act (CSA) effective August 18, 2014. The new scheduling applies to all forms of tramadol. The rescheduling of tramadol comes at a time of growing concern related to abuse, misuse, addiction and overdose of opioid analgesics. Previously tramadol was a controlled substance in only a few states.
Starting August 18, 2014 tramadol prescriptions may only be refilled up to five times within a six month period after the date on which the prescription was written. After five refills or after six months, whichever occurs first, a new prescription is required. This rule applies to all controlled substances in schedule III and IV.
2. Tramadol is associated with a wide array of side effects.
In many people, tramadol is well-tolerated when used for pain, but tramadol can also cause some common and serious side effects. It is important to review with your doctor the side effects that have been reported with tramadol before starting treament Side effects with tramadol may worsen with higher doses.
Common side effects may include:
impaired mental abilities
Serious (but less common or even rare) side effects may include:
life-threatening allergic reactions
angioedema, or swelling under the skin
possibly fatal skin reactions
orthostatic hypotension (low blood pressure that occurs when you stand up from sitting or lying down)
suicide thoughts or action
Withdrawal symptoms may occur if tramadol hydrochloride is discontinued abruptly (DRUG ABUSE AND DEPENDENCE). Reported symptoms have included anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, piloerection, and rarely hallucinations. Other symptoms that have been reported less frequently with tramadol hydrochloride discontinuation include panic attacks, severe anxiety, and paresthesias. Clinical experience suggests that withdrawal symptoms may be avoided by tapering tramadol hydrochloride at the time of discontinuation.
**FYI When you do Wean off of this medication. Just know you will be withdrawing from two different medications. One Opiod and the Other SSRI =(Double trouble)
Seizures have occurred in patients taking recommended doses but are more likely at high doses associated with abuse of tramadol.
*Do not abruptly stop taking tramadol as withdrawal symptoms like nausea, diarrhea, anxiety, or tremors may occur. Consult with your doctor for a tapering dose schedule if you are stopping tramadol treatment.
3. Dangerous drug interactions are possible with tramadol.
Tramadol may cause a dangerous condition known as “serotonin syndrome”. Patients receiving serotonergic drugs such as the migraine agents called “triptans” may be at a higher risk for serotonin syndrome. Brand names of triptans include Imitrex, Zomig, Frova, Maxalt, Axert, Amerge, and Relpax.
Do not take tramadol if you have used alcohol, sedatives, tranquilizers, or narcotic medications. Tramadol should not be combined with these medications or with alcohol at any time. Patients should avoid driving or other activities that require mental alertness until the effects of the drug are known.
Patients should always have a drug interaction review completed each time they start a new medication, including herbal, over-the-counter, and supplement drugs.
4. Tramadol can be habit-forming.
Tramadol is structurally related to the opioids like codeine and morphine and can lead to psychological and physical dependence, addiction, and withdrawal. People with a history of a drug-seeking behavior may be at greater risk of addiction, but illicit actions to obtain the drug can occur in people without a prior addiction, as well.
Do not abruptly stop taking tramadol as withdrawal symptoms like nausea, diarrhea, anxiety, sweating, difficulty in sleep, shivering, pain, tremors, or rarely, hallucinations may occur.
Consult with your doctor before discontinuing tramadol treatment; do NOT discontinue treatment on your own. Withdrawal symptoms may be relieved by re-initiation of opioid therapy followed by a slow, dose reduction combined with symptomatic support, as directed by your doctor.
The most common adverse reactions include nausea, constipation, dry mouth, somnolence, dizziness, and vomiting.
CNS stimulation has been reported as a composite of nervousness, anxiety, agitation, tremor, spasticity, euphoria, emotional lability, and hallucinations. During clinical trials, tolerance development was mild and the reports of a withdrawal syndrome were rare. Symptoms of a withdrawal syndrome have included: panic attacks, severe anxiety, hallucinations, paraesthesias, tinnitus and unusual CNS symptoms (i.e. confusion, delusions, personalization, derealization, and paranoia).
Very common (10% or more): CNS stimulation (up to 14%)
Common (1% to 10%): Anxiety, euphoria, nervousness, sleep disorder, insomnia, depression, agitation, apathy, depersonalization
Uncommon (0.1% to 1%): Emotional lability
Rare (less than 0.1%): Hallucinations, nightmares, dependency
Very rare (less than 0.01%): Withdrawal syndrome
Rare (less than 0.1%): Anaphylaxis, allergic reactions such as dyspnea, bronchospasm, wheezing, angioneurotic edema, swollen skin]
Very common (10% or more): Nausea (up to 40%), constipation (up to 46%), vomiting (up to 17%), dyspepsia (up to 13%)
Common (1% to 10%): Dry mouth, diarrhea, abdominal pain, flatulence, sore throat, gastroenteritis viral
Uncommon (0.1% to 1%): Toothache, appendicitis, pancreatitis
Very common (10% or more): Dizziness (up to 28%), somnolence (up to 25%), headache (up to 32%),
Common (1% to 10%): Confusion, coordination disturbance, tremor, paresthesia, hypoesthesia
Uncommon (0.1% to 1%): Migraine, sedation, syncope, disturbance in attention
Rare (less than 0.1%): Epileptiform seizures
Postmarketing reports: Seizures
Epileptiform seizures primarily occurred following administration of high doses or following concomitant treatment with drugs that lower the seizure threshold or trigger seizures.
Very common (10% or more): Pruritus (up to 11%)
Common (1% to 10%): Sweating, rash, dermatitis
Uncommon (0.1% to 1%): Cellulitis, piloerection, clamminess, urticaria, toxic epidermal necrolysis, Stevens Johnson-syndrome, hair disorder, skin disorder
Common (1% to 10%): Menopausal symptoms, urinary frequency, urinary retention, urinary tract infection
Uncommon (0.1% to 1%): Difficulty in micturition, hematuria, dysuria, cystitis, sexual function abnormality
Very common (10% or more): Flushing (up to 15.8%)
Common (1% to 10%): Vasodilation, postural hypotension, chest pain
Uncommon (0.1% to 1%): Palpitations, myocardial infarction, lower limb edema, peripheral swelling, hypertension, increased heart rate, peripheral ischemia, EKG abnormality, hypotension, tachycardia
Rare (less than 0.1%): Bradycardia
Very common (10% or more): Asthenia (up to 12%)
Common (1% to 10%): Malaise, weakness, pain, feeling hot, influenza like illness, rigors, lethargy, pyrexia
Uncommon (0.1% to 1%): Tinnitus, vertigo, ear infection
Common (1% to 10%): Anorexia, decreased weight, increased blood glucose
Uncommon (0.1% to 1%): Gout
Rare (less than 0.1%): Changes in appetite
Very rare (less than 0.01%): Syndrome of inappropriate antidiuretic hormone secretion
Uncommon (0.1% to 1%): Anemia, ecchymosis
Uncommon (0.1% to 1%): Cholelithiasis, cholecystitis, ALT and AST increased, abnormal liver function tests
Common (1% to 10%): Miosis, visual disturbance, blurred vision
Uncommon (0.1% to 1%): Lacrimation disorder
Frequency not reported: Mydriasis
Uncommon (0.1% to 1%): blood urea nitrogen increased
Common (1% to 10%): Hypertonia, arthralgia, back pain, limb pain, neck pain, muscle cramps, muscle spasms, joint stiffness, muscle twitching, myalgia, aggravated osteoarthritis
Uncommon (0.1% to 1%): Joint swelling, joint sprain, muscle injury, leg cramps
Rare (less than 0.1%): Involuntary muscle contractions
If you don't know. Now you know. I learned the hard way.
I am happy to say I no longer "need to" ingest this what I affectionately name "evil drug" anymore. I use other ways to manage my discomfort. Ice, stretching, Tens Unit (TENS, or transcutaneous electrical nerve stimulation, is a back pain treatment that uses low voltage electric current to relieve pain) Heat, massage to name a few.
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