Tramadol Withdrawal: Tramadol Wikipedia

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Tramadol Withdrawal: Tramadol Wikipedia

Tramadol – Wikipedia

Invented in 1962 by Dr. Kurt Flick, an employee of the German pharmaceutical company GRÜNENTHAL GmbH (Grünental). Soon tramadol became the most prescribed monoalangetic of central action in the world. During the time that has passed since the creation of the drug, he was discharged to more than 70 million tramadol withdrawal: patients around the world. [5].

Pharmacological action [edit | edit code]

A synthetic analgesic that has a central action and action on the spinal cord (promotes the opening of K + and Ca2 + ion channels, causes hyperpolarization of the membranes and inhibits the conduction of pain impulses), enhances the effect of sedative drugs. Activates opiate receptors (μ-, Δ-, κ-) on the pre- and postsynaptic membranes of the afferent fibers of the nociceptive system and in the gastrointestinal tract. Slows down the destruction of catecholamines, stabilizes their concentration in the central nervous system.

The affinity of tramadol to opioid receptors is 10 times weaker than that of codeine, and 6000 times weaker than that of morphine, while the severity of analgesic action is only 5-10 times weaker than morphine.

Tramadol is a racemic mixture of 2 enantiomers – dextrorotatory (+) and levogyrate (-), each of which exhibits a different receptor affinity. (+) Tramadol is a selective agonist of mu-opiate receptors, and also selectively inhibits the reverse neuronal seizure of serotonin. (-) Tramadol inhibits the reverse neuronal capture of norepinephrine. Mono-O-desmethyltramadol (M1 metabolite) also selectively stimulates mu-opiate receptors.

In therapeutic doses, it does not significantly affect tramadol withdrawal: hemodynamics and respiration, does not alter the pressure in the pulmonary artery, and slightly slows down intestinal motility, without causing constipation. It has some antitussive and sedative effects. Inhibits the respiratory center, stimulates the starting area of ​​the vomiting center, the nucleus of the oculomotor nerve.

With prolonged use may develop tolerance.

Tramadol Withdrawal: how to take, composition and reviews

Pharmacokinetics [edit | edit code]

Absorption – 90%; bioavailability – 68% when taken orally (increased with repeated use), 70% – with rectal, with intramuscular – 100%. TCmax after ingestion of tablets – 2 hours, when taking drops – 1 hour, with intramuscular administration – 45 minutes, M1 metabolite – 3 hours. Penetrates through the blood-brain barrier and the placenta, 0.1% is excreted in breast milk. The volume of distribution is 203 l with intravenous administration and 306 l with oral administration. Communication with plasma proteins – 20%.

In the liver, it is metabolized by N- and O-demethylation with subsequent conjugation with glucuronic acid. 11 metabolites were detected, of which mono-O-desmethyltramadol (M1) has pharmacological activity. CYP2D6 isoenzyme is involved in the metabolism of the drug. T1 / 2 in the second phase – 6 h (tramadol), 7.9 h (mono-O-dezmetiltramadol); in patients older than 75 years – 7.4 h (tramadol); in liver cirrhosis – 13.3 ± 4.9 h (tramadol), 18.5 ± 9.4 h (mono-O-dezmetiltramadol), in severe cases – 22.3 h and 36 h, respectively. T1 / 2 in chronic renal failure (CC less than 5 ml / min) – 11 ± 3.2 h (tramadol), 16.9 ± 3 h (mono-O-dezmetiltramadol), in severe cases – 19.5 h and 43.2 h, respectively.

Excreted by the kidneys (25-35% unchanged), the average cumulative rate of renal excretion – 94%. About 7% is excreted through hemodialysis.

Indications [edit | edit code]

Pain syndrome (strong and medium intensity, including inflammatory, traumatic, vascular origin, with cancer, neuralgia). Pain relief during painful diagnostic or therapeutic interventions. Tramadol has also been used to treat opiate withdrawal [6].

Contraindications [edit | edit code]

Hypersensitivity, alcohol poisoning, hypnotic drugs, narcotic analgesics and other psychoactive drugs, pregnancy, lactation period (in the case of long-term use), children’s age (up to 1 year – for parenteral administration; up to 14 years for oral administration), intake MAO inhibitors.

With caution

Opioid dependence, impaired consciousness of various origins, intracranial hypertension, traumatic brain injury, epileptic syndrome (cerebral genesis), bronchial asthma, conditions accompanied by worsening of breathing or marked deterioration of self-control.

Dosing regimen [edit | edit code]

Applied intravenously, intramuscularly, subcutaneously, by mouth, rectally. The total daily dose is 0.4 g. For children over the age of 1 year, by mouth, only drops or parenteral (intravenous, intramuscular, subcutaneous), in a dose of 1-2 mg / kg. The daily dose is 4-8 mg / kg (1 cap – 2.5 mg). The elderly and patients with renal insufficiency require an individual dosage (T1 / 2 lengthening is possible). When creatinine clearance is less than 30 ml / min and in patients with hepatic insufficiency, a 12-hour interval is necessary between taking regular doses of the drug.

How Much Tramadol Can I Take: the benefits and harm, use in sports and bodybuilding

Inside [edit | edit code]

For single use for adults and children over 14 years old – 50 mg. After 30-60 minutes, you can repeat the reception in the same dose, but not more than 8 doses per day. Retard tablets – 100-200 mg every 12 hours. Daily dose – 0.4 g (in exceptional cases, for example in cancer patients, a reduction in the interval to 6 hours and an increase in the daily dose is possible).

Rectally [edit | edit code]

Rectal – 0.1 g. Reception frequency – up to 4 times per day.

Intravenous, intramuscular, subcutaneous [edit | edit code]

Slowly, 0.05–0.1 g. If the effect is not sufficient, then 20–30 minutes after intravenous administration, the infusion can be continued at a rate of 12 mg / h or additionally administered tramadol withdrawal :.

Side Effects [edit | edit code]

The nervous system

Increased sweating, increased urination, dizziness, headache, weakness of tramadol withdrawal: fatigue, lethargy, paradoxical stimulation of the central nervous system (nervousness, agitation, anxiety, tremor, muscle cramps, euphoria, emotional lability, hallucinations), sleep, sleep, sleep, sleep, sleep, sleep, sleep, sleep, sleep, sleepiness consciousness, impaired motor coordination, convulsions of central genesis (with intravenous administration in high doses or with simultaneous prescription of antipsychotic drugs (neuroleptics)), depression I, amnesia, cognitive impairment, paresthesia, unsteady gait.

From the digestive system

Dry mouth, nausea, vomiting, flatulence, abdominal pain, constipation or diarrhea, difficulty swallowing.

Since the cardiovascular system

Manifestations of vasodilation – tachycardia, orthostatic hypotension, syncope, collapse.

Allergic reactions

Urticaria, pruritus, rash, bullous rash. A sharp decrease in blood pressure.

On the part of the urinary system

Difficulty urinating, dysuria, urinary retention.

From the senses

Visual impairment, taste.

On the part of the respiratory system

Dyspnea.

Other

Violation of the menstrual cycle. With prolonged use – drug dependence. With a sharp cancellation – the syndrome of “cancel”.

Overdose [edit | edit code]

Symptoms

Mioz, vomiting, collapse, coma, convulsions, depression of the respiratory center, apnea.

Treatment

Ensuring the airway, maintaining breathing and cardiovascular activity. Opiate-like effects can be stopped by naloxone, seizures by benzodiazepine.

Special instructions [edit | edit code]

Do not use ethanol at the same time. In the case of a single dose there is no need to interrupt breastfeeding. During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.

Interaction [edit | edit code]

Pharmaceutically incompatible with solutions of diclofenac, indomethacin, phenylbutazone, diazepam, flunitrazepam, nitroglycerin. Enhances the action of drugs that inhibit the central nervous system, and ethanol. Inducers of microsomal oxidation (including carbamazepine, barbiturates) reduce the severity of the analgesic effect and the duration of action. Prolonged use of opioid analgesics or barbiturates stimulates the development of cross-tolerance. Anxiolytics increase the severity of the analgesic effect; the duration of anesthesia is increased when combined with barbiturates. Naloxone activates respiration, eliminating analgesia after the use of opioid analgesics. MAO inhibitors, furazolidone, procarbazine, antipsychotic drugs (neuroleptics) increase the risk of seizures (lowering the seizure threshold). Quinidine increases the plasma concentration of tramadol and reduces the metabolite M1 due to competitive inhibition of the isoenzyme

Legislative regulation [edit | edit code]

Tramadol Withdrawal for twine beginners, exercises at home

In some countries (in Ukraine [7] and in Belarus [8]) tramadol is included in the list of narcotic drugs.

In Russia, tramadol is included in the list of essential and essential medicines.

In March 2016, three criminal cases were initiated in Belarus against Russians detained at the Polish-Belarusian border with tablets containing tramadol [9]. In this regard, the Belarusian Customs made a statement [9] that when transporting medicines for personal use, classified under the Belarusian legislation as narcotic, it is necessary to have supporting medical documents; otherwise, there is a risk of up to 10 years in prison.

Notes [edit | edit code]

Tramadol Drug Class: Tramadol was included in the list of drugs restricted to trafficking in Uzbekistan

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Tramadol Drug Class: Tramadol was included in the list of drugs restricted to trafficking in Uzbekistan

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Tramadol was included in the list of drugs restricted to trafficking in Uzbekistan

In Uzbekistan, the lists of narcotic substances banned and restricted to circulation have been expanded. The number of prohibited increased from 238 to 265, limited — from 51 to 53. In particular, tramadol was included in the list of the latter. Extended lists are available on the Norma.uz portal.

In addition, the tramadol drug class increased by four: the number of psychotropic substances limited in circulation (from 81 to 85 positions), and the precursors — three (from 26 to 29 positions).

Tramadol Drug Class in bodybuilding: how to take, action, reviews

The structure of the list of drugs whose turnover is prohibited has also changed. The substances included in it are tramadol drug class: divided into groups and subgroups. For example, the drugs of the tramadol drug class synthetic cannabinoid group include: classical (dibenzopyrans), non-classical (cyclohexylphenols, cyclogenols, quinones), aminoalkylindoles (naphthoylindoles, phenylacetylindoles, benzoylindoles, etc.), eicosanoids (anandamides, etc.), eikozanoids (anandamides), I, I, I, I would not need to, I would like (), I would not have to, I would use (I), I would not have to; etc.) and hybrid cannabinoids.

Tramadol Drug Class: how to take for weight gain, side effects

In early October, it was reported that the Senate of the Oliy Majlis (Parliament) of Uzbekistan approved amendments to the Criminal Code, the Criminal Procedure Code and the Administrative Responsibility Code, according to which law enforcement agencies will begin to prosecute tramadol and some other psychoactive substances.

Prior to the adoption of amendments and new lists of narcotic drugs prohibited and restricted in circulation in law enforcement agencies, it was stated, in particular, that tramadol drug class cannot be held accountable: tramadol sellers. Mostly preventive conversations were held with them, sometimes they were brought to administrative responsibility for non-compliance with the legal requirements of a police officer. However, in October 2017, three natives of the Fergana region were detained, who tried to sell a large batch of tramadol and so-called tablets to the client «lyrics» for 14 million soums ($ 1.7 thousand). On this fact a criminal case was opened — by articles «Illegal possession of potent or poisonous substances» and «Smuggling».

In neighboring Turkmenistan, tramadol turnover has been banned since 2014. The use of this narcotic substance is punishable by imprisonment from 6 to 9 years, and for the sale of it – from 9 to 15 years.

Tramadol Ingredients: Tramadol is on the list of banned drugs during the competition & raquo; VeloLIVE Cycling News

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Tramadol Ingredients: Tramadol is on the list of banned drugs during the competition & raquo; VeloLIVE Cycling News

Tramadol entered the list of prohibited drugs during the competition » VeloLIVE Cycling News

The ban on the use of tramadol ingredients: tramadol during the competition takes effect from March 1, 2019. Tramadol psychotropic opioid analgesic, which has a strong analgesic activity, gives

Tramadol entered the list of prohibited drugs during the competition

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Category:

Tramadol is forbidden to use during the competition from March 1, 2019

The ban on the use of tramadol during the competition comes into force on March 1, 2019. Tramadol — psychotropic opioid analgesic, which has a strong analgesic activity, gives a quick and lasting effect.

A survey by the World Anti-Doping Agency on data for 2017 tramadol ingredients: the year showed that 4.4% of tests taken during the competition from cyclists revealed the use of tramadol, 68% of all urine samples containing tramadol traces taken from athletes 35 Olympic sports, belong to cyclists.

The ban on the use of tramadol aims to protect the health of racers from the negative side effects of this drug.

As reported in the UCI press release, «tramadol can give two types of side effects: nausea and drowsiness, loss of concentration, which increases the risk of blockages, as well as the occurrence of drug dependence».

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Taking into account the above risks and in accordance with the decision of the UCI Management Committee of June 2018, the UCI medical regulations prohibit the use of tramadol during competition.

From March 1, 2019, any driver who participates in a registered national or international calendar competition may be selected for the doping test for tramadol use.

Tramadol Ingredients in bodybuilding, how to take, side effects and reviews

A rider may be disqualified from a competition for the first violation; in addition, he may be fined 5,000 Swiss francs if the rider is a member of a team registered with the UCI. In other cases, the fine will be 1000 Swiss francs.

In the second tramadol ingredients: violation of the rider faces penalties from withdrawing from the competition to 5 months of disqualification. Further violations will be penalized by a 9-month suspension.

All rights reserved. Partial copying of publications is allowed when placing the active link tramadol ingredients: for a continuation, the indication of the author is mandatory.

Article tags: Tramadol UCI International Cycling Union

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What Is Tramadol Used For: Tramadol (Tramal) in the treatment of acute and chronic pain syndromes Osipova N.A. Breast Cancer 4 from 02.26.2003

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What Is Tramadol Used For: Tramadol (Tramal) in the treatment of acute and chronic pain syndromes Osipova N.A. Breast Cancer 4 from 02.26.2003

Tramadol (Tramal) in the treatment of acute and chronic pain syndromes | Osipova N.A. | “Breast Cancer” №4 from 02.26.2003

Moscow Research Institute of Oncology. P.A. Herzen

The main method of treatment of acute and chronic pain syndromes in modern medicine is systemic pharmacotherapy. The latter can be carried out using different methods of administering the analgesic into the body (oral, rectal, sublingual, transdermal, by injection), but in any case, the drug is absorbed into the systemic circulation, and then to the site of its action (unlike regional the method of administration of the analgesic, for example, perineural, epidural).

For the treatment of low-intensity pain, according to WHO recommendations [4], various non-opioid analgesics are used, and for moderate and high-intensity pain, opioid analgesics are used. Non-opioid anesthetics have a predominantly peripheral effect at the level of the focus of pain, have a small analgesic potential and therefore are only suitable for the treatment of mild pain. Opioids are analgesics of central action, implemented through the endogenous opioid system of the body at the level of the spinal cord and brain by inhibiting the upward flow of pain impulses. They differ from each other in their analgesic potential and ability to arrest moderate or severe pain. Due to its good analgesic properties, opioids are widely used in various fields of medicine dealing with intense pain, especially in oncology and surgery [3, 7].

A common feature of all opioids is the non-selective nature of their action, i.e., along with analgesia, they cause a number of other side effects and differ from each other in the severity of certain properties, which is associated with the individual characteristics of their interaction with opioid receptors. . An important condition for proper operation with an opioid is the knowledge of the mechanism of their action.

Mechanism of action and classification of opioids

All known opioids are divided into four main classes, depending on the nature of interaction with receptors.

The main class consists of opioid agonists or agonists of opioid m (mu) receptors, including substances and drugs of different analgesic power, including the powerful drug heroin, traditional strong opioid analgesics – morphine, fentanyl, pyritramide, and also less powerful – promedol, prosidol, tramadol, codeine. This group of opioids has side effects associated with depression of the stem structures and centers of the medulla oblongata, such as sedation (less euphoria), general weakness, inhibition of the cough reflex, and in large doses – respiratory depression (bradypnea, apnea) and blood circulation (hypotension, bradycardia) . Along with these inhibitory effects, opioid agonists have an activating effect on vomiting centers with possible development of nausea (vomiting), as well as on the smooth muscle of hollow organs, which can result in impaired motility of the latter (constipation, urinary retention and bile, a tendency to bronchospasm). All of these serious side effects are most pronounced in the most potent opioid analgesics (fentanyl, morphine) and less common in drugs with lower analgesic potentials [3, 7].

All opioid agonists, except tramadol, have a specific ability to cause physical and mental dependence, so they are included in the International Convention on Drugs into the category of drugs under control [17], and they are subject to special rules for prescription, discharge, accounting, storage, transportation, reporting, defined by the relevant orders of the Ministry of Health of the Russian Federation [1]. Tramadol, which represents an exception, does not refer to drugs, since, according to extensive world and domestic experience, no clear data has been obtained for the development of tramadol dependence. This drug is listed as a potent drug and is written on a prescription form for potent substances [1,9]. A characteristic feature of strong opioids is also tolerance, i.e., a decrease in the analgesic effect with an increase in the duration of opioid injection into the body, which requires, during long-term therapy, a gradual increase in dose to maintain pain relief [4,7]. Thus, the dose of morphine can increase tenfold compared with the initial treatment during several months, reaching or even exceeding 1000 mg / day.

The next class of opioids, partial opioid m – receptor agonists, is represented by buprenorphine, similar in its properties to morphine, but with longer and somewhat less pronounced analgesic and other side effects.

Compared with other classic opioid agonists, buprenorphine has a lower narcotic potential, but in Russia it is also counted as a drug.

Unlike morphine, buprenorphine has a “ceiling” of an analgesic dose, over which the analgesic effect ceases to increase. Different authors define this limit in the range of 2.4–5 mg / day [7,17], which can limit the continuation of therapy with buprenorphine in chronic pain syndrome and is a signal to switch to a more powerful opioid, morphine, which does not have an analgesic dose “ceiling” .

The class of mixed opioid antagonist agonists includes three drugs (pentazocine, butorphanol, what is tramadol used for: nalbuphin), which are k (kappa) receptor agonists and m-receptor antagonists. As k-receptor agonists, these what is tramadol used for: opioids cause less pronounced analgesia than morphine, and have a slightly different spectrum of side effects (sedation prevails, nausea, dizziness, and depression of respiration are less common). As m-receptor antagonists, opioids of this class can weaken or eliminate the actions of classical opioid agonists, including analgesia [3,7,17]. In this regard, the combined use of opioid agonists, antagonists and morphine analgesics is impractical.

Drugs in this class, like buprenorphine, have an inherent effect of the “ceiling” (Ceiling effect). The agonists – antagonists of the last generation butorphanol and nalbuphine (unlike pentazocine) are not listed in the register of narcotic drugs and are potent substances. They play a supporting role in the treatment of pain syndromes due to their antagonistic relationship with opioids of the main class of agonists.

The properties of the s (sigma) –receptor agonist are characterized by ketamine, which is distinguished by its moderate analgesic effect [7] and a whole complex of side activating effects (tachycardia, hypertension, psychomotor agitation).

An opioid antagonist of all groups is naloxone, which rapidly neutralizes all their effects, including analgesia.

Existing opioid analgesics differ not only in the nature of the interaction with certain opioid receptors, but also in the peculiarities of binding with them in strength and duration. The higher the affinity of the opioid for the receptor, the stronger the analgesia, the longer the connection with the receptor, the longer the analgesia [7,17].

Choosing an opioid for treating moderate to high intensity pain

An important consequence of the analysis of the mechanism of action of opioids is the generally accepted position of the main role in opioid pain therapy for analgesics belonging to the class of opioid agonists [4], since drugs of all other groups have certain limitations (effect of the analgesic dose “ceiling”, antagonism in relation to the most powerful analgesics of the morphine group, undesirable side properties). This provision is especially important to consider when treating chronic pain syndrome, in order to obtain an optimal result of pain relief and to avoid possible failures.

The range of existing opioid agonists is quite wide and includes, as mentioned above, analgesics of different potencies, capable of eliminating moderate and severe pain, and indications for treating such pain exist in different areas of medicine.

In which cases is indicated the appointment of an opioid analgesic for pain relief and how to choose the right opioid? To do this, you must first be guided by certain general rules.

Indications for the appointment of an opioid occur when treatment with non-opioid analgesics does not lead to the elimination of pain, that is, pain exceeds the degree of weak. In the treatment of chronic pain in cancer patients, opioid agonists should be preferred.

When determining the intensity of pain, one should be guided by a simple scale of verbal scores of pain (SHO): 0 – no pain, 1 point – weak, 2 points – moderate, 3 points – strong, 4 points – the most severe pain. For the treatment of moderate to high intensity pain in Russia, the guidelines of the Ministry of Health of the Russian Federation recommended: tramadol, prosidol for moderate pain, buprenorphine for severe pain, and morphine or fentanyl (including in the transdermal form) for the most severe pain [10.

Doctors authorized to work with drugs (most often in oncological and surgical institutions) have the right to prescribe opioid analgesics related to narcotic drugs.

How to use What Is Tramadol at home, video lesson

Opioids – non-narcotics, classified as potent drugs (tramadol, butorphanol, nalbuphine), can be written out on prescription form for potent drugs by any doctor in consultation with the head of the department if necessary to relieve pain from the patient, which cannot be eliminated by non-opioid analgesics (articular, neurogenic and other non-opioid painkillers (neuropathic and other). pain). Among opioid agonists, tramadol is the only non-narcotic drug.

Clinical pharmacology of tramadol

Tramadol (Tramal) is an opioid agonist that stands alone among all the opioids of this class, primarily because, unlike them, it does not belong to narcotic drugs [1]. This is confirmed by extensive clinical experience of its use throughout the world and by special scientific research of its drug potential [7,12, 15,16, etc.].

In volunteers who received the maximum dose of tramadol (Tramal, hereinafter referred to as “T”), and in cancer patients who had been treated for this pain for a long time, a drug dependence test was performed using the opioid antagonist naloxone. It is known that in heroin and other drug addicts the introduction of naloxone into the body immediately causes the development of drug withdrawal syndrome (withdrawal syndrome), manifested by severe mental and physical symptoms: severe psychomotor agitation, fear of death, panic, acute cramping pain in the abdomen, vomiting, chills, tremors , tachycardia, etc. In the studied people, as in the experiment on animals, on the background of long-term administration of “T”, naloxone did not cause the indicated symptoms or their manifestations were unclear and did not reach what is tramadol used for: radatsii “withdrawal symptoms mild.” The likelihood of mental dependence on “T” is minimal; in the above studies, the drug did not reveal a euphoric or dysphoric effect. It was established that in patients with opiate addiction “T”, like placebo, does not eliminate subjective discomfort against the background of abstinence [11], i.e. it does not have a substitute effect of the drug (unlike other opioids studied – promedol, butorphanol, nalbuphine , buprenorphine).

Unlike other opioid agonists, “T” has a dual mechanism of action. It has been established that analgesia caused by “T” is not completely eliminated by the opioid antagonist naloxone and, along with the opioid mechanism, is implemented by additional inhibition of pain impulses involving the serotonin – adrenergic systems [13]. That is, according to the mechanism of analgesic action, “T” is not completely identical to other opioid agonists.

Recently, there have been reports in the Russian media about the use of “T” by drug addicts as a substitute for heroin and other strong drugs. As a professional, I consider it necessary to give explanations in connection with the incorrect interpretation of the properties of “T” by journalists. The television showed in detail the case of a drug addict recorded by a video camera after intravenous injection of retard “T” tablets melted on the fire and with something diluted in oral tablets. Such a mixture could contain any substances that are toxic to the body when injected into the blood, therefore it is unlikely that the “T” could be considered as the root cause in this case.

In an article published by the newspaper Moskovsky Komsomolets dated 28.08.02, “T” is characterized as “a potent narcotic drug from the group of heroin synthetics, its action is very similar to methadone.” This characteristic is absolutely untrue, so experts view this publication as “unprofessional and biased”. Neither heroin nor methadone “T” has anything to do with both pharmacological properties and clinical action. It is fundamentally different from them and from other narcotic analgesics by a milder action and minimal narcotic potential, as described in detail above. However, the uncontrolled use of “T”, like any other drug, can lead to serious consequences, because all drugs, without exception, when therapeutic doses are exceeded, cause various side effects of what is tramadol used for: and exhibit toxic properties. This also applies to a wide range of OTC, including analgesic drugs. “T” according to the order of the Ministry of Health of the Russian Federation of August 23, 1999 No. 328 “On rational prescription of medicinal products, rules for prescribing them and the procedure for dispensing them by pharmacies” should be dispensed according to a doctor’s prescription on a form for potent drugs.

The following is a description of the main clinical effects of “T”, which by their nature are similar to the effects of other opioid agonists, but are much less pronounced. This applies to both analgesia and side effects.

Analgesic potential “T” according to different authors, is from 0.1 to 0.2 of the potential of morphine [4, 7], it is equal to or slightly exceeds the potential of codeine; in terms of efficacy, 50 mg of “T” is equivalent to 1000 mg of metamizole [13], i.e. “T” belongs to analgesics intended for pain of moderate intensity.

The most important criterion for the safety of any opioid is the severity of its central depressive effect on respiration and circulation. Numerous studies have not found significant respiratory depression in postoperative patients under the influence of “T” in the range of therapeutic doses from 0.5 to 2 mg per 1 kg of body weight even when administered intravenously by bolus, whereas morphine at a therapeutic dose of 0.14 mg / kg statistically significantly and significantly reduces the frequency of respiration and increases the voltage of CO2 in exhaled air [13]. That is, in the recommended doses, “T” does not cause depression of respiration, but it cannot be excluded that it is possible if these doses are exceeded. There is no inhibitory effect on the blood circulation “T”. In contrast, with intravenous administration of 0.75–1.5 mg / kg, it can increase systolic and diastolic blood pressure by 10–15 mm Hg. and slightly increase the heart rate with a quick return to the original values, which is explained by the sympathomimetic component of its action [13]. No effect of “T” on the level of histamine in the blood and on mental functions was noted [13]. “T” is metabolized in the liver. Only one metabolite of it is active. The half-life of “T” when administered orally or intravenously is 5–6 hours, it can increase in patients with impaired liver and kidney function. About 90% of the oral dose “T” is excreted by the kidneys [14]. “T” has beneficial pharmacokinetic characteristics. Its absolute availability with intramuscular administration is close to 100%, with rectal – 78%, with oral – 68% (with a subsequent increase with continued therapy). These figures are significantly higher than those of morphine and pethidine. The peak concentration of “T” in the plasma when taken through the mouth [14] is achieved after 1.6-2 hours.

Clinical experience with tramal

The first publications on the use of “T” in the clinic relate to the beginning of the 80s of the twentieth century, that is, its medical use has a 20-year history. During this time, the indications for treatment of “T” in various acute and chronic pain syndromes were determined, its analgesic and side properties, optimal methods and methods of its use in various fields of medicine: in oncology, surgery, traumatology, rheumatology, neurology, cardiology, etc. .

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In the practice of Moscow them. PA Herzen “T” is widely used to treat both acute (postoperative – p / o BS) and chronic (CBS) pain in cancer patients. The overall experience of its use at the institute exceeds 6000 observations, and the duration of therapy ranged from several days to many months with CBS.

In appointing “T”, we are guided by the general principles of the medical treatment of pain syndromes [10]. The main criterion is the intensity of pain, as measured by the above scale (SHVO). The indication for the appointment of “T” in both CBS and BS n / a is the pain of moderate intensity (2 points for SCR). There is no need to prescribe a “T” for mild pain (1 point on ShVO), where anesthesia can be achieved with the help of non-opioid analgesics (different NSAIDs, paracetamol preparations). “T” is not indicated even with severe pain (3-4 points for ShVO), since it is not sufficient to eliminate it, and in these cases more powerful opioids should be used to avoid further strengthening of the pain syndrome.

Most often during opioid therapy, including “T”, it is advisable to combine an opioid with non-opioid components in order to increase the effectiveness and tolerability of analgesia, although monotherapy is quite acceptable.

Pathogenetically justified is the addition of “T” to one of non-opioid analgesics of peripheral action, which suppress the production of prostaglandin pain mediator in the pain center (ketoprofen, lornoxicam, diclofenac, etc.) and / or central action inhibiting this mediator at the level of painful structures of the spinal cord (paracetamol). This allows you to get full pain relief while reducing the need for an opioid, that is, when using it in reduced doses and less likely to have side effects. Clinical confirmation of the feasibility of such a tactic of what is tramadol: with opioids is contained in numerous publications, including the work of the staff of our institute [3,5,8,10 and others].

The choice of dosage form, dose of “T” and drugs for combination with it depends on the nature of the pain syndrome, its localization, the individual characteristics of the patient.

Dosage forms and dosages of Tramal. Tramal is presented in various forms:

Injection solution (ampoules 1 and 2 ml), 50 mg in 1 ml.

Capsules 50 mg

Candles 100 mg

Retard tablets 100 mg, 150 mg.

The recommended single dose of 50-100 mg; daily up to 400 mg. The drug is administered 4 times a day. Tramal in the specified forms is produced and available in Russia.

Tramal with chronic pain syndrome of different origin is used widely and successfully. In this article, we consider this on the example of chronic pain syndrome (CSC) of oncological origin, which we constantly deal with in our work.

Taking into account the experience of the Institute on the use of “T” for the treatment of CBS in over 1000 patients, it is advisable to prescribe with uncomplicated moderate (2 points) somatic CBS (tumor damage or metastases of the skeleton, soft tissues, muscles, skin, external lymph nodes) or visceral (damage to internal organs and / or membranes – pleura, peritoneum, internal lymph nodes) type. All incurable cancer patients pass through this phase of CBS, and the duration of CBS of moderate intensity varies widely, due to individual tumor growth rates.

Practice shows that the appointment of “T” is not shown in severe CBS, complicated by the neuropathic component, due to the involvement of nerve formations. In these cases, stronger opioid analgesics are necessary in combination with complex special therapy.

“T” is prescribed when the initial non-opioid therapy (NSAIDs, paracetamol preparations) becomes insufficiently effective, while maintaining this therapy, which has its own pathogenetic orientation, which complements the action of the opioid.

The presence of different dosage forms makes it possible to choose the best of them for a particular patient. In most cases, the usual oral forms of what is tramadol: (capsules, retard tablets) are applicable, and in the absence of this possibility (patients with dysphagia in cancer of the esophagus, stomach) another non-invasive route of administration can be used – rectal. In the form of what is tramadol: “T” injections for long-term treatment of CBS are usually not used due to invasiveness.

For long-term therapy, retard tablets are the most convenient, which must be taken twice a day: 100-150-200 mg every 12 hours. The duration of all other forms of “T” is 5-6 hours, so they are taken 4 times a day.

Selection of the optimal dose “T” begins with a minimum single dose of 50 mg (1 capsule) in order to assess both the analgesic effect and the tolerability of the drug. With good analgesia and tolerability, they retain this single dose, administered 3-4 times per day (taking into account the duration of analgesia). If there is insufficient analgesia after 40–60 minutes, a second similar dose should be taken and its effect evaluated. If, after 1 hour, sufficient anesthesia is achieved, the therapy is carried out in single doses of 100 mg up to 4 times a day (capsules or suppositories), but it is more advisable to recommend a patient to take long-term retard tablets 150-200 mg 2 times a day, which is much more convenient (the first dose in the morning after sleep, the second – in the evening before bedtime). Additional non-opioid analgesics prescribed by their own scheme.

A clinical trial of “T” in oncological patients with CBS [6,7,8] showed that with initial moderate pain (2 points) the drug always causes its elimination, but with stronger pain, anesthesia with the above therapeutic doses is not achieved, therefore if a single a dose of “T” of 100 mg in the non-retard form is not sufficient to relieve pain, which means that the intensity of the pain has been underestimated and that analgesic therapy must be strengthened. This can be achieved either by switching from “T” to a stronger opioid, while maintaining the same non-opioid therapy, or by additional prescription of another non-narcotic analgesic, not previously used. For example, if after prescribing “T” against the background of previous therapy with diclofenac, ketoprofen or other NSAIDs, the pain decreased but did not stop (weak pain remained), it is advisable to connect one of the paracetamol preparations: Panadol 500-1000 mg 4 times a day or Solpadine ( contains, in addition to paracetamol, small doses of codeine and caffeine) in the same doses per paracetamol. Solpadein, despite the presence of codeine, is not an accounting drug due to the minimum dose of codeine, which, however, well complements the effect of “T”, as an opioid of the same class with it [9]. Such a combination of “T” with non-narcotic analgesics can be effective for a more or less long period, depending on the course of the cancer process.

Such therapy (while it is effective) is more accessible to patients than drug treatment, given the still unformed system of full supply of narcotic analgesics for cancer patients in our country.

“T” based CBS treatment is usually well tolerated by patients. When analgesia is achieved, the quality of life improves – night sleep, mood, physical activity. This “T” compares favorably with more powerful opioids (morphine, buprenorphine), which, causing analgesia, simultaneously lead to inhibition of physical and mental activity and other significant side effects. Assessing the tolerability of “T”, it should be said that the nature of its side properties is not fundamentally different from that of morphine and its derivatives, but the frequency and degree of their severity of “T” is much less. It is a much milder opioid than morphine, both for analgesic and for side effects.

According to the literature and my own experience [2,3,7,8], adverse symptoms in the treatment of “T” are observed in about half of the patients and are most often manifested by transient drowsiness, less often by nausea (very rarely vomiting), dry mouth. Constipation complicating therapy with codeine or morphine, is not typical for “T”, as well as urinary retention. Perhaps transient dizziness. Drowsiness and nausea, manifested at the beginning of treatment “T”, as a rule, stop within 1-2 weeks and in most cases do not require correction. If these symptoms are present, patients are recommended to lie down after taking “T” for 30–40 minutes. With persistent nausea, the appointment of an antiemetic agent is shown (metoclopramide, 10–20 mg 3–4 times a day, with a gradual cessation as the nausea subsides). The frequency and severity of these adverse symptoms are similar when using different dosage forms “T”. When using candles, symptoms of irritation of the rectal mucosa are possible (soreness and tenesmus). To avoid these phenomena, the candle should be inserted as far as possible – outside the sphincter, into the cavity of the rectal ampulla.

We did not observe cases of depression of respiration and blood circulation under the action of “T” in the indicated therapeutic doses, and they are also not described in the literature [2,3,5,6,7,13].

The data we obtained on the efficacy and safety of “T” in cancer patients with CBS are confirmed by the results of a multicenter study “T” in Russia with various pain syndromes in 2,000 outpatients [2].

In our practice, Tramal is the medium of choice for opioids of moderate analgesic potency for the treatment of moderately severe CBS. Its advantages are:

effectiveness combined with good tolerability and the absence of dangerous side effects;

the status of a non-narcotic drug, which increases its accessibility for patients, facilitates the work of medical personnel for its intended use and accounting.

Tramal in the treatment of postoperative pain. Most of the surgical interventions in various areas of surgery, including in oncology, are operations of average trauma. In oncology, these are widespread operations such as radical mastectomy, thyroidectomy, transvaginal amputation of the cervix, removal of soft tissue tumors, etc. Compared with radical intracavitary, these operations are less traumatic, but are quite extensive and are accompanied by significant postoperative pain syndrome requiring opioid analgesics. However, traditional opioids (morphine, promedol, etc.) are not suitable for patients after such operations, since their use, especially in the early period after general anesthesia, is dangerous for the development of central respiratory depression and requires monitoring of the patient in the conditions of the intensive care unit. Meanwhile, in their condition, patients after such operations do not need to be hospitalized in the intensive care unit, but they need good and safe pain relief.

In our institute, the optimal tactics of anesthesia for pain relief for this type of operation has been developed and has been constantly applied over the past years. It consists of a combination of “T” with peripheral analgesics from a number of NSAIDs or metamizole. We consider it preferable to use one of the NSAIDs on the principle of prophylactic analgesia, i.e., with the introduction of the first dose before the operation and with the continuation of therapy with this drug after the operation in combination with “T”. This tactic has been successfully applied in more than 5,000 patients [5,8,10].

Preventive preoperative doses of NSAIDs are 30 mg for ketorolac, 100 mg for ketoprofen, and 8 mg for lornoxicam; Metamizole dose – 1000 mg. Postoperative analgesia is supported by the planned use of one of these peripheral analgesics in the recommended daily dose in combination with “T”, the average analgesic daily dose of which is tramadol: varies, according to our data, from 345 ± 29 mg on the 1st day after surgery up to 205 ± 16 mg (4th day). At the same time, good analgesia is achieved with the active state of operated patients without serious adverse symptoms characteristic of morphine and promedol (drowsiness, lethargy, hypoventilation of the lungs).

The developed method of postoperative anesthesia on the basis of “T” in combination with one of the peripheral analgesics is effective, safe, allows for anesthesia of the patient in the general ward, without special intensive observation.

Conclusion

Tramadol (Tramal) occupies a special place among all opioid analgesics, which is determined by the peculiarity of the mechanism of central action and clinical pharmacology. It differs from the traditional narcotic analgesics of the morphine series by a less pronounced analgesic effect, but at the same time less pronounced side effects. In analgesic doses, he is deprived of the main dangerous properties of morphine and its analogues – a depressive effect on vital functions and the ability to cause opioid dependence. Therefore, it is safer than other opioids and counted not as narcotic, but as potent drugs. Tramadol has advantages over the traditional opioid of similar analgesic potency – codeine, which belongs to a number of drugs and does not have so many different non-invasive and injectable forms.

All these features of tramadol allow it to be successfully and widely used for the treatment of acute and chronic pain syndromes of moderate intensity in various fields of medicine, including oncology and surgery, where its role is especially great.

Literature:

1. Babayan E. A., Gaevsky A. V., Bardin E. V. Legal aspects of drug trafficking, psychotropic, potent, toxic substances and precursors. M. MCFER, 2000, 438 p.

2. Bunyatyan A. A., Trekova N. A., Osipova N. A., Manukyan L. M., Folomeev M. Yu. Analgetik Tramal in the treatment of acute and chronic pain in 2,000 outpatients. New drugs. 1997, Vol. 7, pp. 3-11.

3. Lebedeva R.N., Nikoda V.V. Pharmacotherapy of acute pain. M.AIR ART, 1998, p. 7 – 39.

4. Cancer anesthesia and palliative treatment. WHO, Geneva, 1992, 76 p.

5. Osipova N. A., Petrova V. V., Dolgopolova T. V., Vetsheva M. S., Andrianova K. Yu., Beresnev V. A. Synthetic opioids of the last generation in oncosurgery. Russian Medical Journal, 1995, No. 1, p. 35 – 39.

6. Osipova N. A., Novikov G. A., Prokhorov B. M., Loseva N. A., Sokolenov A. S., Abuzarova G. R. Tramal in outpatient therapy for chronic pain in cancer patients. New drugs, 1997, Vol. 7, s. 3-11.

7. Osipova N. A., Novikov G. A., Prokhorov B. M. Chronic pain syndrome in oncology. M. Medicine, 1998, 178 p.

8. Osipova N. A., Novikov G. A. Pain syndromes in the oncological clinic. In the book. “Selected lectures on clinical oncology”, M. 2000, p. 213 – 226.

9. Osipova N. A., Abuzarova G. R. Treatment of chronic pain in incurable cancer patients at home. Doctor, 2002, № 4, p. 7 – 9.

Is Tramadol in bodybuilding: how to take, composition, reviews

10. The procedure and timing of the use of narcotic analgesics. Methodical instructions of the Ministry of Health of the Russian Federation., M. 2001, 23 p.

11. Pchelintsev M.V., Soloviev S.L., Safronov A.G., Zvartau E. E. Clinical and psychological studies of the psychotropic effect of opiate receptor agonist-antagonists. In the book. “Pharmacodynamics of painkillers in experiment and clinic”, L., 1990, p. 130 – 136.

12. Barth, H., Durra, S., Giertz, H., Goroll, D., Flohe L. Long-term administration of tramadol. Pain, 1987 b, suppl. 4, Abstract No. 439, p. 231.

13. Drugs. Reprint, (Focusion Tramadol). Aug. 1993, V. 46, No. 2, p. 313 – 340.

14. Liao S., Hill J.F., Nayak R.K. Pharmacokinetics of tramadol following single and multiple oral doses in man. Pharmaceutical. Research, 1992, 9 Suppl., P. 308, Abstract No. PPDM 8206.

15. Preston K.L., Jasinski D.R., Testa M. Abuse potential and Pharmacological comparison of Tramadol, Morphine and Pethidine. Drug and Alcohol Dependence, 1991, 27, p. 7 – 17.

16. Richter, W., Barth, H., Flohe L., Giertz, H. Clinical review of the course of oral therapy with Tramadol. Arzneimittel – Forchung / Drug Research 1985, 35, p. 1742 – 1744.

17. WHO Expert Committee on Drug Dependence: Twenty-fifth Report. Series 775. WHO, Geneva, 1989.

Tramadol Vs Hydrocodone: Tramadol

Content:

Tramadol Vs Hydrocodone: Tramadol

Tramadol Headache for burning fat for men

Tramadol in Belozersk

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The information on the drug Tramadol Stud, given in this section, is intended for medical and pharmaceutical specialists and should not be used for self-treatment. The information is given to familiarize with the basic properties of the drug and can not be considered as official. Actual prices can always be seen in the section Search and order drugs in pharmacies. Pain syndrome of strong and moderate intensity, in tons. Pain relief during painful diagnostic or therapeutic measures.

Possible substitutes for the drug Tramadol Stud: Tramadol Tramal Tramal Retard Adamon Long Adamon Long Tramadol Tramadol An analgesic opioid. Hypersensitivity, conditions accompanied by respiratory depression or marked oppression of the central nervous system, alcohol poisoning, sleeping pills, narcotic analgesics, etc.

Drug addiction, confusion, intracranial hypertension, TBI, epileptic syndrome of cerebral genesis in patients with abdominal pain of obscure genesis.

Dosage and administration: After the min, you can repeat the dose in the same dose of tramadol vs hydrocodone :, but not more than 8 doses per day. Retard tablets – mg every 12 hours. Daily dose – 0. Reception frequency – up to 4 times a day. The total daily dose is 0. It activates the opiate receptors of the m-delta-kappa of the pre- and postsynaptic membranes of the afferent fibers of the nociceptive system in the brain and gastrointestinal tract.

Slows the destruction of catecholamines, stabilizes their concentration in the central nervous system. The mono-O-desmethyltramadol M1 metabolite also selectively stimulates mu-opiate receptors. The affinity of tramadol to opioid receptors is 10 times weaker than that of codeine and several times weaker than that of morphine.

The severity of analgesic action is weaker than morphine. The analgesic effect is due to a decrease in the activity of nociceptive and an increase in the antinociceptive systems of the body.

Tramadol (Tramal) in the treatment of acute and chronic pain syndromes At therapeutic doses does not significantly affect hemodynamics and respiration, does not change the pressure in the pulmonary artery, slightly slows down intestinal motility, without causing constipation. It has some antitussive and sedative effects. Inhibits the respiratory center, stimulates the starting area of ​​the vomiting center, the nucleus of the oculomotor nerve. With prolonged use may develop tolerance.

Tramadol Vs Hydrocodone good, harm and calorie, sugar and carbohydrates

Analgesic effect develops after minutes after ingestion and lasts up to 6 hours. From the nervous system: From the tramadol vs hydrocodone: the digestive system: From the urinary system: From the senses: From the respiratory system: With prolonged use – drug dependence.

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This list includes the following drugs: How to you tramadol vs hydrocodone: contact. Therapeutic mud 49 [D] Darsonvalization .. It also has a sedative effect. Tramadol injection. Analogs of Tramadol in the presence of available structural analogues. Pain syndrome of strong and medium intensity, t. The site provides information on the cost in various pharmacies and their addresses. Rules for publishing reviews and questions from visitors. Doctors also prescribe tramadol for the treatment of arthritis, fibromyalgia and other chronic pain conditions. When abruptly canceled – the syndrome of “cancel”. Opiate-like effects can be stopped by naloxone seizures – benzodiazepine. Do not use for the treatment of drug withdrawal syndrome. Do not use ethanol at the same time. In the case of a single dose, there is no need to interrupt tramadol vs hydrocodone: breastfeeding.

During the period of treatment, care must be taken when driving vehicles and occupying others.

Tramadol: dosage and side effects | Medical encyclopedia Pharmaceutical incompatible with solutions of diclofenac indometacin phenyl butazonadiazepamaflunitrazepamanitroglycerin.

Inductors of microsomal oxidation in tons. Prolonged use of opioid analgesics or barbiturates stimulates the development of cross-tolerance. Anxiolytics increase the severity of the analgesic effect; the duration of anesthesia is increased when combined with barbiturates. Naloxone activates respiration, eliminating analgesia after the use of opioid analgesics. MAO inhibitors, furazolidone procarbazinantipsychotic drugs neuroleptics increase the risk of seizures decrease seizure threshold.

Quinidine increases the plasma concentration of tramadol and reduces the metabolite M1 due to competitive inhibition of the CYP2D6 isoenzyme. Questions, answers, reviews on the drug Tramadol Stud: Data on prices and availability in pharmacies listed on this page are updated twice a day.

Tramadol Hcl 50Mg: Tramadol (tablets 50 and 100 mg)

Content:

Tramadol Hcl 50Mg: Tramadol (tablets 50 and 100 mg)

Tramadol (tablets 50 and 100 mg) # 8212 tramadol hcl 50mg :; JSC “Organika”

Tramadol Hcl 50: how to take, composition, reviews

pharmachologic effect

Tramadol is an opioid synthetic analgesic with a central action and action on the spinal cord (facilitates the opening of K + channels and Ca2 — tramadol hcl 50mg: channels, causes membrane hyperpolarization and inhibits the conduction of pain impulses), increases the effect of tramadol hcl 50mg: sedative drugs. Activates opiate receptors (mu, delta, kappa) on the pre- and postsynaptic membranes of the afferent fibers of the nociceptive system in the brain and the gastrointestinal tract.

The analgesic effect is due to tramadol hcl 50mg: a decrease in the activity of nociceptive and an increase in the antinociceptive systems of the body.

In therapeutic doses, it does not significantly affect hemodynamics and respiration, does not change the pressure in the pulmonary artery, and slightly slows down tramadol hcl: intestinal motility, without causing constipation. It has some antitussive and sedative effects. Tramadol hcl :. Inhibits the respiratory center, stimulates the starting area of ​​the vomiting center, the nucleus of the oculomotor nerve.

With prolonged use may develop tolerance.

Analgesic effect develops 15-30 minutes after ingestion and lasts up to 6 hours.

Tramadol Hcl 50Mg: how to take, reviews

Indications

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For tramadol hcl tablets: 100 mg:

Pain syndrome (strong and moderate intensity, incl. Inflammatory, traumatic, vascular origin).

Pain relief during painful diagnostic or therapeutic interventions.

For tablets 50 mg:

Medium high tramadol hcl pain syndrome: intensity of various etiologies (postoperative period, injuries, pain in cancer patients).

Tramadol Classification: Tramadol (Tramadol) GARANT

Content:

Tramadol Classification: Tramadol (Tramadol) GARANT

Tramadol (Tramadol) | GUARANTOR

Tramadol Class: the right technique, typical mistakes

Tramadol (Tramadol)

Side effects:

DROPS:

Classification of the incidence of side effects (WHO):

very often> 1/10

often from> 1/100 to < 1/10

infrequently from> 1/1000 to < 1/100

rarely from> 1/10000 to < 1/1000

very rarely from < 1/10000, включая отдельные сообщения.

– From the central and peripheral nervous system:

Very often: dizziness;

Often: headache;

Infrequently: anxiety, confusion, drowsiness;

Seldom: euphoria, emotional instability, sleep disturbance, nightmares, cognitive disorders, hallucinations, amnesia; impaired coordination, convulsions, paresthesia, tremor, impaired concentration, epileptiform seizures, with prolonged use – the development of drug dependence;

Very rarely: panic attacks, ringing in the ears;

– Since the cardiovascular system:

Rarely: tachycardia, palpitations, cardiovascular collapse, syncope, orthostatic hypotension, cardiovascular insufficiency;

Very rare: bradycardia, arterial hypertension;

– On the part of the respiratory system:

Rarely: shortness of breath, respiratory depression, pulmonary edema;

– From the senses:

Very rarely: reduced visual acuity, sometimes mydriasis, a violation of taste;

– From the digestive system:

Very often: nausea;

Often: vomiting, constipation or diarrhea, dryness of the oral mucosa;

Infrequently: dyspepsia, abdominal pain, bloating;

Rarely: difficulty swallowing;

– Very rarely: increased activity of liver transaminases;

– From the skin:

Often: sweating;

Infrequently: skin rash, skin itch;

Rarely: urticaria;

– From the genitourinary system:

Infrequently: urinary retention, increased frequency of urination, violation

menstrual tramadol classification: cycle, signs of menopause;

Seldom: dysuria;

– From the musculoskeletal system:

Seldom: muscular weakness;

– Metabolism:

Infrequently: anorexia;

Seldom: decrease in body weight;

Allergic reactions:

Rarely: allergic reactions, manifested by dyspnea, bronchospasm, wheezing, as well as angioedema.

Other: with long-term use – drug dependence; with abrupt cancellation – “cancellation” syndrome.

CASCULAS:

The most frequent adverse reactions are nausea and dizziness, noted in more than 10% of patients.

The frequency is determined as follows:

Very often:> 1/10;

Often:> 1/100 < 1/10;

Infrequently:> 1/1000 < 1/100;

Rarely:> 1/10 000 < 1/1000;

Very rarely: <1/10000;

Not enough data: can not be determined based on available

data.

-Violations of the cardiovascular system:

Infrequently: effect on cardiovascular regulation (palpitations, tachycardia, orthostatic hypotension or collapse). These side effects are mainly observed with intravenous administration of the drug or with significant physical exertion.

Rarely: bradycardia, increased blood pressure.

-Metabolic and nutritional disorders:

Seldom: changes in appetite.

-Respiratory disorders:

Rarely: respiratory depression, shortness of breath.

With a significant excess of the recommended doses with the simultaneous use of other drugs that depress the central nervous system (CNS), respiratory depression is possible.

Worsening of the condition in bronchial asthma was noted, however, tramadol classification is causative: – no investigative connection with the use of the drug was established.

-Nervous system disorders:

Very often: dizziness.

Often: headache, drowsiness.

Rarely: speech disorders, paresthesia, tremor, epileptiform seizures, involuntary muscle contractions, impaired coordination, syncope. Epileptiform seizures are possible after the use of high doses of tramadol and with simultaneous use with drugs that lower the threshold of convulsive readiness.

– Mental Disorders:

Rarely: hallucinations, confusion, sleep disturbances, anxiety, delirium, and nightmares. After the use of tramadol, various rarely observed undesirable reactions from the psyche are possible (depending on the patient’s personality and the duration of treatment). These side effects include mood changes (usually tramadol classification: euphoria, sometimes dysphoria), activity changes (usually decrease, sometimes increase), impaired cognitive functions and perceptions (for example, decision-making, perception disorders).

Perhaps the development of drug dependence.

– Violations by the organ of vision:

Rarely: miosis, mydriasis, blurred vision.

– Disorders of the gastrointestinal tract:

Very often: nausea.

Often: constipation, dry mouth, vomiting.

Infrequently: emetic desires, a feeling of heaviness in the epigastrium, flatulence, diarrhea.

– Violations of the skin and subcutaneous tissues:

Often: sweating.

Infrequently: itch, rash, urticaria.

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– Disorders of the musculoskeletal and connective tissue:

Seldom: muscular weakness.

– Disorders of the liver and biliary tract:

In some cases, there was an increase in the activity of liver enzymes, which coincided in time with the therapy with tramadol.

– On the part of the kidneys and urinary system:

Rarely: urination disorders (difficulty urinating, dysuria and urinary retention).

– Immune system disorders:

Rarely: allergic reactions (shortness of breath, bronchospasm, wheezing, angioedema) and anaphylaxis.

– Common disorders:

Often: fatigue.

Seldom: the possible cancellation symptoms are similar to the opioid withdrawal symptoms: agitation, anxiety, nervousness, sleep disturbances, hyperkinesia, tremor, and gastrointestinal symptoms.

Other symptoms that are very rare with the abolition of tramadol include: panic attacks, severe anxiety, hallucinations, paresthesias, tinnitus and other extremely rare symptoms from the central nervous system (confusion, hallucinations, depersonalization, derealization, paranoia).

If the side effects indicated in the instruction have occurred, or other side effects that are not indicated in the instruction are noticed, inform your doctor about it.

INJECTION:

Classification of the incidence of side effects (WHO):

very often> 1/10

often from> 1/100 to < 1/10

infrequently from> 1/1000 to < 1/100

rarely from> 1 / 10,000 to < 1/1000

very rarely from < 1/10000, включая отдельные сообщения.

-Since the cardiovascular system:

Infrequently: disturbances of cardiovascular regulation (palpitations, tachycardia, postural hypotension or collapse).

These adverse effects may occur, after intravenous administration and in patients of physical exertion.

Rarely: bradycardia, fainting, high blood pressure.

-From the nervous system:

Very often: dizziness.

Often: headache, drowsiness.

Rarely: changes in appetite, speech disorders, paresthesia, depression, amnesia, tremor, respiratory depression, epileptiform seizures, involuntary muscle contractions, impaired coordination, instability of gait, blurred vision, fainting, weakness, fatigue, paradoxical stimulation of the central nervous system, sweating.

Convulsions are possible after the use of high doses of tramadol and with simultaneous use with drugs that reduce the threshold of convulsive readiness.

-From the psyche:

Rarely: hallucinations, confusion, sleep disturbance, anxiety, delirium,

anxiety and nightmares.

After the use of tramadol, various rarely observed undesirable reactions from the psyche are possible (depending on the patient’s personality and the duration of treatment). These undesirable drug reactions include a change in mood (usually euphoria, sometimes dysphoria), a change in motor activity (usually a decrease, sometimes an increase), impaired cognitive functions and perceptions (for example, a decision-making process, disorders of perception). Perhaps the development of drug dependence. Possible withdrawal symptoms are similar to opioid withdrawal symptoms: agitation, anxiety, nervousness, sleep disturbances, hyperkinesia, tremors, and gastrointestinal symptoms. Other symptoms that are very rare with the abolition of tramadol include: panic attacks, severe anxiety, hallucinations, paresthesias, tinnitus and other very rare symptoms from the CNS tramadol classification: (disruption of orientation in time and space, hallucinations, depersonalization, derealization, paranoia).

-On the part of the organ of vision:

Rarely: blurred vision, miosis;

Unknown: mydriasis.

-On the part of the respiratory system:

Rarely: shortness of breath.

With a significant excess of the recommended doses with the simultaneous use of other drugs that depress the central nervous system (CNS), respiratory depression is possible.

It was noted the deterioration of bronchial asthma, however, a causal relationship with the use of the drug is not installed.

-From the digestive system:

Very often: nausea.

Often: vomiting, constipation, dry mouth.

Infrequently: emetic urges, a feeling of heaviness in eggshgastriya, flatulence, diarrhea.

Very rare: pain in the abdomen, difficulty in swallowing.

-From the skin and subcutaneous tissue:

Often: sweating.

Infrequently: skin reactions (eg, itching, rash, urticaria).

-From the musculoskeletal system:

Seldom: muscular weakness.

-Liver and biliary tract:

In some cases, there was an increase in the activity of microsomal liver enzymes in time coinciding with the therapy with Gramadol.

-On the part of the kidneys and urinary system:

Rarely: urination disorders (difficulty urinating, dysuria and urinary retention).

On the part of the immune system:

Rarely: allergic reactions (shortness of breath, bronchospasm, wheezing, angioedema) and anaphylaxis.

-Metabolism:

Frequency unknown: hypoglycemia.

– Common disorders:

Often: increased fatigue.

RECTAL SUPPOSITORIES:

Tramadol Classification: technique and types of squats

Classification of the incidence of side effects (WHO):

very often> 1/10

often from> 1/100 to < 1/10

infrequently from> 1/1000 to < 1/100

rarely from> 1/10000 to < 1/1000

very rarely from < 1/10000, включая отдельные сообщения.

-From the central and peripheral nervous system:

Very often: dizziness;

Often: headache;

Infrequently: anxiety, confusion, drowsiness;

Seldom: euphoria, emotional instability, nightmares, cognitive disorders, hallucinations, amnesia; impaired coordination of movements, convulsions, paresthesias; tremor, concentration disorders, epileptiform seizures, with prolonged use – the development of drug dependence;

Very rarely: panic attacks, ringing in the ears;

-Since the cardiovascular system:

Rarely: tachycardia, palpitations, cardiovascular collapse, syncope, orthostatic hypotension, cardiovascular insufficiency;

Very rarely: bradycardia, increased blood pressure;

-On the part of the respiratory system:

Rarely: shortness of breath, respiratory depression, pulmonary edema;

-From the senses:

Very rarely: reduced visual acuity, sometimes mydriasis, a violation of taste;

-From the digestive system:

Very often: nausea;

Often: vomiting, constipation or diarrhea, dryness of the oral mucosa;

Infrequently: dyspepsia, abdominal pain, bloating;

Rarely: difficulty swallowing;

Very rarely: increased activity of liver transaminases;

-From the skin:

Often: sweating;

-From the genitourinary system:

Infrequently: urinary retention, increased frequency of urination, irregular menstruation, signs of menopause;

Seldom: dysuria;

-From the musculoskeletal system:

Seldom: muscular weakness;

-Metabolism:

Infrequently: anorexia;

Seldom: decrease in body weight;

-Allergic reactions:

Seldom: allergic reactions (for example, urticaria, pruritus, rash, bullous rash, angioedema) and anaphylaxis, which can cause azole dyes E122, E124 and E151.

Other: with long-term use – drug dependence; with abrupt cancellation – “cancellation” syndrome.

Tramadol Vs Oxycodone: Tramadol (50 mg) instructions for use, indications. (Other names Tramadol)

Content:

Tramadol Vs Oxycodone: Tramadol (50 mg) instructions for use, indications. (Other names Tramadol)

Tramadol (50 mg): instructions for use, indications. (Other names: Tramadol)

Full description (Tramadol (50 mg)): use, composition, dosage, indications, contraindications, side effects. Other names: Tramadol

Russian

азақша

Tradename

Tramadol

International non-proprietary name

Tramadol

Dosage Form

Capsules 50 mg

Composition

One capsule contains

active ingredient – tramadol hydrochloride 50 mg,

excipients: starch, calcium dihydrophosphate, lactose, sodium methyl parahydroxybenzoate, sodium propyl parahydroxybenzoate, polyvinylpyrrolidone (PVP K30), talc,

the composition of the capsule shell: gelatin, iron (III) yellow oxide (E172), brilliant blue (E133).

Description

Hard gelatin capsules size “2” light green / light green color. The contents of the capsules are white or almost white.

Pharmacotherapeutic group

Analgesics. Opioids. Other opioids. Tramadol.

ATH code N02AX02

Pharmacological properties

Tramadol Vs Oxycodone: the benefits and harm, the use of diabetes instead of sugar

Pharmacokinetics

Suction

After ingestion, tramadol is rapidly and almost completely absorbed in the gastrointestinal tract. The average oral bioavailability is approximately 68%. Eating does not have a significant impact on the rate and extent of absorption. Serum concentration of 100 ng / l (minimum effective analgesic concentration) is reached approximately 0.7 hours after administration and lasts for 9 hours.

Distribution The distribution after oral and intravenous administration is approximately 306 and 203 liters, respectively. Plasma protein binding is about 20%. Tramadol penetrates through the placenta and its concentration in umbilical cord blood is 80% of the concentration in the mother’s blood.

Metabolism Approximately 85% of tramadol is metabolized. Tramadol is metabolized by N- and O-demethylation. With the exception of the O-demethylated metabolite (M1), all metabolites are pharmacologically inactive.

Removal

90% of tramadol and its metabolites are excreted through the kidneys, the rest is excreted with feces. The half-life is 5-6 hours and is the same as in tramadol and its metabolites.

In cases of impaired renal function, the volume and rate of excretion decreases, therefore, in patients with creatinine clearance less than 0.5 ml / s, a reduction in dosage and an increase in the intervals between dosing is recommended.

Metabolism of tramadol and M1 is reduced in patients with severe cirrhosis of the liver, and therefore the dosage must be adjusted.

In patients older than 75 years, the peak concentration of tramadol in the blood plasma slightly increases and the half-life is longer, so dose adjustment is required.

Pharmacodynamics

Tramadol is a centrally acting analgesic. He is a non-selective opioid receptor agonist. µ, δ and κwith higher affinity for µ-receptors. Tramadol inhibits neuronal uptake of norepinephrine, and also increases the release of serotonin, which leads to the analgesic effect of the drug.

Tramadol in therapeutic doses has almost no effect on the cardiovascular system (does not have a suppressive effect and does not increase the pressure in the pulmonary artery), does not cause smooth muscle spasm, histamine release, therefore, anaphylactic reactions occur rarely. The effect on breathing is minimal and can only manifest at higher doses. The development of addiction and addiction are also very rare.

Indications for use

– pain syndrome of medium and strong intensity

Dosage and administration

The dose is selected individually depending on the intensity of pain and sensitivity of the patient. The smallest effective analgesic dose is usually used. The maximum permissible dose of the drug per day is 400 mg.

If not stated otherwise, the drug should be taken as follows:

Adults

Acute pain: 1-2 tablets (50-100 mg) 3-4 times a day. For patients with low body weight, the dose is calculated at a rate of 0.7 mg / kg. The duration of treatment depends on the clinical need.

Pain associated with chronic diseases: The recommended starting dose is 50 mg or 100 mg, followed by a dose titration every 4-6 hours, depending on the intensity of the pain. It is important to regularly assess the need for continuation of treatment, since there is evidence of the onset of withdrawal symptoms and the development of dependence.

Children

The drug is not intended for the treatment of children and adolescents under 18 years of age.

Elderly patients

Usually in the treatment of patients under the age of 75 years, a dose adjustment is not required if they have no clinical manifestations of hepatic or renal failure. In patients older than 75 years, the elimination period may be increased. Therefore, if necessary, increases the interval between doses of the drug in accordance with the needs of the patient.

Renal failure

In patients with renal insufficiency, drug elimination may be delayed. The initial dose may be standard. These patients need to consider the need to lengthen the interval between doses of the drug in accordance with the individual characteristics of the patient.

For patients with creatinine clearance <30 мл/мин интервал между приемом препарата должен быть увеличен до 12 часов.

Tramadol is not recommended for patients with severe renal insufficiency with creatinine clearance <10 мл/мин. При гемодиализе или гемофильтрации трамадол выводится очень медленно и поэтому пост-диализное назначение трамадола для поддержания анальгезирующего эффекта нецелесообразно.

Liver failure

In patients with impaired liver function, prolonged elimination of the drug is noted. The standard dose should be divided into 2 parts or the interval between doses of the drug should be increased to 12 hours.

These patients need to consider the need to lengthen the interval between doses of the drug in accordance with the individual characteristics of the patient. Tramadol is not recommended for patients with severe liver failure.

Mode of application

Capsules must be taken whole, without breaking and chewing, with a sufficient amount of liquid, with or without food.

Reception duration

Under no circumstances should the duration of treatment with tramadol exceed a period of extreme need for its administration. If necessary, long-term administration of tramadol for anesthesia due to the nature and severity of the disease should be regularly monitored (if necessary with interruptions in the treatment process) to determine the further need and scope of therapy.

Side effects

The most common side effects such as nausea and vomiting, which develop in 10% of patients.

The following frequency is observed:

Often: ge; 1/10

Often: ge; 1/100, <1/10

Infrequently: ge; 1/1000, <1/100

Seldom: ge; 1/10 000, <1/1000

Very rarely: <1/10 000

Violations of the cardiovascular system:

Infrequently

– heart palpitations, tachycardia, orthostatic hypotension, cardiovascular collapse. Such adverse reactions can occur, in particular, when administered intravenously, as well as in physically weakened patients.

Seldom

– bradycardia, increased blood pressure

Respiratory disorders

Seldom

– respiratory depression, shortness of breath

With a significant excess of the recommended dose and the simultaneous use of other drugs that depress the central nervous system, respiratory depression can develop. There is evidence of increased asthma symptoms, although a causal relationship has not been established.

The nervous system

Often

– dizziness

Often

– headache, drowsiness

Seldom

– change in appetite, speech disorders, paresthesia, tremor, epileptiform seizures, involuntary muscle contractions, impaired coordination, syncope.

Convulsions developed, mainly, after taking high doses of tramadol or after the simultaneous use of drugs that reduce seizure threshold.

Mental disorders:

Seldom

– hallucinations, sleep disturbances, delirium, anxiety and nightmares. After the introduction of tramadol, a variety of adverse psychological phenomena can occur, the intensity of which varies in each case (depending on the individual characteristics and duration of treatment). These include mood changes (usually euphoria, in some cases dysphoria), changes in motor activity (usually depression, in some cases amplification), and cognitive impairment and sensory perception (for example, impaired decision-making ability and impaired perception). May develop drug dependence. Symptoms associated with withdrawal syndrome may develop, just as with the abolition of tramadol vs oxycodone opiates :: agitation, anxiety, nervousness, insomnia, hyperkinesia, tremor, and gastrointestinal disturbances. Very rarely, when discontinuation of tramadol, symptoms such as panic attacks, severe anxiety, hallucinations, paresthesia, tinnitus and central nervous system disorders (ie confusion, delusions, depersonalization, derealization, paranoia) are encountered.

Visual impairment

Seldom

– pupillary constriction, dilated pupils, blurred vision

Gastrointestinal disorders

Often

– nausea

Often

– constipation, dry mouth, vomiting

Infrequently

– belching, discomfort on the part of the gastrointestinal tract (a feeling of constriction in the stomach, swelling), diarrhea

Diseases of the skin and subcutaneous fat

Often

– hyperhidrosis

Infrequently

– skin reactions (eg, itching, rash, urticaria)

Damages of the musculoskeletal system and connective tissues

Seldom

– motor tramadol vs oxycodone: weakness

From the hepatobiliary system

In several cases not related to each other, an increase in the activity of hepatic enzymes was observed, which coincided with the administration of tramadol.

Kidney and urinary system disorders

– difficulty urinating, urination disturbance (dysuria and urinary retention)

Immune system disorders

Seldom

– allergic reactions (eg, difficulty breathing, bronchospasm, wheezing, angioedema) and anaphylactic reaction

Metabolic disorders and nutrient absorption

Unknown

– hypoglycemia

General violations

Often

– fatigue

Contraindications

hypersensitivity to tramadol and / or auxiliary ingredients of the drug and other opioid analgesics

acute intoxication with depressants of the central nervous system

Tramadol Effects how to take, reviews

(alcohol, centrally acting analgesics, opioids, psychotropic drugs, hypnotics)

severe renal failure (creatinine clearance less than 10 ml / min)

severe liver failure

simultaneous use of MAO inhibitors (and for 14 days

after their cancellation)

patients with epilepsy, for which can not adequately

be monitored

children and adolescents up to 18 years

pregnancy and lactation

Drug interactions

Tramadol should not be used in combination with MAO inhibitors.

Patients who received MAO inhibitors for 14 days prior to the use of opioid analgesics, life-threatening interactions were observed on the central nervous system, respiratory and cardiovascular systems. Such interactions with MAO inhibitors are not excluded with the simultaneous appointment of tramadol.

With simultaneous use of tramadol with drugs that have a depressant effect on the central nervous system, as well as with ethanol, mutual enhancement of their action is possible.

The use of carbamazepine, barbiturates and other inducers of microsomal enzymes can lead to a weakening of the analgesic action of tramadol.

Prolonged use of tramadol stimulates the development of cross-tolerance to other opioid analgesics.

With the joint or prior use of cimetidine (an enzyme inhibitor), clinically significant interactions are unlikely. The combination of opioid receptor agonists / antagonists (for example, buprenofine, nalbuphine, pentazocine) and tramadol is not recommended because the analgesic effect of a pure agonist is reduced under these conditions.

With simultaneous use of Tramadol with selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenalin serotonin reuptake inhibitors (SNRIs), tri- and tetracyclic antidepressants, antipsychotics and other drugs that reduce seizure threshold, the risk of seizures increases.

When tramadol is used in combination with other serotonergic substances, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline serotonin reuptake inhibitors (SNRIs), MAO inhibitors, tri- and tetracyclic antidepressants may develop serotonin syndrome. Symptoms of serotonin syndrome: confusion, agitation, hyperthermia, sweating, ataxia, hyperreflexia, myoclonus and diarrhea.

Serotonin syndrome is possible if one of the following symptoms is observed:

– Spontaneous convulsions

– Induced seizures or twitching of the eye muscles on the background of excitement and sweating

– Tremor and hyperreflexia

– Hypertension and body temperature> 38 ° C and induced or ocular muscle twitching.

Cancellation of serotonergic drugs causes rapid relief of symptoms. Treatment depends on the type and severity of the symptoms.

Particular caution should be exercised with the simultaneous use of tramadol and coumarins (eg, warfarin) because of the risk of reducing prothrombin time with the development of bleeding and hemorrhages.

Other CYP3A4 inhibitors, such as ketoconazole and erythromycin, can inhibit the metabolism of tramadol (N-demethylation) and active O-desmethyltramadol. The clinical significance of this interaction is not well understood.

In a limited number of studies, it was found that pre-or postoperative use of an antiemetic agent, a 5-HT3 antagonist, ondansetron, increased the need for tramadol for postoperative pain.

Tramadol Vs Oxycodone on the skin: treatment of stretch marks, causes

special instructions

Tramadol should be used with caution and risk / benefit assessment in the following conditions:

– Symptoms of cancellation. Therapeutic doses of tramadol can cause withdrawal symptoms (message rate is 1/8000 cases)

– Drug addiction. Cases of the development of a symptom of dependence are rare and much less common than withdrawal symptoms. The clinical need for treatment with tramadol must be controlled by a physician. Tramadol has a low potential for developing addiction. However, long-term use may develop addiction, mental and physical dependence. In patients with a penchant for drug abuse or drug dependence, treatment with tramadol should be carried out only for a short period and under the strict supervision of a physician.

– Patients with opioid dependence. Tramadol is not applicable as a substitute for patients with opioid dependence, as it does not suppress the symptoms of morphine withdrawal.

– In patients who are sensitive to opioids, Tramadol should be administered with caution.

– Tramadol should be prescribed with caution when head injuries, increased intracranial pressure, liver failure (reduced metabolism of tramadol and its active metabolites) and renal failure (reduced speed and lengthening elimination of tramadol and its active metabolites), with a reduced level of consciousness and in patients prone to convulsive disorders or in shock.

– Patients with convulsive readiness. There have been cases of convulsive symptoms when prescribing therapeutic doses of tramadol, and the risk of seizures may increase if the recommended daily dose is exceeded. Treatment of tramadol patients with epilepsy or a predisposition to seizures should be considered only if there is a clinical rationale. The risk of developing convulsive syndrome is increased in patients taking both tramadol and drugs that reduce the convulsive threshold.

– The drug should be prescribed with caution in patients with respiratory failure or with simultaneous administration with depressants of the central action or when the doses significantly exceed the recommended doses, because in this case, the development of respiratory depression cannot be ruled out.

– The simultaneous appointment of carbamazepine or alcohol in the treatment of tramadol is not recommended.

– Because of the reported deaths in case of an unintentional overdose of tramadol, associated with the use of mentally active drugs and substances, including alcohol, tramadol should be administered with caution to patients with alcohol dependence and receiving any active psychoactive substances.

With prolonged (more than 3 months) use of analgesics, with an interval of a day or more often, a headache may develop or intensify. In this case, you should not increase the dose of tramadol. After consultation with the doctor, it is necessary to resolve the issue of stopping the use of analgesics.

Pregnancy and lactation period

Pregnancy

Animal studies have shown that very high doses of tramadol affect organ development, ossification and infant mortality. Tramadol penetrates the placenta. There is not enough data on the safety of using tramadol for treating people during pregnancy. For this reason, tramadol cannot be used to treat pregnant women.

The introduction of tramadol before or during birth does not affect uterine contractility. In newborns, it can cause changes in respiratory rate, which, as a rule, are clinically insignificant.

Chronic use during pregnancy can lead to the development of a newborn withdrawal syndrome.

Breastfeeding tramadol vs oxycodone:

During lactation, about 0.1% of the dose taken by the mother is excreted in milk. Do not use the drug during breastfeeding.

Reproductive functions

The results of post-marketing observations did not reveal the effect of tramadol on reproductive functions. The results of studies involving animals did not reveal the effect of tramadol on reproductive functions.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous machinery

Even if used in accordance with the instructions, tramadol can cause drowsiness and dizziness, as a result of which the reaction of the drivers and operators of the mechanisms of tramadol vs oxycodone can worsen: This applies in particular to the simultaneous intake of other psychotropic substances, in particular alcohol.

Overdose

Symptoms of Tramadol overdose are similar to those that may occur with other analgesics (opioids) of central action.

Symptoms: constriction or dilation of pupils, vomiting, collapse, a drop in blood pressure, heartbeat, depression of consciousness (up to a comatose state), epileptic seizures, difficulty breathing, and stopping (apnea).

Treatment:

Maintaining / restoring the vital functions of respiration and blood circulation in a specialized department. An antidote in the case of respiratory depression is naloxone, for convulsions it is advisable to use diazepam.

In case of overdose with oral administration of the drug, it is necessary to take activated charcoal, gastric lavage is recommended in the first 2 hours after administration of tramadol. After 2 hours, it is necessary to conduct a detoxification event using a large amount of liquid.

Tramadol is slightly excreted by hemodialysis and hemofiltration, therefore the treatment of acute intoxication with tramadol by these types of interventions is not advisable.

Release form and packaging

10 capsules are placed in a blister packaging made from polyvinyl chloride film and aluminum foil.

For 1 or 2 blister packs together with instructions for medical use in the state and Russian languages ​​are placed in a pack of cardboard.

Storage conditions

In original packaging, in a dry place at a temperature not higher than 30 ° C.

Keep out of the reach of children!

Shelf life

3 years

Do not use after the expiration date

Pharmacy sales terms

On prescription

Name and country of the manufacturer

Protech Biopharma Pvt. Ltd. India

Name and country of the packer

Protech Biopharma Pvt. Ltd. India

Name and country of registration certificate holder

Protech Biopharma Pvt. Ltd. India

Address of the organization that receives claims from consumers on the quality of products (goods) in the Republic of Kazakhstan

LLP “Denovo Impex, Republic of Kazakhstan, Almaty 050062, ul. Utegen Batyr, 15

tel .: 727 2437415

fax: 727 2437416

e-mail: denovo.kz@rambler.ru

Tramadol 100Mg: Tramadol (Tramadolum) – a description of the substance, instructions, use, contraindications and formula.

Content:

Tramadol 100Mg: Tramadol (Tramadolum) - a description of the substance, instructions, use, contraindications and formula.

Tramadol (Tramadolum) – a description of the substance, instructions, use, contraindications and formula.

Description of the active ingredient tramadol 100mg: Tramadol (Tramadolum): instructions, use, contraindications and formula

Enhances the action of drugs that depress the central nervous system (including tranquilizers, sleeping pills, sedatives and anesthetic drugs), and ethanol. Inductors of microsomal oxidation (including carbamazepine, barbiturates) reduce the severity of the analgesic effect of tramadol and the duration of action. Since carbamazepine increases tramadol metabolism and increases the risk of seizures, the simultaneous use of carbamazepine and tramadol is not recommended. Prolonged use of opioid analgesics or barbiturates stimulates the development of tramadol 100mg: cross-tolerance. Anxiolytics increase the severity of the analgesic effect; the duration of anesthesia is increased when combined with barbiturates. Naloxone activates respiration, eliminating analgesia after the use of opioid analgesics. MAO inhibitors, furazolidone, procarbazine, neuroleptics increase the risk of seizures (decrease seizure threshold). Quinidine increases tramadol 100mg tramadol 100mg :: the plasma concentration of tramadol and decreases the metabolite M1 due to competitive inhibition of the CYP2D6 isoenzyme.

Which Tramadol 100Mg is beneficial and which are harmful? What fat is good for health?

Inhibitors of CYP2D6 isoenzymes (such as fluoxetine, paroxetine and amitriptyline) and CYP3A4 (such as ketoconazole, erythromycin) can decrease tramadol metabolism and increase the risk of serious side effects, including convulsions and serotonin syndrome.

Serotonergic drugs such as antidepressants of the SSRI group, MAO inhibitors, antifungal drugs (triptans), linezolid (an antibiotic that is a reversible non-selective MAO inhibitor), as well as lithium drugs when used together with tramadol can cause serotonin syndrome.

Tramadol 100Mg – how to take, reviews

Analeptics and psychostimulants reduce activity, they completely block naloxone and naltrexone (direct antagonists).

Is Tramadol An Opiate: TRAMADOL is … What is TRAMADOL

Content:

Is Tramadol An Opiate: TRAMADOL is ... What is TRAMADOL

TRAMADOL is … What is tramadol an opiate: is TRAMADOL?

See what “TRAMADOL” is in other dictionaries:

Tramadol – (Tramadol) Chemical compound … Wikipedia

Is Is Tramadol An Opiate harmful or beneficial to humans?

tramadol – n., number of synonyms: 1 • tramal (1) The synonym dictionary is tramadol an opiate: ASIS. V.N. Trishin is tramadol an opiate :. 2013 … Synonyms Dictionary

Tramadol-ratiopharm – Active ingredient ›› Tramadol * (Tramadol *) Latin name Tramadol ratiopharm АТХ: ›› N02AX02 Tramadol Pharmacological group: Opioids, their analogues and antagonists Composition and form of production Capsules 1 caps. Tramadol 50 mg in: … … Dictionary of medical drugs

Tramadol Lannaher – Active ingredient ›› Tramadol * (Tramadol *) Latin name Tramadol Lannacher АТХ: ›› N02AX02 Tramadol Pharmacological group: Opioids, their analogues and antagonists Nosological classification (ICD 10) ›› R52.1 Permanent non-closure pain … Dictionary of medical drugs

Tramadol retard – Active ingredient ›› Tramadol * (Tramadol *) Latin name Tramadol retard ATH: ›› N02AX02 Tramadol Pharmacological group: Opioids, their analogues and antagonists Composition and release form 1 sustained release tablet contains … … Dictionary of medical drugs

What foods contain Is Tramadol An Opiate: a list of foods rich in melanin

Tramadol STADA – Active ingredient ›› Tramadol * (Tramadol *) Latin name Tramadol Stada АТХ: ›› N02AX02 Tramadol Pharmacological group: Opioids, their analogues and antagonists Composition and form of release Capsules1 caps .tramadol hydrochloride 50 mg in addition … … Dictionary of medical drugs

Tramadol-Akri is tramadol an opiate: – Active ingredient ›› Tramadol * (Tramadol *) Latin name Tramadol Akri ATX: ›› N02AX02 Tramadol Pharmacological group: Opioids, their analogues and antagonists Nosological classification (ICD 10) ›› R52.0 Acute pain ›› R52.1 Permanent … … Dictionary of medical drugs

Tramadol Slovak Pharma – Active Ingredient ›› Tramadol * (Tramadol *) Latin name Tramadol Slovakofarma ATX: ›› N02AX02 Tramadol Pharmacological group: Opioids, their analogues and antagonists Nosological classification (ICD 10) ›› I21 Acute myocardial infarction … … Medicinal Medicine Dictionary

Tramadol (tramal) is a synthetic opioid of moderate analgesic potency (0.15 of the morphine potential), has a second non-opioid mechanism of central action (inhibits the reuptake of norepinephrine and serotonin in the structures of the central nervous system). Tramadol in therapeutic doses … … Official terminology

Is Tramadol in bodybuilding: the best porridge for a set of muscle mass and health

Tramadolum – TRAMADOL (Tramadolum). (#) trans 2 [(dimethylamino) methyl] 1 (m methoxyphenyl) cyclohexanol hydrochloride. Synonyms: Tramal, Crispin, Melanate, Tramadol hydrochloride, Tramal. It has strong analgesic activity, gives a quick and … … Dictionary of medical drugs