Tramadol in ampoules: instructions for use, price, analogues, indications, contraindications. Errors in pain relief with Tramal after surgery
One of the most effective and popular medications for the treatment of cancer pathologies is Tramadol. Instructions for use in ampoules for cancer state that the product helps to dull the painful sensations caused by the pathogenic effect of atypical cells, and also improves the physical and psychological condition of a person. Since Tramadol belongs to the group of opioid analgesics, it affects the central nervous system and the spinal cord, in addition, it enhances the effect of other synthetic drugs. Since the medication is potent, it should be taken only as prescribed by a doctor, strictly following the instructions.
Tramadol for cancer patients is a powerful analgesic of the opioid category. The main purpose of the drug is to support the functioning of the central nervous system (CNS) and spinal cord. For people diagnosed with a severe form of cancer, this medicine is indispensable, since only it has a pronounced analgesic effect. The patient experiences relief within 20 minutes after administration of the solution, and the effect lasts up to 6-7 hours.
Among other advantages of the drug are:The analgesic effect is achieved due to the fact that the active components of the drug awaken opiate receptors in the brain and gastrointestinal tract, while preventing the decomposition of catecholamines. Numerous clinical studies have confirmed that, despite the powerful analgesic effect, Tramadol has a gentler effect on the body compared to other drugs in this pharmaceutical category (with a similar dosage of morphine).
No negative effect on the blood;
sedative effect;
antitussive effect.
But it is necessary to understand that Tramadol is a dangerous drug that, if taken for a long time or inappropriately, will cause many complications. Oncologists warn that the medication should not be taken for a long time, as it can cause addiction and also disrupt the functioning of the respiratory center.
If the patient ignores medical recommendations and uses the medication for longer than the prescribed time, the drug will soon stop working and the dosage will need to be increased. All this will lead to the cancer patient becoming dependent on Tramadol.
Opioid drugs are prescribed only in extreme cases, if there are appropriate indications. The use of such drugs for moderate and tolerable pain is prohibited.
More often the medication is prescribed for the following indications:
Receiving severe injuries accompanied by severe pain (for example, a fracture of the spine or femur);
surgical intervention;
neuralgia with pain syndrome;
formation of malignant neoplasms stages 3 and 4;
carrying out complex diagnostic examinations accompanied by severe pain.
Many patients with common fractures ask to be prescribed Tramadol.
It is necessary to understand that this potent medication can cause a variety of complications, so it is prescribed only in extreme cases.
Contraindications
If the drug is prescribed, the instructions for using Tramadol in ampoules must be read in full. Not only the oncologist, but also the patient should know what complications may arise as a result of treatment with the drug. Doctors warn that this medicine can only be used if there are no contraindications, otherwise the situation may worsen.
Tramadol is strictly prohibited for use when:1. Carrying a child and lactation period.
2. Severe form of liver failure and renal pathologies.
3. Central nervous system dysfunction.
4. Diseases of the respiratory tract.
5. Less than 12 months old.
6. Tendency to psychiatric disorders.
7. Individual intolerance to the active components of Tramadol.
Hypertensive patients should take this medicine with extreme caution. Even if side effects do not appear during the first time, the patient will still need to be regularly monitored by the treating doctor.
How long do people live on Tramadol for cancer? It is impossible to answer this question with certainty, since it all depends on which organ is affected by the atypical cells, what degree of the disease is diagnosed in the patient and whether the pathology is accompanied by metastasis. Since Tramadol is most often prescribed for stage 3 or 4 cancer, the further prognosis for the patient’s survival is not favorable, and only 15% of patients can survive up to 5 years. It is also important to remember that if you take the medication for a long time, the body may begin to react negatively to the active ingredients, and the drug will have to be discontinued.
The most common side effects are:Deterioration in the functioning of the cardiovascular system. Often, during drug treatment, tachycardia and orthostatic hypertension develop. Many patients also suffer from loss of consciousness;
blurred vision and loss of taste;
menstrual irregularities;
dysfunction of the digestive system. The patient feels nauseous and suffers from constant flatulence, often with bowel dysfunction (constipation may be accompanied by diarrhea). When using the medication, it is also possible to experience pain in the abdominal cavity and dry mouth;
manifestation of severe allergies, accompanied by a bullous rash and itching;
deterioration of the central nervous system. This is where complications arise in 70% of cases. A few days after the patient begins receiving injections, severe headaches, migraines, and lethargy appear. Many patients also complain of insomnia and anxiety. 10% of patients suffer from memory loss, deterioration of attention and hallucinations.
The greatest danger is that with long-term use, cancer patients develop dependence, and they can no longer live without Tramadol. Withdrawal of the drug provokes real “withdrawal”.
This condition is usually accompanied by the following symptoms:Cardiopalmus;
nagging muscle pain;
runny nose;
increased blood pressure;
vomit;
cramps and suffocation.
It is important to understand that at stage 4 cancer, not every patient will be able to live with such symptoms; about 20% of patients fall into a coma or die after stopping the drug.
Interaction with other medications
Regardless of what type of tumor is diagnosed in the patient, it is strictly forbidden to use Tramadol simultaneously with MAO inhibitors (monoamine oxidase). When combined with similar medications, a synergistic effect may occur (such a reaction may also occur if the patient drinks alcoholic beverages while using Tramadol).
It is strictly not recommended to inject Tramadol while taking Carbamazepine, since in this case you will need to increase the dosage. If the patient takes any psycholeptics, there is a risk of severe convulsions. The action of Tramadol is negatively affected by barbiturates, since this pharmaceutical group reduces the analgesic effect.
Very often, relatives of patients are interested in how to strengthen Tramadol for oncology? Indeed, often at the last stage of the disease, pain does not subside even with the use of such powerful means. It is important to understand that the use of Tramadol simultaneously with other medications must be done with prior agreement with the treating physician, otherwise the treatment can lead to the most disastrous consequences.
Most often, the medication is recommended to be combined with:1. Solpadeine Forte in tablets.
2. Diphenhydramine.
3. Ketarol.
4. Naklofen.
5. Pentalgin in ampoules.
The dosage and duration of treatment are selected individually for each patient. It is important to understand that a certain combination will act individually for each patient.
Analogs
If a patient is diagnosed with carcinoma or sarcoma, the pain will intensify as the pathology progresses. Since the drug is not sold in every pharmacy, you need to know what can replace Tramadol for oncology and which medications have the same enhanced effect.
If necessary and after consultation with your doctor, the product can be replaced with:Mambron;
Tramolin;
Tramadol hydrochloride;
Tramagite;
Tramaol;
Adamonllong 100.
It is important to remember that all of these drugs are powerful narcotic painkillers, so they are sold in pharmacies only by prescription and are prescribed exclusively for pain relief. To minimize the risk of complications, medications should be stored in a cool place, away from direct sunlight.
Most reviews about Tramadol are positive; this medication really copes with its task and helps relieve pain. But it is necessary to remember, in order not to nullify the effect of treatment and not to aggravate the situation, the drug must be used strictly in accordance with the instructions and under the supervision of the attending physician.
When taken correctly, Tramalol not only helps improve the patient’s general condition and relieve pain, but also prolongs life by 5-7 years.
Tramadol has been used for more than 30 years in Europe and more than 10 years in the USA for the treatment of patients with moderate and severe chronic pain of non-cancer etiology (Mongin G., 2007).
Tramadol (Tramal®) is a mixed-action analgesic, from a chemical point of view, representing a racemate consisting of two enantiomers. (+)-Tramadol and its metabolite (+)-desmethyl-tramadol (metabolite M1) are agonists of opioid receptors of the μ (mu) type. Additionally, (+)-Tramadol stimulates the release of the central transmitter serotonin in the area of presynaptic serotonergic nerve endings, and also suppresses its return through the membrane of the nerve ending (reverse neuronal uptake). At the same time, the levorotatory isomer (-)-Tramadol inhibits the reuptake of the neurotransmitter norepinephrine (norepinephrine).
This mechanism of action is strongly reminiscent of the pharmacological effects of tricyclic antidepressants and, as in their case, leads to the accumulation of antinociceptive mediators serotonin and norepinephrine in the central nervous system, which, as mentioned earlier, leads to the suppression of the transmission of pain signals in the spinal cord and brain coming from peripheral tissues or anatomical structures of the back to pain centers (thalamus). Such unique properties have determined the partial “atypicality” of tramadol among “classical” analgesics, and the combination of three completely different mechanisms of pharmacological action in one molecule significantly expands the range of its effects in relation to the pathophysiology of pain, and also determines an absolutely unique profile of effectiveness and safety (Keskinbora K., Aydinli I., 2006) (Grond S., Sablotzki A., 2004) (Dyer P., Desmeules J., Collart L., 1997).
Tramadol at the recommended dose of 400 mg/day has high bioavailability and is used 2 times a day, which is sufficient for adequate pain control. Tramadol is effective for pain of various origins: for moderate-severe acute and chronic pain, including neuropathic, spinal pain, osteoarthritis, and traumatic pain. Because tramadol has an opioid component of pharmacological action (i.e., it stimulates opioid μ receptors), its spectrum of adverse effects is largely similar to that of most opioid analgesics. So, against the background of tramadol, nausea, vomiting, lethargy (drowsiness), constipation, and dry mouth are observed.
However, unlike opioids, tramadol does not cause respiratory depression, cardiovascular complications, drug dependence and has less clinical and toxicological significance. However, in contrast to NSAIDs and acetaminophen, tramadol has a more pronounced analgesic effect against the backdrop of a favorable safety profile, given that it does not cause gastrointestinal complications typical of NSAIDs and does not have the potential hepatotoxicity of acetaminophen (Keskinbora K. , Aydinli I., 2006) (Klotz U., 2003) (Gibson T.P., 1996) .
The analgesic effect of tramadol after oral administration develops within 1 hour after oral administration and reaches a maximum within 2 hours (Lewis K.S., Han N.H., 1997).
Tramadol, when taken orally, has equivalent effectiveness to codeine, for example, for toothache. For refractory cancer pain, tramadol is significantly less effective compared to morphine. For non-cancer chronic pain, including lumbar pain, the effectiveness of tramadol is equivalent to that of a combination of codeine and acetaminophen (Lewis K.S., Han N.H., 1997).
Tramadol significantly reduces pain in patients with chronic pain due to osteoarthritis, improves sleep parameters, joint mobility and physical function. Tramadol-based drugs may be prescribed to treat patients with an inadequate analgesic response or contraindications to the use of NSAIDs or COX2 inhibitors (Barkin R.L., 2008).
Reeves R.R. and Cox S.K. published the results of an observation of patients with chronic pain syndrome with depression that developed immediately after stopping tramadol therapy for several years. Symptoms of depression were successfully relieved after administration of the antidepressant venlafaxine. Tramadol and venlafaxine have many common properties, including structural similarity, serotonergic and adrenergic effects, and a similar metabolic pathway in the body. The authors provide convincing arguments, as well as their own evidence, that tramadol can act not only as an analgesic, but also as an antidepressant, preventing the development of depression against the background of chronic pain (Reeves R.R., Cox S.K., 2008).
Recently, for the treatment of adult patients with severe chronic pain syndromes requiring hourly pain control for a long time, the drug tramadol ER 29 (100-300 mg), which is a tablet that provides a prolonged release of the substance, was proposed (Barkin R.L., 2008). The drug is superior to placebo in the treatment of moderate to severe chronic pain syndromes in patients with osteoarthritis. As shown in one randomized, double-blind, placebo-controlled study and in a flexible dose study, tramadol ER improves physical function ( Western Ontario and McMaster Universities Osteoarthritis Index) on the 12th week of admission. The main undesirable effects are manifested in the form of vertigo, nausea, constipation, drowsiness and sweating (Babul N., 2004) (Hair P.I., 2006).
Almost simultaneously with the above-mentioned tramadol ER, the drug tramadol SR in slow-release capsules was proposed. “The special “device” of the capsules ensures a gradual release of the analgesic and determines its “smoother” pharmacokinetic profile, based on an even slower release of the substance and the absence of peak concentrations in the blood and their fluctuations. The bioavailability of tramadol SR is equivalent to that of tramadol ER. Tramadol SR is available in capsules of 100 mg of the substance and is taken 2 times a day.
The effectiveness of tramadol with this dosing regimen is equivalent to tramadol ER, available in 50 mg capsules taken 4 times a day. According to some data, patients receiving tramadol SR for severe chronic pain are significantly less likely to complain of nausea compared to tramadol ER. In a post-marketing study (n=3,888), use of tramadol SR capsules in 35% of patients with moderate-severe chronic non-cancer pain was associated with a reduction in pain intensity (93.4%) (Keating G/M., 2006).
The efficacy and safety of tramadol ER in the treatment of patients with non-specific chronic low back pain was assessed in a large, randomized, open-label, placebo-controlled trial involving 619 patients receiving tramadol ER or placebo for 12 weeks. Patients tolerated opioid therapy well, and tramadol ER provided effective and durable pain relief compared with placebo. Adverse events were expressed mainly in the form of nausea, headaches, diarrhea or constipation, dizziness and insomnia (Vorsanger G.J., 2008).
One open-label study assessed the effectiveness and safety of tramadol ER in the treatment of patients with chronic non-cancer pain (n=919) for 1 year. An additional 38-week open-label study was conducted versus placebo in 72 patients with low back pain and 61 patients with osteoarthritis. In both studies, individual doses were selected (titration). Thus, for patients ≥75 years of age, the dose was 600 mg/day, for patients under 75 years of age - 300-400 mg/day. 257 patients (24%) completed both studies.
Adverse events that may have been related to the experimental treatment included nausea, dizziness, and constipation. Average pain intensity ratings (from 0 - no pain up to 100 - very severe pain) after each visit (at certain time points in the study) improved significantly, with more than 50% of patients characterizing the treatment as “good”, “very good” (“excellent”). (Pascual M.L., 2007).
Two 6-week comparative, randomized, double-blind studies compared the effectiveness, tolerability and safety of the analgesic tramadol (at a dose of 50 mg / 4 times a day) and the selective COX2 inhibitor celecoxib (at a dose of 200 mg / 2 times a day) in therapy chronic lumbar pain. Ultimately, celecoxib demonstrated significantly greater efficacy compared to tramadol (the number of patients who responded to treatment was 63.2% versus 49.9% in study No. 1, respectively, and in study No. 2 - 64.1% versus 55.1%) . In groups of patients receiving celecoxib, fewer adverse events were observed and with lower frequency (O'Donnell J.B., 2009).
The efficacy and safety of tramadol at a dose of 400 mg/day (4 weeks) in the treatment of patients with chronic low back pain was also confirmed in another randomized, placebo-controlled, double-blind study involving 254 patients. The most frequently reported adverse events were dizziness, nausea, drowsiness and headaches (Schnitzer T.J., 2000).
Considering the mechanism of action of tramadol, more precisely its ability to cause the accumulation of mediators serotonin and norepinephrine in the central nervous system and peripheral tissues, the risk of pharmacological interactions with other drugs that have a similar pharmacological effect should be taken into account. So, Ripple M.G. et al. described the case of the death of a 36-year-old man (an alcoholic) after a pre-existing convulsive seizure caused by taking tramadol, as well as the antidepressants venlafaxine, trazodone and the antipsychotic quetiapine, each of which affects serotonergic transmission (Ripple M.G., 2000).
Tramadol belongs to category C substances according to the classification FDA Classification of Drug Safety During Pregnancy, for which certain undesirable effects (teratogenic, embryotoxic or other) were noted in a number of studies on laboratory animals. Such drugs should be prescribed in exceptional cases with a careful assessment of the risks and benefits for the mother and fetus (Briggs G.G., Freeman R.K., Yaffe S.J., et al., 1988).
At the same time, in some cases, tramadol is used to relieve acute pain in gynecological and obstetric practice (López Rosales C., 1997). Moreover, against the background of intramuscular administration for the purpose of pain relief during labor, tramadol is characterized by significant placental patency towards the fetal body. In the liver of the fetus and newborn, the mechanism of neutralization of tramadol occurs according to the same pattern as in adults, with the subsequent formation of an active metabolite (metabolite M1). However, the rate of excretion of the metabolite by the kidneys from the body of the fetus and newborn is slowed down, which could potentially underlie the creation of its high concentration in the blood. At the same time, according to Claahsen-van der Grinten H.L. et al., despite differences in the pharmacokinetic profile in the fetus and newborns, tramadol is an effective and safe method of pain relief during labor (Claahsen-van der Grinten H.L., 2005).
Shah N.H. et al. in an experiment using a preparation of isolated myometrium of a non-pregnant female uterus, they showed that tramadol is able to reduce contractility (contractility) of the uterus through stimulation of β1-adrenergic receptors. At the same time, researchers argue that such effects of tramadol are realized only at high (toxic) doses and are unlikely when tramadol is used in therapeutic doses (Shah N.H., 2013).
The level of excretion (allocation) of tramadol and its active metabolite into breast milk is low. Moreover, when tramadol is used by women during lactation, its concentration in breast milk is significantly lower than the concentration of the analgesic in the blood of a newborn after tramadol is administered to the mother during labor analgesia. In this regard, it is unlikely that adverse events regarding the health of the newborn will be observed while taking tramadol during breastfeeding (Allegaert K., Rochette A., Veyckemans F., 2011) (Kmetec V., Roskar R., 2003) ( Hartenstein S., 2010).
In one study, 75 lactating women received tramadol 100 mg every 6 hours after cesarean section. Observation of 75 newborns was carried out within 2-4 days after birth. Thus, during examinations of newborns, no clinically significant adverse events from the health of mothers and newborns were identified (Ilett KF1, 2008).
Tramadol may increase serum levels of the hormone prolactin. This fact, however, does not have a clinically significant effect on the intensity of milk secretion in women during breastfeeding (Seitz W., 1982). For example, one randomized clinical trial found no significant differences in lactation levels in women receiving tramadol or naproxen (Sammour R.N., 2011).
Tramadol is used to relieve severe to moderate pain. Its action is similar to that of narcotic analgesics. It affects the brain, changing its response to pain. Tramadol can be taken in tablet form or in ampoule (liquid) form.
How to use tramadol
Tramadol is used as prescribed by a doctor to relieve pain. Typically, the drug is taken every 4 or 6 hours. You can take tramadol with or without food. Ask your doctor how to relieve nausea while taking the drug (for example, your doctor may tell you to lie down for 1 to 2 hours after taking the drug and try not to move your head).
The dosage of the drug depends on your health condition and response to treatment. The risk of side effects can be reduced if you start using tramadol with a minimum dose and then increase it further. Follow your doctor's directions carefully.
The maximum recommended dose of tramadol is 400 mg per day. If you are over 75 years of age, the maximum recommended dose is 300 mg per day. Do not increase your dose on your own, or take the medicine more often or for longer than prescribed.
As a general rule, painkillers work more effectively if they are taken at the first sign of pain; if you expect it to worsen, the effect of taking the drug may decrease. If you have persistent pain (such as that associated with arthritis), your doctor may also prescribe long-acting narcotic medications. This type of therapy may also include non-narcotic drugs, for example, acetaminophen, ibuprofen. Ask your doctor if it is safe to use tramadol in combination with other medications.
If tramadol is used for a long time, then after you stop taking it you may experience a “withdrawal reaction”: increased anxiety, profuse sweating, nausea, runny nose, muscle pain. To prevent withdrawal reactions, your doctor may reduce your dose gradually. With long-term use of tramadol, its effectiveness may also decrease. If you feel this is what is happening, be sure to tell your doctor.
Along with the benefits of tramadol, the medicine can also cause drug addiction. The formation of such dependence may be increased if you have a history of drug addiction or alcohol addiction. Tramadol should be taken strictly in accordance with medical prescriptions to reduce the occurrence of such risks. You should also tell your doctor if the pain does not go away or becomes worse when using tramadol.
Side effects
Taking tramadol may cause side effects such as constipation, vomiting, dizziness, drowsiness or headache. Some of these effects may disappear after using tramadol for some time. If these symptoms persist, tell your doctor. To prevent constipation, ask your doctor to prescribe an appropriate diet and drink more water. Let your doctor also help you choose the most effective laxative.
Remember that your doctor has prescribed Tramadol because you believe the drug will provide more benefits than the risks of side effects.
If you experience unlikely but serious side effects such as changes in mental status or mood (confusion, hallucinations), severe stomach or intestinal pain, difficulty urinating, be sure to tell your doctor.
Seek immediate medical attention if you experience fainting, shallow breathing, unusual sleepiness, or trouble waking up from sleep. The medicine can also increase the level of serotonin in the body. Rare, but can cause a serious condition called serotonin syndrome. The risk of increased overall toxicity in the body occurs if you are simultaneously taking other drugs that also increase serotonin levels. If you experience symptoms such as fast heartbeat, hallucinations, loss of coordination, severe dizziness, nausea, vomiting, diarrhea, muscle twitching, severe anxiety, seek emergency medical attention.
Serious allergic reactions to tramadol are quite rare. You should also seek medical help if you have a rash or itching, swelling (of the face, tongue, throat), severe dizziness, and trouble breathing.
Precautionary measures
Before taking tramadol, tell your doctor if you are allergic to this medication or have other allergies. This medicine may contain inactive ingredients that can cause allergic reactions or other problems. Ask your doctor for more information about tramadol.
Before prescribing tramadol, your doctor should know your medical history. Especially the presence of brain disorders (head injuries, tumors, seizures), breathing problems (asthma, apnea, chronic obstructive pulmonary disease (COPD), kidney and liver diseases, a tendency to mental disorders).
If possible, the doctor should tell you your family history: has any of your relatives suffered or is suffering from drug addiction or alcoholism, is there any stomach or intestinal diseases, diseases of the gallbladder or pancreas in the family.
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This medicine may cause dizziness and drowsiness. Avoid driving, using machinery, or doing any activity that requires alertness until you are sure it is safe to do so. Avoid drinking alcohol. Give your doctor a complete list of the medications you use. Including those purchased without a prescription.
Older people may be most susceptible to side effects from tramadol use. They are characterized by confusion, dizziness, drowsiness, and slow or shallow breathing. Before using tramadol, women of childbearing age should talk with their doctor about the risks and benefits. You should tell your doctor if you are pregnant or planning to become pregnant. During pregnancy, the use of tramadol is important if it is impossible to do without taking the drug. At the same time, using tramadol during the first two months of pregnancy increases the risk of birth defects in the unborn child.
Taking tramadol in high doses or for a long time before the expected due date can also harm the unborn baby. Reducing the dose and number of doses of the drug can reduce the risk. You should also tell your doctor if you notice symptoms in your newborn such as slow or shallow breathing, irritability, persistent vomiting, diarrhea, or crying. If the drug passes into breast milk, tramadol can also cause unwanted effects on the newborn. Tell the doctor right away if your baby experiences unusual sleepiness, difficulty feeding, or trouble breathing. Consult your doctor before you start breastfeeding.
Interactions
Tramadol interactions with other medications may increase the risk of serious side effects. Other pain medications (mixed narcotic agonists-antagonists, narcotic antagonists) may interact with tramadol. Taking MAO inhibitors with tramadol can cause serious (sometimes fatal) problems. Avoid taking isocarboxazid, linezolid, moclobemide, phenelzine, Phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine while taking tramadol. Most MAO inhibitors should also not be taken within two weeks of starting tramadol. Follow your doctor's orders exactly.
The risk of increased serotonin levels increases if you are also taking other drugs that increase serotonin. This group includes certain antidepressants, such as fluoxetine/paroxetine, duloxetine/venlafaxine and others. Some medications may help remove tramadol from the body, which will negatively affect the effect of taking the drug. These include quinidine, azole imidazole (eg, itraconazole), drugs used to treat HIV (eg, ritonavir), macrolide antibiotics (eg, erythromycin), drugs used to treat seizures (eg, carbamazepine).
The risk of side effects such as slow or shallow breathing and excessive drowsiness may increase if you take tramadol with other medications that have similar side effects. Be sure to tell your doctor if you are taking medications to improve sleep or relieve anxiety (alprazolam, diazepam, zolpidem), muscle relaxants, other narcotic pain medications (morphine), and psychiatric medications (risperidone, amitriptyline, trazodone). The combination of medications may need to be changed.
Overdose
In case of overdose of the drug, you must contact emergency medical services.
Notes
The drug is not used with other medications. Tramadol is used to treat a specific condition and no other. Taken only on the recommendation of the attending physician. A missed dose does not affect the final result.
Storage
Tramadol should be stored at room temperature, protected from light and moisture, out of the reach of children and pets.
Note 1:
This review article on how and when tramadol is used is not a substitute for the complete instructions from the manufacturer of the drug, serves for brief information purposes only and cannot be a definitive guide to action. Carry out any actions related to treatment and use of medications solely on the basis of the prescription of your attending physician.
Tramadol is a drug from the group of opiates. How exactly the medicine acts directly on a cancer patient, as well as what you need to know in order to get the maximum effect from it, we will describe below.
Action
Tramadol is an analgesic of synthetic origin. It affects the central nervous system and spinal cord, which provides:
- membrane hyperpolarization;
- opening of both calcium and potassium channels;
- inhibition of the spread of pain impulses.
Its main property is to enhance sedative medications. In addition, it also excites opiate receptors of the nociceptive system located in the brain, as well as in the gastrointestinal tract.
Tramadol helps slow down the breakdown of catecholamines and maintains their necessary concentration in the central nervous system. At the same time, the effect of the drug as a whole is much weaker than that of Codeine. In addition, it is 6,000 times less potent than morphine.
If Tramadol is used in therapeutic doses, it does not have any special effect on the intensity of respiration or hemodynamics. At the same time, it somehow reduces intestinal motility, which, however, does not lead to constipation. Even when taken systemically, the patient does not experience an increase in blood pressure in the lungs. It has an unexpressed antitussive effect and an equally vague sedative.
In the brain, the medicine has a depressing effect on the respiratory center, and, on the contrary, has a stimulating effect on the emetic center.
Long-term use of Tramadol often leads to the development of tolerance to it. The analgesic effect occurs no earlier than after 15 minutes. It is stored for 6 hours.
About efficiency
Quite often, patients complain that the named medicine does not relieve pain very well. As a result, they increase the doses, and Because of this, the amount of medication given out per week is not enough. For what reason does this happen?
Many people have a sneaking suspicion that doctors are simply making calculations incorrectly. In reality, there is no mistake here - the doctor prescribes exactly the volume that is given in the current instructions.
But patients themselves often take Tramadol incorrectly. The main mistake here is lack of system.
As medical practice shows, one category of cancer patients prefers to endure until the end and agrees to an injection only when the pain becomes unbearable. In this situation, a relatively large volume of medication is needed.
At the same time, others, even with relatively minor suffering, immediately inject themselves with the maximum permissible dose. In both cases, there is an overuse of medication.
In order for the dispensed Tramadol to be sufficient and to act as effectively as possible for a long time, you should start taking it at the first sign of pain and only in the amount prescribed by the doctor.
How to use
In the early stages, it is usually customary to prescribe capsules containing 50 milligrams of Tramadol. If this amount is not enough, then an hour later the patient drinks another one. The maximum permissible daily intake for cancer patients is 400 mg or 8 pills.
Patients of retirement age with liver or kidney disease must take the drug very carefully and at long intervals.
Tramadol drops in an amount of 20 are consumed, dissolved in water or moistened with a piece of sugar. If relief does not occur, then after 30 minutes you are allowed to repeat the dose. The instructions indicate that after this the next dose can be taken only after 6 hours. A patient can use a maximum of 160 drops per day.
For moderate pain, Tramadol is administered:
- a dropper into a vein;
- subcutaneously;
- intramuscularly.
It is permissible to give up to 100 milligrams of the drug at a time. It is important to administer the medication slowly. If the intake does not bring relief, the dose prescribed by the doctor is injected again after about an hour.
In oncology, when cancer has already developed and causes severe pain, the maximum amount of Tramadol per day when administered by injection is 600 milligrams.
In some cases, suppositories are prescribed. One candle contains 100 mg of medication. You are allowed to use 5 pieces per day.
Contraindications
Tramadol should not be used if:
- pregnancy;
- breastfeeding;
- hypersensitivity to active ingredients;
- conditions accompanied by depression of the central nervous system or breathing;
- traumatic brain injury;
- abdominal pain of unknown origin;
- confusion;
- epilepsy;
- intracranial increased pressure.
Initially, you should limit yourself to only tablet Tramadol, while the pain is not too severe. It is important to remember that no medicine gives an immediate effect. If the overall condition is stable and there is no sharp deterioration, then it is recommended to drink the product in the initially selected volume for several days.
The tablets must be taken after meals and washed down with a small amount of milk - this will relieve the stomach from irritation.
Injections are started if the pain intensifies to medium intensity. The transition to injections should be discussed with your doctor.
According to reviews, among drugs that act as a Tramadol enhancer, the best option is Aminazine. It significantly increases the analgesic properties. They begin to take it if the patient’s condition cannot be alleviated with the main remedy alone. Here it is additionally necessary to monitor blood pressure and pulse.
- Paracetamol;
- Analgin;
- Indomethacin.
Thanks to this, a synergistic effect occurs.
For injections, the medicine is combined with Diphenhydramine or Relanium. Moreover, if the first one can be injected into one syringe with Tramadol, then the second one must be injected separately.
Do not combine the drug with:
- Phenelzine;
- Moclobemide;
- Iproniazid;
- Selegilin.
It should not be used with narcotic painkillers.
Tramadol is a synthetically produced analgesic, belongs to the group of opioid drugs, has a positive effect on the central nervous system and spinal cord, causing hyperpolarization of membranes, and inhibits the transmission of pain impulses. It has a strong analgesic effect that can last up to 12 hours. Activates opiate receptors in the brain and gastrointestinal tract. Slows down the destruction and stabilizes the concentration of catecholamines in the central nervous system. Instructions for using Tramadol in ampoules and tablets are in our article.
The drug is available in tablet form and as a solution. The tablets are white or slightly yellowish, flat-cylindrical, with a chamfer.
The active substance of this medicine: tramadol hydrochloride 100 mg. Auxiliary components: potato starch - 100 mg, milk sugar - 295 mg, magnesium - 5 mg. The drug has a mixed mechanical effect.
In what cases is medicine indicated for back pain?
Indications for taking a fairly strong analgesic are only severe pain:
- Initial stages of neuralgia.
- Postoperative period.
- Last stages.
- Mechanical injuries.
- Diseases of the heart and blood vessels.
- The presence of inflammatory processes in the body.
How to use Tramadol in tablets and ampoules correctly
Tramadol can only be taken after reaching one year of age. A single dose of the drug for oral administration is 50 mg, intramuscularly or intravenously 50-100 mg. If oral administration of the drug does not have a positive result 30 minutes after administration, you can take another dose. But not more than 50 mg. Despite the simplicity of the instructions for using Tramadol in injections and tablets, the drug can only be used in consultation with a doctor.
For unbearable pain, doctors prescribe 500 mg every 4-5 hours.
It is important to know that in this case, only inpatient treatment under strict supervision by a specialist and with the availability of specialized medical equipment is acceptable.
For children from one to 14 years of age, the daily dose of the analgesic is 2 mg per kilogram of weight. Regardless of age, the minimum daily dose is 400 mg. The duration of the entire course of taking Tramadol is determined only by your doctor.
The principle of action of the drug
Tramadol activates opiate receptors in the spinal cord, brain, and gastrointestinal tract. The analgesic effect of the drug is explained by a decrease in nociceptive activity and an increase in antinociceptive functions in the human body.
This medicine may cause the following negative effects:
- fainting conditions;
- tachycardia;
- collapse;
- diarrhea or, on the contrary, constipation;
- bloating;
- headache in the temple area;
- heavy sweating;
- poor sleep;
- depressive states;
- spasms of the lower extremities;
- memory impairment.
In severe cases, taking the medicine leads to disruption of taste buds, decreased vision, and an unstable menstrual cycle may occur.
Abrupt withdrawal of the drug can lead to sleep disturbances, diarrhea, nausea or even vomiting, and headaches.
Contraindications to the use of analgesics
Like any other medication, Tramadol has a number of contraindications that should be strictly observed:
- individual intolerance to the components of the drug;
- constant attacks of suffocation;
- depressed states, depression;
- abuse of alcohol, drugs or psychotropic drugs;
- severe renal failure;
- pregnancy period 1st trimester;
- lactation period;
- age up to one year.
Overdose
If the body is severely intoxicated with this drug, a person may experience rather unpleasant symptoms. Such as: muscle cramps, miosis, vomiting, in advanced cases it can reach coma. Treatment of overdose consists of supporting the cardiovascular system and respiratory tract. In order to eliminate seizures, experts recommend taking Benzodiazepine, and to alleviate the general condition of a person, use Naloxone.
But you should not do this yourself; the patient must be urgently transported to the nearest medical care unit.
Similar drugs for pain relief
Analogues of Tramadol according to the personal ATC code: Tramaclosidol, Sintradon, Tramal, Tramolin, Protradon. It is important to know that you should not decide to treat the drug with an analogue without a doctor’s testimony.
special instructions
With great caution, doctors prescribe painkillers to people who suffer from intracranial hypertension, alcoholism, and epilepsy. Long enough use of this analgesic can cause addiction; while using Tramodol, all alcohol-containing drinks are strictly prohibited.
Cost of medicine
The price of Tramadol in ampoules is about 60 rubles per pack. In tablet form, the cost is 70 rubles. But it is important to know that Tramadol is only available with a doctor's prescription. The doctor makes a prescription on a special form for powerful analgesics.
Drug interactions with other drugs
The analgesic cannot be used in conjunction with Diclafenac and Indomethacin, Nitroglycerin. In addition, painkillers should not be used together with alcoholic beverages. Since it increases the negative effect of the drug.
Lactation and pregnancy period
During pregnancy and breastfeeding, it is best to avoid using the drug and, if necessary, take herbal analgesics. During lactation, it is also better not to take Tramadol, since even in small quantities it will be excreted in breast milk.
Why you should not take painkillers without consulting a doctor, watch the video: