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The preparation Tramadol is used as prescribed by a doctor, the dosing regime is selected individually depending on the severity of pain syndrome and sensitivity of the patient.


Unless otherwise prescribed, Tramadol should be used in the following doses:


adults and teenagers over 14 years of age (more than 25 kg) - 1 tablet (50 mg), if necessary, after 30-60 minutes you can take another tablet; in case of severe pain, a single dose may be 100 mg (2 tablets).


Depending on the intensity of the pain syndrome, the analgesic effect is usually maintained for 4-6 hours.


The tablets should be swallowed without chewing, drunk with a small amount of liquid, or pre-soluble in 1/2 glass of water, regardless of the meal.


The daily dose should not exceed 400 mg (8 tablets).


Higher doses may be used to treat pain in cancer and severe postoperative pain.


In elderly patients (aged over 75 years), due to the possibility of delayed withdrawal, the interval between administration of the drug may be increased according to individual characteristics.


In patients with kidney and liver diseases, tramadol may last longer. In QC < 30 ml/min and in patients with hepatic insufficiency, 12 h interval between successive doses of Tramadol is necessary. The interval between successive doses may be increased.


Do not use Tramadol in patients with severe renal impairment (QC less than 10 ml/min) or hepatic failure.


Do not use the drug beyond the period justified therapeutically.


If tramadol is used for a long time due to the intensity of pili etiology of pain syndrome, periodic control (if necessary with interruptions in the administration of the drug) is necessary to determine the need for further therapy and optimize the dose.


Side-effects:

According to the World Health Organization (WHO), undesired reactions are classified according to their frequency as follows: very often (≥1/10), often (≥1/100 to <1/10). infrequently (≥1/1000 to <1/1000), rarely (≥1/10 000 to <1/1000), very rarely (<1/10000); frequency unknown (it was not possible to determine the frequency of occurrence).


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


Violations of the cardiovascular system:


Infrequent: effects on cardiovascular regulation (palpitations, tachycardia, orthostatic hypotension or collapse). These side effects are mainly observed during intravenous injection or when there is significant physical activity.


rare: bradycardia, high blood pressure.


Breakdowns on the metabolic and nutritional side:


Rare: changes in appetite.


Violations of the respiratory system, chest and mediastinal organs:


Rare: Respiratory depression, shortness of breath.


Respiratory depression is possible if the recommended doses are significantly exceeded, with the simultaneous use of other drugs that depress the central nervous system (CNS).


There was a deterioration in bronchial asthma, but no cause-effect relationship with the drug was established.


Violations of the nervous system:


very often: dizziness;


Frequent: headache, drowsiness;


rarely: speech disorders, paresthesia, tremor, epileptiform seizures, involuntary muscle contractions, coordination disorders, fainting. Epileptiform seizures are possible after using high doses of tramadol and at the same time with drugs that lower the threshold of seizure readiness.


Psychiatric disorders:


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Rare: hallucinations, mental confusion, sleep disturbance, anxiety, delirium and nightmares. After tramadol use, various rarely observed unwanted reactions from the psyche are possible (depending on the patient's personality and duration of treatment). These side effects include mood changes (usually euphoria, sometimes dysphoria), changes in activity (usually decreased, sometimes increased), and cognitive and perception impairments (e.g., decision making, perception disorders). Drug dependence may develop.

Visual impairment:

Rare: myosis, mydriasis, blurred vision.

Violations of the gastrointestinal tract:

very often: nausea;

frequently: constipation, dry mouth, vomiting;

infrequent: vomiting, heaviness in epigastria, flatulence, diarrhoea.

Violations of the skin and subcutaneous tissues:

frequently: sweating;

infrequently: itching, rash, hives.

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