Tramadol is prescribed for the treatment of moderate to severe pain and is intended for regular use over extended periods of time. Increasing the size or frequency of the dosage prescribed to you may lead to an addiction and health problems. If your tramadol dosage seems to stop working or you begin feeling pain again although the dose has not changed, do not take more. This is your body developing a tolerance to tramadol and is the first sign of an addiction.

Become Accountable for Your Tramadol Use

Prescription drug abuse and addiction is often accidental. This can make identifying or admitting to addiction difficult. Tramadol users may be embarrassed that they have become addicted. However, the best approach to ending tramadol use is to admit to addiction and find the help you need from loved ones and medical professionals. Become accountable for both your addiction and your sobriety.

Getting Over Tramadol Withdrawal Symptoms

Long-term tramadol users will experience withdrawal symptoms when they stop taking Tramadol. The withdrawal symptoms increase in severity the longer you abuse Tramadol. A residential inpatient program will provide the best care and guidance during tramadol detox and withdrawal.

Withdrawal symptoms for tramadol usually begin within 12 to 20 hours of last dose. These symptoms are similar to opiate withdrawal symptoms but tend to last longer. Symptoms tend to last around seven days before tapering in severity. Tramadol withdrawal symptoms experienced during this time may include the following:

• Anxiety
• Depression
• Severe mood swings
• Sweating
• Insomnia
• Headaches
• Tremors/seizures

Treat the Entire Tramadol Addiction

Prescription drug abuse sometimes develops because of an underlying issue. Treating the entire addiction means focusing on the non-physical effects of an addiction. Dual Diagnosis and Cognitive Behavioral Therapy are two ways to treat the mental, emotional and psychological triggers and aspects of tramadol abuse and contribute to the likelihood of long-term sobriety.

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It is important to follow the doctor?s prescription because tramadol overdose can be fatal. Altering the dosage in anyway, such as increasing the milligrams in a single dosage, can lead to overdose. Overdose happens when the body is unable to process the amount of the digested drug. However, all overdoses are not necessarily fatal. They can be accidental or intentional. Those taking it for therapeutic purposes or for recreational reasons can both be at risk. Typically, the maximum recommended dosage is 400 mg per day. Most people are not even prescribed this much; they are usually prescribed 200 mg per day or less. Often, an overdose occurs when tramadol is mixed with a different kind of drug or alcohol. Anything taken in conjunction with Tramadol that can depress the nervous system even more can lead to overdose or death.

What to Expect in an Overdose

In overdose, Tramadol induces significant neurological toxicity (seizures, coma, respiratory depression), but cardiovascular toxicity is mild. Anyone in close proximity to someone taking it or as the patient prescribed this particular drug should know the signs of an overdose. Medical attention should be sought immediately if any of the signs of an overdose begin to appear. The earlier you seek help, the better the outcome may be.

Symptoms can vary from person to person and depend on factors including how an individual?s body responds to the drug, how much was taken and whether it was taken in combination with any other substances. Although respiratory depression and constipation are less common with Tramadol, even amongst other opioids, it can occur, in particular, after overdose and with impaired renal function. Unlike other opioids, Tramadol abuse is not usually associated with the development of tolerance, physical dependence or psychological addiction. There is an increase in the risk of seizures where epilepsy is prevalent. To diagnose a possible overdose, look for these signs:

• Drowsiness
• Shallow breathing
• Slow heartbeat
• Weakness
• Cold or clammy skin
• Light-headed
• Fainting
• Coma
• Seizures
• Cardiac arrest
• Coma
• Constricted pupils
• Constipation
• Itching skin
• Hallucinations
• Low blood pressure
• Muscle convulsions
• Sedation
• Stomach spasms

Be aware of other opioid overdose symptoms that could also appear, which include:

• Dark urine
• Diarrhea
• Increased, unusual sweating
• Loss of consciousness
• Severe confusion
• Severe drowsiness
• Severe nervousness
• Yellow eyes or skin

Based on the severity of the overdose, a user can be at risk of long-term organ damage.

Caution with Tramadol

Death does have the chance of occurring in the first hour of overdose so proper procedures must be followed. Simply not exceeding the dosage recommended by the physician puts a patient at a lower risk for overdose.
It?s important that when prescribed, to notify the doctor of any current medication allergies or medical conditions that could compromise or interact adversely with Tramadol such as:

• Kidney disease
• Liver disease
• Stomach disorders
• History of depression, mental illness or suicide attempt

Another precaution to take in decreasing the risk of Tramadol overdose is to avoid taking Tramadol when also taking large doses of the following. This is not a complete list so it should be discussed with a medical professional.

• Sleeping pills
  • Dalmane
  • Halcion
  • Restoril

• Narcotic pain relievers
  • Darvon
  • Demerol
  • Morphine
  • Percocet

• Psychotherapeutic drugs
  • Antidepressants
  • Tranquilizers
  • Sedatives (including alcohol)

How to Treat Tramadol Overdose

If you suspect or have observed an overdose, there are a few things to avoid. Only if it is impossible for emergency crews to get to the location of the overdose, an overdose patient should not be taken by someone to the E.R. on their own. They should also not try to induce vomiting. They should also try to prevent the person who overdosed from moving around, which may accelerate the speed at which the Tramadol enters the blood stream. Unless emergency crews suggest, do not give the person who has overdosed anything to eat or drink. In most cases, 911 should be the first call. Not necessarily poison control.

A Tramadol overdose may be treated with a drug to counteract the effects. Other Tramadol treatments may include induced vomiting, pumping of the stomach and close monitoring of the breathing and heart rates.

If you think you or a loved one is overdosing on tramadol, take them to the emergency room where they can get their stomach pumped or possibly a different medication to neutralize the effects.

Tramadol Dependency

Tramadol is a highly dependent drug. Often, tramadol addictions happen accidentally by patients unknowingly abusing their prescribed medication. When used for a prolonged amount of time, the body builds up a certain amount of tolerance. The user has to continually take more per dosage in order to receive the same initial effect. This is a dangerous concept because eventually, the body will not be able to handle the amount of the drug administered. This is when an overdose may occur.

Tramadol Facts

Tramadol is in a group of drugs called opiate agonists. It is used to treat moderate to severe pain by changing the way the body senses pain. Tramadol can either be taken as a normal tablet or an extended-release (long-acting) tablet to be taken through the mouth. The regular tablet can be taken with or without food every four to six hours, or as needed. The extended-release tablet should only be taken once a day around the same time every day. When using extended-release the patient either needs to always take it with food or always take it without food. The extended-release tablets should only be taken whole. It is dangerous to split, chew, crush, snort or inject the dissolved form of the tablet. It is important to only take the medication as the doctor prescribes because it is a highly dependent drug.

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As with most prescribed pain treatment medications, there are serious side effects and the possibility of dependence and addiction; Tramadol is no exception. Originally, Tramadol was marketed as a safe form of narcotic, unlike its stronger cousins in the oxycodone and hydrocodone families. Unfortunately this wasn?t the case because of its morphine like tendencies. Although Tramadol abuse is most commonly taken orally, it can also be crushed and snorted or even injected.

The following are signs of Tramadol abuse and dependence:

• Depression
• Anxiety
• Severe mood swings
• Aggressiveness or anger
• Electric shock sensations
• The feeling of ?pins and needles?
• Restless leg syndrome
• Sneezing
• Insomnia
• Sweating
• Palpitations
• Tremors
• Headache

Although Tramadol is viewed as the lesser of narcotic-like pain relievers, its withdrawal symptoms last up to twice as long as other opioids.

With any prescription pain reliever, it is best to let a parent, friend or guardian be aware that you are taking these medications. The side effects and withdrawal symptoms can become overwhelming and can lead to abuse.

Are You Addicted to Tramadol?

Tramadol is one of the most widespread, addictive and readily available drugs today. Regular use results in physical and psychological damage and dependence.

There are thousands of people that have used, gone through treatment and now live normal, healthy lives.

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Tramadol, the generic version of Ultram, is a synthetic analgesic medication. The exact mode of action of tramadol is unknown but it is said to work like morphine. Tramadol binds to opioid receptors in the brain — receptors that transmit the sensation of pain throughout the body. Here are 10 things you should know about tramadol to ensure its safe use.

1 – Tramadol is prescribed to treat moderate to moderately severe pain.

Tramadol belongs to the class of drugs known as opiate agonists. Primarily, tramadol works by changing the way the body senses pain. Some people mistakenly believe that tramadol is an NSAID (nonsteroidal anti-inflammatory drug), but it is not.

2 – Tramadol is available in immediate release and extended release formulations.

Tramadol may be prescribed as an immediate release tablet (50 mg.) or as an extended release tablet (100, 200, or 300 mg.). The extended release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment. Your doctor will determine the appropriate dosage schedule for you.

3 – Tramadol extended release tablets must be taken whole, not split, chewed or crushed.

It is important to take tramadol properly and to follow prescribing instructions. If taken improperly or in a way that is not recommended, serious side effects and even death can result.

4 – Tramadol can be habit-forming for some people.

Do not take more tramadol than has been prescribed for you. Taking more tramadol or taking it more often can cause dependency on it. You should also not stop taking tramadol without first consulting your doctor. You may experience withdrawal symptoms if you stopped it suddenly. You doctor will likely decrease your dose of tramadol gradually.

5 – Drug interactions are possible with tramadol.

Be aware of the following possible drug interactions:

• Carbamazepine reduces the effect of tramadol
• Quinidine increases the concentration of tramadol by 50% to 60%
• Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects.

Be sure to tell your doctor about all medications you are taking.

6 – Tramadol, when combined with certain other substances, can increase central nervous system and respiratory depression.

In other words, breathing may be affected or even stop if tramadol is combined with alcohol, narcotic drugs, anesthetics, tranquilizers, or sedatives.

7 – The use of tramadol during pregnancy should be avoided.

Because the safety of tramadol use during pregnancy has not been established, the medication should not be used during pregnancy. The safe use of tramadol in nursing mothers has also not been established.

8 – Tramadol is usually well-tolerated. Any side effects are usually temporary.

Some of the common side effects associated with tramadol include:

• nausea
• constipation
• dizziness
• headache
• drowsiness
• vomiting

Less common side effects include: itching, sweating, diarrhea, rash, dry mouth, and vertigo. There have been patients who developed seizures after taking tramadol.

9 – A Cochrane Review of tramadol to treat osteoarthritis revealed some small benefit.

The Cochrane Review stated that when tramadol is taken for up to 3 months, there may be decreased pain, improvements in function and stiffness and overall well-being. However, tramadol can cause side effects that are significant enough to require that the patient must stop taking the medication. Risks outweigh benefits for many people who have tried tramadol.

10 – If an overdose of tramadol has occurred, call your local poison control center, or call 911 if it appears to be an emergency situation.

Symptoms of an overdose include decreased pupil size, difficulty breathing or staying awake, unconscious, coma, heart attack, or seizure. Call for help, even if you are unsure about what to do.

Source: 1, 2, 3

How should I take tramadol?

Take tramadol exactly as prescribed. Never take tramadol in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Tramadol can be taken with or without food, but take it the same way each time.

Do not crush, chew, or break a tramadol tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

To take tramadol orally disintegrating tablets (Rybix ODT):

• Keep the tablet in its blister pack until you are ready to take it.
• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.
• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
• Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

If you use the tramadol extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Tramadol may be habit-forming. Never share tramadol with another person, especially someone with a history of drug abuse or addiction. Do not stop using tramadol suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Store tramadol at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle. Tramadol is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Tramadol Dosing Information

Usual Adult Tramadol Dose for Pain:

For mild to moderate severe chronic pain not requiring rapid onset of analgesic effect:
Initial dose: 25 mg every morning
Titration: increase in 25 mg increments as separate doses every 3 days to reach 100 mg per day taken as 25 mg 4 times per day. Then the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg per day taken as 50 mg 4 times per day.
Maintenance: After titration, tramadol 50 mg to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg per day.

For the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time:
Extended-Release Tablets:
Initial Dose: 100 mg once daily and titrated up as necessary by 100 mg increments every five days to relief of pain and depending upon tolerability.
Maximum Dose: Extended-release tablets should not be administered at a dose exceeding 300 mg per day.

For patients in whom rapid onset of analgesic effect is required and for whom the benefits outweigh the risk of discontinuation due to adverse events associated with higher initial dose:
Dose: 50 mg to 100 mg can be administered as needed for pain relief every 4 to 6 hours, not to exceed 400 mg per day.

Usual Geriatric Tramadol Dose for Pain:

For patients over 65 years:
Dose selection should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy.

For patients over 75 years:
Maximum dose of regular oral tablets: 300 mg per day in divided doses

Usual Pediatric Tramadol Dose for Pain:

16 years old and up:
Brand name: Ryzolt
Initial: 100 mg once daily
Titrate by 100 mg increments every 2 to 3 days if needed for pain control
Maximum: 300 mg/day

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A tramadol overdose can be fatal.

Overdose symptoms may include extreme drowsiness, shallow breathing, muscle weakness, slow heartbeat, cold or clammy skin, fainting, or seizure.

What should I avoid while taking tramadol?

Do not drink alcohol. It may cause a dangerous decrease in your breathing when used together with this medicine. Tramadol may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

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Tramadol

Generic Name: tramadol (TRAM a dol)
Brand names: Rybix ODT, Ryzolt, Ultram, Ultram ER

What is tramadol?

Tramadol is a narcotic-like pain reliever.

Tramadol is used to treat moderate to severe pain. Tramadol extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock.

Tramadol may also be used for other purposes not listed in this medication guide.

Important information about tramadol

You should not take this medication if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, or if you have ever attempted suicide. Do not take tramadol while you are intoxicated (drunk) or taking any of the following: alcohol or street drugs, narcotic pain medicine, sedatives or tranquilizers, or medicine for depression, anxiety, or mental illness.

Seizures (convulsions) have occurred in some people taking this medicine. Tramadol may be more likely to cause a seizure if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, narcotic, or medicine for nausea and vomiting.

Seek emergency medical attention if you think you have used too much of this medicine. A tramadol overdose can be fatal.

Tramadol may be habit-forming. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Never share tramadol with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Do not crush the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

Before taking tramadol

You should not take this medication if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, or if you have ever attempted suicide.

Do not take tramadol while you are intoxicated (drunk) or taking any of the following:

• alcohol or street drugs;
• narcotic pain medicine;
• sedatives or tranquilizers (such as Valium);
• medicine for depression or anxiety; or
• medicine for mental illness (such as bipolar disorder, schizophrenia).

Seizures have occurred in some people taking tramadol. Talk with your doctor about your seizure risk, which may be higher if you have:

• a history of drug or alcohol addiction;
• a history of epilepsy or other seizure disorder;
• a history of head injury;
• a metabolic disorder; or
• if you are also taking an antidepressant, muscle relaxer, narcotic, antipsychotic, or medicine for nausea and vomiting.

To make sure you can safely take tramadol, tell your doctor if you have any of these other conditions:

• kidney disease (or if you are on dialysis);
• cirrhosis or other liver disease;
• a stomach disorder; or
• a history of depression, mental illness, or thoughts of suicide.

FDA pregnancy category C. It is not known whether tramadol will harm an unborn baby. Tramadol may cause serious or fatal side effects in a newborn if the mother uses this medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Tramadol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking tramadol. Do not give this medication to anyone younger than 16 years old without the advice of a doctor.

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