Tramadol
Generic Name
Tramadol 50 mg Capsule
Manufacturer
Various Generic Manufacturers
Country
Global
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tramadol 50 mg capsule | ৳ 6.00 | N/A |
Description
Overview of the medicine
Tramadol is an opioid analgesic used to treat moderate to moderately severe pain. It works by changing how the brain and nervous system respond to pain.
Uses & Indications
Dosage
Adults
Initial dose 50 mg orally every 4-6 hours as needed, not to exceed 400 mg/day. May start with 25 mg/day and titrate.
Elderly
For patients >75 years, maximum 300 mg/day. Consider longer dosing intervals.
Renal_impairment
For creatinine clearance <30 mL/min, 50-100 mg every 12 hours. Not recommended for severe renal impairment (CrCl <10 mL/min).
Hepatic_impairment
For cirrhotic patients, 50 mg every 12 hours. Not recommended for severe hepatic impairment.
How to Take
Administer orally with or without food. Swallow capsule whole, do not crush or chew. Take with a full glass of water.
Mechanism of Action
Tramadol acts as a weak opioid agonist at mu-opioid receptors. It also inhibits the reuptake of norepinephrine and serotonin, which contributes to its analgesic effects.
Pharmacokinetics
Onset
Within 1 hour
Excretion
Primarily excreted renally (approximately 90% as metabolites), with a small amount excreted in feces.
Half life
Approximately 6.3 hours (unmetabolized tramadol), 7.4 hours (M1 metabolite)
Absorption
Rapidly and almost completely absorbed after oral administration. Bioavailability is about 75%.
Metabolism
Extensively metabolized in the liver primarily by CYP2D6 (to O-desmethyltramadol/M1, active) and CYP3A4 (to N-desmethyltramadol/M2, inactive).
Side Effects
Contraindications
- Acute intoxication with alcohol, hypnotics, other opioid analgesics, psychotropic drugs
- Opioid-dependent patients
- Severe respiratory depression
- Acute or severe bronchial asthma
- GI obstruction (including paralytic ileus)
- Concomitant use of MAO inhibitors or within 14 days of discontinuing them
- Children younger than 12 years of age (post-operative pain in children younger than 18 years of age following tonsillectomy and/or adenoidectomy)
Drug Interactions
Warfarin
Potential for INR increase and bleeding.
Quinidine
Increased tramadol exposure, reduced M1 metabolite.
Carbamazepine
Decreased tramadol plasma concentrations, reduced analgesic effect.
MAO Inhibitors
Risk of serotonin syndrome and opioid toxicity.
SSRIs/SNRIs/TCAs
Increased risk of seizures and serotonin syndrome.
CNS Depressants (Alcohol, Benzodiazepines)
Increased risk of respiratory depression, sedation, coma, and death.
Storage
Store at controlled room temperature (20°C to 25°C), away from moisture and direct light. Keep out of reach of children. Protect from freezing.
Overdose
Symptoms include respiratory depression, somnolence, coma, seizures, miosis, cardiac arrest, and death. Naloxone can reverse respiratory depression, but may increase seizure risk. Supportive care is essential.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy, especially near term, due to potential for neonatal opioid withdrawal syndrome. Excreted in breast milk, not recommended during lactation. Consult a doctor.
Side Effects
Contraindications
- Acute intoxication with alcohol, hypnotics, other opioid analgesics, psychotropic drugs
- Opioid-dependent patients
- Severe respiratory depression
- Acute or severe bronchial asthma
- GI obstruction (including paralytic ileus)
- Concomitant use of MAO inhibitors or within 14 days of discontinuing them
- Children younger than 12 years of age (post-operative pain in children younger than 18 years of age following tonsillectomy and/or adenoidectomy)
Drug Interactions
Warfarin
Potential for INR increase and bleeding.
Quinidine
Increased tramadol exposure, reduced M1 metabolite.
Carbamazepine
Decreased tramadol plasma concentrations, reduced analgesic effect.
MAO Inhibitors
Risk of serotonin syndrome and opioid toxicity.
SSRIs/SNRIs/TCAs
Increased risk of seizures and serotonin syndrome.
CNS Depressants (Alcohol, Benzodiazepines)
Increased risk of respiratory depression, sedation, coma, and death.
Storage
Store at controlled room temperature (20°C to 25°C), away from moisture and direct light. Keep out of reach of children. Protect from freezing.
Overdose
Symptoms include respiratory depression, somnolence, coma, seizures, miosis, cardiac arrest, and death. Naloxone can reverse respiratory depression, but may increase seizure risk. Supportive care is essential.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy, especially near term, due to potential for neonatal opioid withdrawal syndrome. Excreted in breast milk, not recommended during lactation. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacture date when stored correctly.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA (US) and DGDA (Bangladesh)
Patent Status
Generic (Patent Expired)
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established tramadol's efficacy in various pain conditions including post-operative pain, chronic low back pain, and osteoarthritis pain. Ongoing research explores its use in neuropathic pain and chronic pain management strategies.
Lab Monitoring
- Monitor liver and kidney function in patients with impairment.
- Monitor for signs of respiratory depression, sedation, and opioid withdrawal.
- Monitor for signs of serotonin syndrome, especially with concomitant serotonergic drugs.
Doctor Notes
- Assess patient's risk for addiction, abuse, or misuse prior to prescribing and regularly during treatment.
- Educate patients and caregivers on safe use, storage, and disposal of opioids.
- Taper dosage gradually upon discontinuation to avoid withdrawal symptoms.
- Monitor for signs of respiratory depression, especially at initiation or dose escalation.
- Consider drug interactions carefully, particularly with other CNS depressants and serotonergic agents.
Patient Guidelines
- Do not share your medication with others.
- Do not take more than prescribed.
- Avoid alcohol and other CNS depressants.
- Store at room temperature away from moisture and heat.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness, drowsiness, and impaired judgment. Avoid driving or operating machinery until you know how this medicine affects you. Alcohol can intensify these effects.
Lifestyle Advice
- Maintain adequate hydration and dietary fiber to help with constipation.
- Avoid driving or operating heavy machinery until you know how this medication affects you.
- Engage in light physical activity if possible, to help manage pain and reduce constipation.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.