Tramavir
Generic Name
Tramadol Hydrochloride
Manufacturer
Hypothetical Pharma Co.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tramavir 100 mg tablet | ৳ 13.00 | N/A |
Description
Overview of the medicine
Tramavir 100 mg Tablet contains Tramadol Hydrochloride, a synthetic opioid analgesic used for the relief of moderate to severe pain. It works by binding to mu-opioid receptors and by inhibiting the reuptake of norepinephrine and serotonin.
Uses & Indications
Dosage
Adults
Initial dose is typically 50-100 mg every 4-6 hours as needed, not exceeding 400 mg per day. Dosage should be individualized based on patient response.
Elderly
For patients over 75 years, maximum dose should not exceed 300 mg per day. Dosing interval may need to be extended.
Renal_impairment
For creatinine clearance less than 30 mL/min, the dosing interval should be extended to 12 hours, and the maximum dose should not exceed 200 mg per day.
How to Take
Take orally with or without food. Swallow the tablet whole; do not crush, chew, or split, especially extended-release forms.
Mechanism of Action
Tramadol acts as a weak mu-opioid receptor agonist. It also inhibits the neuronal reuptake of norepinephrine and serotonin, which contributes to its analgesic effects. This dual mechanism provides its pain-relieving properties.
Pharmacokinetics
Onset
Analgesic effect typically begins within 30-60 minutes.
Excretion
Mainly excreted by the kidneys, with approximately 90% of the dose eliminated renally.
Half life
The elimination half-life is approximately 6-7 hours for the parent drug and 7-9 hours for the active O-desmethyltramadol metabolite.
Absorption
Rapidly and almost completely absorbed after oral administration, with a bioavailability of about 75%. Peak plasma concentrations occur within 2 hours for the parent drug and 3 hours for the active metabolite.
Metabolism
Primarily metabolized in the liver via CYP2D6 and CYP3A4 enzymes. The O-desmethyltramadol metabolite (M1) is pharmacologically active and more potent than the parent drug.
Side Effects
Contraindications
- Acute intoxication with alcohol, hypnotics, analgesics, opioids, or other psychotropic drugs.
- Patients receiving monoamine oxidase inhibitors (MAOIs) or who have taken them within the last 14 days.
- Severe respiratory depression.
- Acute asthma in unmonitored settings or in the absence of resuscitative equipment.
Drug Interactions
Warfarin
May enhance the anticoagulant effect of warfarin, increasing bleeding risk.
Quinidine
Inhibits tramadol metabolism by CYP2D6, potentially increasing tramadol levels and side effects.
Carbamazepine
Significantly reduces tramadol plasma concentrations, potentially leading to reduced analgesic effect.
MAO Inhibitors
Contraindicated due to risk of serotonin syndrome and seizures.
SSRIs, SNRIs, TCAs
Increased risk of serotonin syndrome.
CNS Depressants (e.g., alcohol, benzodiazepines)
Increased risk of respiratory depression, sedation, coma, and death.
Storage
Store at room temperature (below 30°C), away from moisture and direct light. Keep out of reach of children.
Overdose
Symptoms include respiratory depression, seizures, miosis, cardiovascular collapse, and coma. Treatment involves supportive measures, maintaining a patent airway, and administration of naloxone for opioid effects. Hemodialysis is not effective.
Pregnancy & Lactation
Not recommended during pregnancy, especially during the third trimester, due to the risk of neonatal opioid withdrawal syndrome. Excreted in breast milk; advise caution or consider alternative for breastfeeding mothers.
Side Effects
Contraindications
- Acute intoxication with alcohol, hypnotics, analgesics, opioids, or other psychotropic drugs.
- Patients receiving monoamine oxidase inhibitors (MAOIs) or who have taken them within the last 14 days.
- Severe respiratory depression.
- Acute asthma in unmonitored settings or in the absence of resuscitative equipment.
Drug Interactions
Warfarin
May enhance the anticoagulant effect of warfarin, increasing bleeding risk.
Quinidine
Inhibits tramadol metabolism by CYP2D6, potentially increasing tramadol levels and side effects.
Carbamazepine
Significantly reduces tramadol plasma concentrations, potentially leading to reduced analgesic effect.
MAO Inhibitors
Contraindicated due to risk of serotonin syndrome and seizures.
SSRIs, SNRIs, TCAs
Increased risk of serotonin syndrome.
CNS Depressants (e.g., alcohol, benzodiazepines)
Increased risk of respiratory depression, sedation, coma, and death.
Storage
Store at room temperature (below 30°C), away from moisture and direct light. Keep out of reach of children.
Overdose
Symptoms include respiratory depression, seizures, miosis, cardiovascular collapse, and coma. Treatment involves supportive measures, maintaining a patent airway, and administration of naloxone for opioid effects. Hemodialysis is not effective.
Pregnancy & Lactation
Not recommended during pregnancy, especially during the third trimester, due to the risk of neonatal opioid withdrawal syndrome. Excreted in breast milk; advise caution or consider alternative for breastfeeding mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory bodies
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated tramadol's efficacy and safety in treating acute and chronic moderate to severe pain conditions. Studies also explore its use in neuropathic pain and its interaction with other serotonergic agents.
Lab Monitoring
- Renal function tests (for patients with renal impairment or long-term use).
- Hepatic function tests (for patients with hepatic impairment or long-term use).
Doctor Notes
- Counsel patients on the risks of addiction, abuse, and misuse. Emphasize not to exceed prescribed dose.
- Monitor for signs of respiratory depression, especially during initiation or dose escalation.
- Assess for concurrent use of serotonergic drugs due to serotonin syndrome risk.
- Consider lower doses and extended intervals in elderly patients and those with renal/hepatic impairment.
Patient Guidelines
- Take exactly as prescribed and do not exceed the recommended dose.
- Do not stop taking the medicine suddenly without consulting your doctor, as withdrawal symptoms may occur.
- Avoid alcohol and other CNS depressants.
- Be aware of symptoms of serotonin syndrome (e.g., agitation, hallucinations, rapid heart beat, fever).
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Tramavir may cause dizziness, drowsiness, and impaired mental or physical abilities. Patients should not drive or operate hazardous machinery until they are reasonably certain that Tramavir does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Avoid activities requiring mental alertness, such as driving or operating machinery, until you know how the medicine affects you.
- To prevent constipation, maintain adequate hydration and consider dietary fiber intake.
- Discuss any concerns about addiction or dependence with your doctor.
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