Tranal
Generic Name
Tramadol Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tranal 100 mg suppository | ৳ 15.06 | N/A |
Description
Overview of the medicine
Tranal 100 mg Suppository contains Tramadol Hydrochloride, an opioid analgesic used to relieve moderate to severe pain. It acts on opioid receptors in the brain and spinal cord to alter the perception of pain.
Uses & Indications
Dosage
Adults
Adults: 100 mg rectally every 4-6 hours as needed, not exceeding 400 mg/day.
Elderly
Elderly (>75 years): Maximum 300 mg/day, with increased dosing interval.
Renal_impairment
Renal impairment (CrCl <30 mL/min): 100 mg every 12 hours. Not recommended in severe renal impairment.
How to Take
The suppository should be inserted rectally. Ensure hands are clean before and after insertion. Do not cut or break the suppository.
Mechanism of Action
Tramadol is a centrally acting analgesic. It has a dual mechanism of action: it is a weak μ-opioid receptor agonist, and it also inhibits the reuptake of norepinephrine and serotonin, which enhances the inhibitory effects of these neurotransmitters on pain transmission in the spinal cord.
Pharmacokinetics
Onset
Typically within 30-60 minutes
Excretion
Mainly via kidneys (renal excretion), with about 90% eliminated as metabolites and 10% as unchanged drug.
Half life
Approximately 6-7 hours
Absorption
Well absorbed following rectal administration, though absorption may be slower and peak concentrations may be lower than oral administration.
Metabolism
Extensively metabolized in the liver by CYP2D6 to O-desmethyltramadol (M1), which is more potent than tramadol, and by CYP3A4 and CYP2B6 to other inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to tramadol or any component of the suppository
- Acute intoxication with alcohol, hypnotics, analgesics, opioids, or other psychotropic drugs
- Patients with epilepsy not adequately controlled by treatment
- Concomitant use with MAO inhibitors or within 14 days of discontinuing them
Drug Interactions
Warfarin
Increased INR and bleeding risk.
MAO Inhibitors
Increased risk of serotonin syndrome and seizures.
Serotonergic Drugs (e.g., SSRIs, SNRIs)
Increased risk of serotonin syndrome.
CNS Depressants (e.g., alcohol, benzodiazepines)
Increased risk of respiratory depression, profound sedation, coma, and death.
Storage
Store below 30°C in a cool, dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include respiratory depression, seizures, coma, cardiac arrest, and death. Naloxone can reverse opioid effects, but may not fully reverse seizures. Supportive care and gastric decontamination (if oral overdose) are crucial.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy, especially in the third trimester, due to risk of neonatal withdrawal syndrome. Excreted in breast milk; not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date, check packaging for exact date.
Availability
Pharmacies and Hospitals
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of tramadol for various pain conditions. Ongoing research continues to explore its long-term effects and comparisons with other analgesics.
Lab Monitoring
- Monitor respiratory rate and level of consciousness, especially during initiation or dose escalation.
- Monitor liver and kidney function in patients with pre-existing impairment.
Doctor Notes
- Assess patient's pain level and history of substance abuse before prescribing.
- Counsel patients on the risks of addiction, respiratory depression, and serotonin syndrome.
- Consider lower doses and extended intervals in elderly and renally impaired patients.
Patient Guidelines
- Use exactly as prescribed by your doctor.
- Do not exceed the recommended dose.
- Avoid alcohol and other CNS depressants.
- Report any signs of difficulty breathing, extreme drowsiness, or rash immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
May cause drowsiness, dizziness, or blurred vision. Avoid driving or operating heavy machinery until you know how this medicine affects you.
Lifestyle Advice
- Stay hydrated to help prevent constipation.
- Engage in light physical activity if possible and advised by your doctor.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.