Tramadol is one of the most commonly prescribed medications for pain in the united states.
It is often given because it is felt to be more safe than hydrocodone,
oxycodone or any of the other narcotics out there. But is this true?
Keep watching to find out a little more about Tramadol and to see if it is safe for you.
Hi, I?m Dr. Erik Richardson a board certified Family Practice physician.
I?d like to welcome you to FamilyMed, a channel that focuses giving you practical and accurate
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So today, we are going to be talking about the pain medication Tramadol. This is a medication
that has been around for quite some time. It was first patented in Europe in the 1960?s but
wasn?t approved in the united states until the mid 1990?s. It?s main indication is to treat moderate
to moderately severe pain that isn?t controlled by other medications like ibuprofen or Tylenol.
It?s actually a very commonly prescribed. In 2019, it was the 29th most prescribed medication in the
United States. One of the main reasons why it has become so popular is due to the belief that
this medication is safter or not as strong as some of the other narcotic medications.
Now pain is one of the hardest things we treat in medicine and there isn?t a lot of great options
out there that are proven to work and don?t have a lot of baggage and problems with them. So ,the
thought of having something that may help but won?t cause the same problems of some of the
other narcotic medications is appealing to many doctors. The problem with this,
is that it can give many a false sense of security and that can get patients in trouble.
Tramadol is a narcotic pain medication that does block the receptors in the brain that help disrupt
how your body perceives pain. Tramadol is a little bit different though because not only does it work
on the opoid receptors in the brain for pain control, it also has effect on increasing your
serotonin and norepinephrine levels in your brain. This can have some advantages when you
are trying to treat pain but it also brings some challenges that we will talk about in a minute.
Like I said before it tramadol is not as potent as your stronger narcotics like
hydrocodone or oxycodone. It?s going to be more similar to medications like codeine.
That has some advantages and disadvantages. One of the advantages is that because it is
not as potent the potential for addiction and dependency is a little bit less
than the stronger medications ,but the danger of that thinking, is that you are still at risk for
dependency, addiction and abuse by taking it. Because of that, it is a schedule IV controlled
substance in the united states. That means that it a doctor can give refills of the medication
but you cannot get more than 5 refills and the original prescription expires after 6 months.
So Tramadol most commonly comes in an immediate release tablet of 50
and 100mg and and extended release tablet of 100, 200 and 300mg. The immediate release version
is meant to be taken from 50-100mg every 4-6 hours as needed for pain. The extended release
doses are meant to be taken once a day. Ok, so let?s talk about some of the issues
and side effects that you need to be careful of and watch for.
The most common ,more mild side effects that you may see, are similar to what you can find
with other pain medications. It can cause some dizziness and drowsiness, nausea and vomiting,
some dry skin or dry mouth, some itching and some occasional headaches.
Most of these symptoms tend to be mild and by being careful how you take them,
you can avoid or minimize most of these. For example, to avoid the nausea and vomiting, taking
them with food can oftentimes make a difference. It can make you sleepy, so certainly taking it
at night or being aware and avoiding driving or other dangerous activities are very important.
These can be bothersome, but they are not the most concerning of side effects. Any pain
medication can cause similar symptoms so most of us are familiar with these kinds of effects.
They aren?t necessarily harmful, just bothersome and taking the proper precautions can help.
Where we need to focus most of our time though is in some of the more concerning effects that can be
dangerous and even deadly if you are not careful. One of our biggest concerns with any of the pain
medications is dependency and abuse. When used properly the risk of this with tramadol is lower
but it still can be an issue. It?s very important that you work closely with your doctor, you don?t
take more than prescribed and you take them as little as possible to control your symptoms.
If you are on them chronically then your body will likely become dependant on them over time. This
doesn?t mean that you are addicted but you don?t want to just stop them abruptly. If you notice
that you are needing more and more to be able to control the pain, this is a big warning sign that
this may not be the right treatment for you. If you already have had a history of addiction
or even a family history of the same, you need to make your doctor aware and take extra precautions.
Another thing to be aware of is tramadol can make it easier for you to have seizures.
One of the things that it can do is lower what we call your seizure threshold. So things that may
normally not kick off a seizure may while on this medication. Those most at risk are those who have
an underlying seizure disorder or are taking other medications that can also decrease this risk. For
example, I once had a patient who came to me who had been on tramadol and bupropion-a common
antidepressant medication which also can decrease this threshold, after suffering a seizure.
This isn?t common but it is possible, so make sure you are reviewing all your medications with
your doctor and pharmacist before taking this. Now speaking of medications, other medications
that you need to be careful taking together are your other antidepressants.
Because of the effects that Tramadol can have on serotonin and norepinephrine,
combining these medications can increase your risk of developing a condition called Serotonin
Syndrome. This is a condition where your body gets too much serotonin. This is very rare but can
present with symptoms like agitation, confusion, rapid heart rate and high blood pressure,
dilated pupils, loss of muscle coordination, muscle rigidity, diarrhea and heavy sweating.
If you think this is happening to you, get into your doctor or the emergency room right away.
There are quite a few interactions that tramadol can have with other medications so again,
it?s important to make sure you review all of them with your doctor and pharmacist.
Another area that you need to be careful with while taking this medication relates to
how narcotic type medications can affect your breathing. Narcotics can suppress your reflex
to breathe and tramadol is no different. Watching for issues with shortness of breath or just slowed
breathing are very important and you should stop the medication and contact your doctor if you do.
Because of that people with breathing issues such as asthma, COPD, or any other state
that makes breathing more difficult should really be careful and likely avoid tramadol
as well as any other narcotic medication. Because of the way it works finally you need
to strictly avoid taking this medication with any other medication or substance that causes
sedation. This means any other types of narcotics or sedative medications like your benzodiazepines
like Xanax or Ativan or others like this, or sleep aids and even alcohol really need
to be avoided taking them together. Finally we need to talk about the
risk of overdose. Although it may not be as significant as with your stronger narcotics,
it certainly is possible, especially if you combine it with the substances I just mentioned.
If you or a family member taking it starts having symptoms such as smaller pupils,
difficulty breathing, slow or shallow breathing, extreme drowsiness or sleepiness, unable to
respond or wake up, slowed heatbeat, muscle weakness or cold and clammy skin, you need to
get help right away. This is a medical emergency. So that?s an overview of some of the most
important things you need to know about taking tramadol. It can be an effective medication for
treating pain. As with most medications, the majority of people do just fine with taking.
Hopefully being aware of the things that you need to watch out for can help you be a little
more safe if you need to take this medication. If you work closely with your doctor and take
the medication as prescribed, you will have the best chance of having this medication control
your pain and get back to better health. Well, I hope you found this to be helpful,
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Richardson and remember to take care of your body because it?s the only one you have.