Tramadol XX 200mg Tablet
hab Pharmaceuticals Ltd
Generic Name: Tramadol
Brand Names: Ultram, Conzip, Ryzolt, Rybix ODT, Fusepaq Synapryn
Active Ingredient: Tramadol Hydrochloride
Other Ingredients: Magnesium Stearate, Microcrystalline Cellulose, Pregelatinized Starch
Tramadol is an opioid medication used to relieve moderate to severe pain. It works in the central nervous system (CNS) to alter how the body feels and reacts to pain. The long-acting or extended-release form is used for around-the-clock treatment of chronic pain.
With prolonged use, Tramadol may become habit-forming, leading to physical or mental dependence. It must not be taken more often or in higher doses than prescribed by a medical professional. Misuse of this drug can cause addiction, overdose, or even death.
The dose for Tramadol varies between patients, depending on the strength of the drug, the patient’s level of pain, and how the patient reacts to the medicine. The doctor may start prescribing a low dosage and gradually increase to find the dosage that best works for the patient.
The number of doses to take per day, the allowable time between doses, and the required length of time the medicine should be taken, depending on the ailment or medical condition for which the medicine is used.
The typical doses for adults (17 years old and above) are as follows.
For moderate to severe pain:
- Disintegrating tablets: At first, 50-100mg, taken every 4-6 hours as required, but may be increased as needed. The maximum dose is 400mg per day.
- Regular tablets: At first, 25mg per day, taken once every morning, but may be increased as needed. The maximum dose is 400mg per day.
For chronic pain:
- Extended-release tablets: At first, 100mg, taken once per day, but may be increased as needed. The maximum dose is 300mg per day.
- Regular tablets: At first, 50-100mg per day, taken every 4-6 hours as required, but may be increased as needed. The maximum dose is 400mg per day.
- Tramadol is not recommended for pediatric use.
- For children 16 years old and below, use and dosage must be carefully determined by the doctor in charge.
- For geriatrics (75 years old and above), the maximum dose is 300mg per day.
- For patients with liver damage (cirrhosis), the dose should not be more than 100g per day.
- For patients with kidney disease, the dose should not be more than 200mg.
- Regular or dissolvable tablets can be taken with or without food.
- Typically, the extended-release, long-acting tablets or capsules should be taken at the same time every day.
- Be careful when removing the medicines from the packaging and be sure your hands are dry before taking the tablets.
- Place the medicine on your tongue as soon as you take it out of the packaging. Do not chew, crush, open, or split the medication. Swallow it whole with a glass of clean water.
Before you start using Tramadol, read the medication guide given by your pharmacist and every time you get a refill. Do not hesitate to ask your doctor or pharmacist in case you have questions or confusions.
Drug interactions may increase your risk for severe side effects and alter how your medications work. It is important to keep a complete list of all the medications and supplements you take and communicate it with your doctor and/or pharmacist. Do not start or stop taking any medication or change the dosage without prior approval of your doctor.
Some medications, such as Selegiline, Rasagiline, and Naltrexone, are NOT to be taken along with Tramadol. Your doctor may change your other medicines or decide not to prescribe this drug.
Taking Tramadol with any of the medications listed below is generally not recommended but may be needed on some occasions. If both drugs are prescribed, it may be necessary to change the dosage or how often you take both or one of the medicines.
Asenapine – Aripiprazole – Anileridine – Amoxapine – Amobarbital – Amitriptyline – Amisulpride – Alprazolam – Alfentanil – Acetophenazine – Acepromazine
Butorphanol – Butabarbital – Buspirone – Bupropion – Buprenorphine – Brompheniramine – Bromperidol – Bromopride – Bromazepam – Benperidol – Baclofen
Cyclobenzaprine – Codeine – Cocaine – Cobicistat – Clovoxamine – Clorgyline – Clorazepate – Clonazepam – Clomipramine – Clobazam –Clarithromycin – Citalopram – Chlorzoxazone – Chlorprothixene – Chlorpromazine – Chlorpheniramine – Chlordiazepoxide – Chloral Hydrate – Ceritinib – Carphenazine – Carisoprodol – Cariprazine – Carbinoxamine – Carbamazepine
Duloxetine – Droperidol – Doxylamine – Doxepin – Dothiepin – Donepezil – Dolasetron – Diphenoxylate – Diphenhydramine – Dihydrocodeine – Difenoxin – Dichloralphenazone – Diazepam – Diacetylmorphine – Dextromethorphan – Dexmedetomidine – Desvenlafaxine – Desipramine – Darunavir – Dantrolene
Ethylmorphine – Ethopropazine – Ethchlorvynol – Eszopiclone – Estazolam – Escitalopram – Enflurane – Eletriptan
Fospropofol – Fluvoxamine – Fluspirilene – Flurazepam – Fluphenazine – Flupenthixol – Fluoxetine – Fluconazole – Flibanserin – Fentanyl – Femoxetine
Hydroxyzine – Hydroxytryptophan – Hydromorphone – Hydrocodone – Hexobarbital – Halothane – Haloperidol – Halazepam
Isoflurane – Isocarboxazid – Iproniazid – Imipramine – Iloperidone – Idelalisib
Ketamine – Ketazolam – Ketobemidone
Lurasidone – Lorcaserin – Lorazepam – Lofepramine – Lithium – Linezolid – Levorphanol – Levomilnacipran
Morphine Sulfate Liposome – Morphine – Moricizine – Molindone – Moclobemide – Mirtazapine – Mirabegron – Milnacipran – Midazolam – Metoclopramide – Methylene Blue –Methotrimeprazine – Methohexital – Methocarbamol – Methdilazine – Methadone – Metaxalone – Mesoridazine – Meptazinol – Meprobamate – Mephobarbital – Meperidine – Melperone – Meclizine
Nortriptyline – Nitrous Oxide – Nitrazepam – Nicomorphine – Nefazodone – Naratriptan – Nalbuphine
Oxymorphone – Oxycodone – Oxazepam – Orphenadrine – Opium Alkaloids – Opium – Ondansetron – Olanzapine
Protriptyline – Propoxyphene – Propofol – Propiomazine – Promethazine – Promazine – Prochlorperazine – Procarbazine – Primidone – Prazepam – Piritramide – Pipotiazine – Piperacetazine – Pimozide – Pimavanserin – Phenobarbital – Phenelzine – Perphenazine – Periciazine – Perazine – Perampanel – Pentobarbital – Pentazocine – Penfluridol – Peginterferon Alfa-2b – Paroxetine – Paregoric – Papaveretum – Palonosetron – Paliperidone
Quinidine – Quetiapine – Quazepam
Rizatriptan – Risperidone – Remoxipride – Remifentanil – Ramelteon
Suvorexant – Sumatriptan – Sulpiride – Sufentanil – St John’s Wort – Sodium Oxybate – Sibutramine – Sertraline – Sertindole – Secobarbital – Safinamide
Trimipramine – Trimeprazine – Triflupromazine – Trifluperidol – Trifluoperazine – Triazolam – Trazodone – Tranylcypromine – Topiramate – Tolonium Chloride – Tizanidine – Tilidine – Thiothixene – Thioridazine – Thiopropazate – Thiopental – Thiethylperazine – Temazepam – Tapentadol
Vortioxetine – Vilazodone – Venlafaxine
Zuclopenthixol – Zotepine – Zopiclone – Zolpidem – Zolmitriptan – Ziprasidone – Zaleplon
Note: Some drugs should not be taken at or about the same time as eating food or certain types of food as interactions may also occur. Using tobacco or alcohol with certain drugs may likewise cause interactions. Strictly follow your doctor’s special instructions as regards use of food, tobacco, or alcohol. Some interactions can be extremely dangerous and, in some cases, fatal.
Before taking Tramadol, it is imperative that you disclose the following to your doctor or pharmacist:
- Allergies to Tramadol or to other opioid pain medications: Tramadol may contain other inactive ingredients that can trigger serious allergic reactions such as anaphylaxis, which can be life-threatening and thus requires prompt medical attention. Ask your pharmacist for a full list of ingredients.
- Your medical history, especially of: mental/psychological disorders (e.g. depression, confusion), brain disorders (e.g. epilepsy, seizures, tumor, head injury), lung or breathing problems (e.g. sleep apnea, asthma, hypercapnia, chronic-obstructive pulmonary disease), intestinal/stomach problems (e.g. paralytic ileus, intestinal blockage, diarrhea due to infection, constipation), phenylketonuria (PKU), problems with urination, pancreatitis, gallbladder disease, liver disease, kidney disease, and obesity.
- Family or personal history of substance addiction or overuse: such as to alcohol or other drugs.
- Usage of prescription or non-prescription medications, nutritional supplements, vitamins, or herbal products: Many drugs interact with Tramadol and it may be necessary to change the doses of the medications and monitor you closely for side-effects.
- Usage of monoamine oxidase (MAO) inhibitors: Your doctor will likely advise you not to take Tramadol if you are taking or have taken such medications within the past two weeks.
- If you are or may be pregnant: During pregnancy, Tramadol should be taken only if clearly needed as it may harm the unborn child. Talk to your doctor about the possible risks and benefits.
- If you are breastfeeding: Breastfeeding while taking Tramadol is not recommended. The drug passes into breastmilk and can lead to undesirable effects in breasted infants, such as difficulty breathing, noisy or shallow breathing, unusual sleepiness, limpness, and confusion.
- Tramadol can cause extreme drowsiness and dizziness and affect your coordination. Do not drive, operate machinery, or do any activity that requires alertness until you are able to do it safely.
- Avoid marijuana and alcoholic beverages. Tell your doctor if you have issues with alcoholism or are taking marijuana or CBD products.
- This drug may affect the hormones and fertility in both men and women. Discuss potential risks with your doctor.
- Before undergoing emergency treatment or any type of surgery (including dental surgery), tell the doctor or dentist that you are taking Tramadol. Taking this drug along with other medicines used during emergency treatments or surgery may increase side-effects.
- Some children and older adults may be more susceptible to the side-effects of this drug, such as confusion, severe sleepiness, dizziness, and shallow/slow/noisy breathing.
- Do not stop taking Tramadol abruptly without consulting your doctor first. The doctor may need to gradually reduce your dose before completely stopping it. This is to prevent your condition from worsening and reduce the risk of withdrawal symptoms such as diarrhea, anxiety, nausea, headache, sweating, tremors, shivering, and trouble sleeping.
- This drug may cause constipation and other problems with digestion. Speak to your doctor about modifying your diet.
- Tramadol may interfere with some laboratory tests (such as lipase/amylase levels) and possibly result in false or inaccurate test results. Tell all the doctors and laboratory personnel that you are using this drug.
Tramadol has some side effects which may subside as your body adjusts to the medication. If any of the side effects persist or become severe, contact your doctor or pharmacist immediately.
More Common Side-effects:
- abdominal pain, constipation, diarrhea, heartburn, nausea, vomiting;
- agitation, anxiety, nervousness, sweating
- changes in mood, irritability
- cough, dry mouth, sore throat, stuffy nose
- dizziness, drowsiness, fever, headache
- feeling of warmth, feeling unusually cold, flushing (tingly feeling), shivering
- general feeling of discomfort, restlessness
- impotence, loss of interest in sex
- joint pain, muscle pains, and aches
- loss of appetite, loss of pleasure
- missed menstrual periods, irregular ovulation
- redness of the face, neck, arms, and occasionally, upper chest
- skin rash, redness of the face, arms, neck, and in some occasions, upper chest
- tired feeling, weakness
- trouble concentrating
Less Common Side-effects:
- abdominal fullness, bloating
- absent or weak pulses in the legs
- blisters, severe itching, redness, and swelling of the skin
- blood in the urine, darkened urine, difficulty with urinating, frequent urge to urinate
- blurred vision, lightheadedness or dizziness when getting up from a sitting or lying position
- chest pain, severe nausea, recurring fever, nasal congestion, tightness of the chest
- cold or pale bluish-colored hands or feet
- fainting, seizures (convulsions)
- hot flushes, night sweats
- increased blood pressure, increased heart rate, irregular heartbeat
- jaundice (yellowing of the skin and eyes)
- loss of coordination, trouble to perform daily tasks
- mild hallucination, loss of memory, loss of voice
- muscle cramping, spasms, stiffness, or twitching
- numbness and/or tingling of the face
- numbness, pain, tingling, or weakness in the feet and hands
- pain or discomfort in the neck, jaw, arms, or back
- reduced sensation to touch
- severe cramping, uncontrollable shaking of the hands or feet
- sudden changes in weight (loss or gain)
If you experience signs of an allergic reaction (difficulty breathing, hives, swelling in the throat or face) or a serious skin reaction (skin pain, purple or red skin rashes, burning in the eyes, sore throat, fever), get emergency medical attention as soon as possible.
After using the medicine, you may still experience some side-effects that require medical attention. Consult your doctor immediately.
If you notice possible side-effects other than what’s listed above, seek the advice of a healthcare professional.
Tramadol overdose has toxic effects and can be fatal, especially when used without a prescription. Naloxone is usually given when someone has overdosed but it only partially reverses the dangerous effects and can increase the risk of convulsions or seizures.
Symptoms of overdose include:
- cold, clammy skin
- difficulty breathing/shortness of breath
- irregular or slow heartbeat
- irresponsiveness / loss of consciousness (coma)
- lightheadedness, dizziness
- muscle weakness
- narrowed/pinpointed pupils
- reduced awareness
- respiratory depression
- extreme drowsiness
- unusual fatigue / lethargy
If you or anyone you know has overdosed or shows symptoms of tramadol overdose, seek immediate medical help or contact the poison help line promptly.
It is extremely important that you use Tramadol exactly as instructed by your doctor, no more no less. If you miss a dose, take it as soon as you recall. However, if it’s almost time for your next intake, skip your missed dose and continue the regular dosing schedule. Do not double your dose to make up for the missed one as it may have dangerous effects.
Store all medications in a closed container, case, or cabinet at room temperature, away from moisture, direct light, and heat. Keep out of reach of children and pets. Do not freeze.
Do not store medicines that are out-of-date or no longer needed. Do not pour into a drain or flush down the toilet unless otherwise instructed by a healthcare professional. Consult a local waste disposal company or your pharmacist about proper disposal of expired or unusable medicines.