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Tramadol Tramadol rac-(1R,2R)-2-(dimethylaminomethyl)-1- (3-methoxyphenyl)-cyclohexanol IUPAC name CAS number 27203-92-5 ATC code N02AX02 PubChem 33741 DrugBank APRD00028 Chemical formula C16H25NO2 Molecular weight 263.4 g/mol Bioavailability 68-72% Increases with repeated dosing. Metabolism Hepatic demethylated & glucuronidated Elimination half-life 5-7 hours Excretion Renal Pregnancy category C (USA) C (Australia) Legal status Schedule 4 (Australia) Routes of administration Oral, IV, IM Tramadol (INN) (IPA: [?tr?m?d?l]) is an atypical opioid which is a centrally acting analgesic, used for treating moderate to severe pain. It is a synthetic agent, unrelated to other opioids, and appears to have actions on the GABAergic, noradrenergic and serotonergic systems. Tramadol was developed by the German pharmaceutical company Grunenthal GmbH and marketed under the trade name Tramal‚R. Grunenthal has also cross licensed the drug to many other pharmaceutical companies that market it under various names, some of which are listed below. Tramadol is available in both injectable (intravenous and/or intramuscular) and oral preparations. It is usually marketed as the hydrochloride salt (tramadol hydrochloride). Dosages vary depending on the degree of pain experienced by the patient. Tramadol is approximately 10% as potent as morphine, when given by the IV/IM route. Oral doses range from 50?400 mg daily, with up to 600 mg daily when given IV/IM. Contents [hide] 1 Mechanism of action 2 Metabolism 3 Adverse effects 4 Dependence 5 Proprietary preparations 6 References [edit] Mechanism of action The mechanism of action of tramadol has yet to be fully elucidated, but it is believed to work through modulation of the GABAergic, noradrenergic and serotonergic systems. The contribution of non-opioid activity is demonstrated by the analgesic effects of tramadol not being fully antagonised by the ?-opioid receptor antagonist naloxone. Tramadol is marketed as a racemic mixture with a weak affinity for the ?-opioid receptor (approximately 1/6000th that of morphine). The (+)-enantiomer is approximately four times more potent than the (-)-enantiomer in terms of ?-opioid receptor affinity and 5-HT reuptake, whereas the (-)-enantiomer is responsible for noradrenaline reuptake effects (Shipton, 2000). These actions appear to produce a synergistic analgesic effect, with (+)-tramadol exhibiting 10-fold higher analgesic activity than (-)-tramadol (Goeringer et al., 1997). The serotonergic modulating properties of tramadol mean that it has the potential to interact with other serotonergic agents. There is an increased risk of serotonin syndrome when tramadol is taken in combination with serotonin reuptake inhibitors (e.g. SSRIs), since these agents not only potentiate the effect of 5-HT but also inhibit tramadol's metabolism. [edit] Metabolism Tramadol undergoes hepatic metabolism via the cytochrome P450 isozyme CYP2D6, being O- and N-demethylated to 5 different metabolites. Of these, M1 is the most significant since it has 200 times the ?-affinity of (+)-tramadol, and furthermore has an elimination half-life of 9 hours compared to 6 hours for tramadol itself. In the 6% of the population who have slow CYP2D6 activity, there is therefore a slightly reduced anlagesic effect. Phase II hepatic metabolism renders the metabolites water-soluble and they are renally excreted. Thus reduced doses may be used in renal and hepatic impairment. [edit] Adverse effects The most commonly reported adverse drug reactions are nausea, vomiting and sweating. Drowsiness is reported, although it is less of an issue compared to other opioids. Respiratory depression, a common side effect of most opioids, is not clinically significant in normal doses. By itself, it does not increase the seizure threshold, though it may do if used in combination with SSRIs, tricyclic antidepressants, or in patients with epilepsy. [edit] Dependence Some controversy exists regarding the dependence liability of tramadol. Grunenthal has promoted it as an opioid with a low risk of dependence compared to traditonal opioids, claiming little evidence of such dependence in clinical trials. They offer the theory that since the M1 metabolite is the principal agonist at ?-opioid receptors, the delayed agonist activity reduces dependence liability. The noradrenaline reuptake effects may also play a role in reducing dependence. Despite these claims it is apparent, in community practice, that dependence to this agent does occur. This would be expected since analgesic and dependence effects mediated by the same ?-opioid receptor. However, this dependence liability is considered relatively low by health authorities, such that tramadol is classified as a Schedule 4 Prescription Only Medicine in Australia, rather than as a Schedule 8 Controlled Drug like other opioids (Rossi, 2004). Similarly, tramadol is not currently scheduled by the U.S. DEA, unlike other opioid analgesics. Nevertheless, the Prescribing Information for Ultram warns that tramadol "may induce psychic and physical dependence of the morphine-type." [edit] Proprietary preparations Grunenthal, which still owns the patent to tramadol, has cross-licensed the agent to various pharmaceutical companies internationally. Thus tramadol is marketed under many trade names including: Adolonta, Contramal, Crispin, Nobligan, Siverol, Tiparol, Toplagic, Tradolan, Tralgit, Tramacet, Tramadin, Tramal, Ultracet, Ultram, Zamadol and Zydol. [edit] References Goeringer KE, Logan BK, Christian GD. Identification of tramadol and its metabolites in blood from drug-related deaths and drug-impaired drivers. J Anal Toxicol 1997;21(7):529-37. PMID 9399121 Rossi S, editor. Australian Medicines Handbook 2004 (AMH). Adelaide: Australian Medicines Handbook; 2004. ISBN 0-9578521-4-2. Shipton EA. Tramadol ? present and future. Anaesth Intensive Care 2000;28(4):363-74. PMID 10969362 Ultram ? U.S. Prescribing Information Analgesics edit {Paracetamol (acetaminophen)} {NSAIDs} {Opiates} {Tetrahydrocannabinol} NSAIDs edit {Aspirin} {Celecoxib} {Diclofenac} {Diflunisal} {flurbiprofen} {Ibuprofen} {Indomethacin} {Ketoprofen} {Ketorolac} {Meloxicam} {Naproxen} {Piroxicam} {Rofecoxib} {Valdecoxib} Opioids edit {Alfentanil} {Buprenorphine} {Carfentanil} {Codeine} {Codeinone} {Dextropropoxyphene} {Diamorphine (Heroin)} {Dihydrocodeine} {Fentanyl} {Hydrocodone} {Hydromorphone} {Methadone} {Morphine} {Morphinone} {Oxycodone} {Oxymorphone} {Pethidine (Meperidine)} {Remifentanil} {Sufentanil} {Tramadol} Categories: Analgesics | Opioids Article Discussion Edit this page History

tramadol

tramadol is an appetite suppressant that is used in combination with exercise to help you shed the weight and to meet goals during a weight loss plan over the course weeks and months.

how to take tramadol

You will have the best benefits of tramadol when you take it in the morning. Try to take your medication when you first get up in the morning so you have at least half an hour before you are going to eat breakfast. This is a medication that can take up to half an hour to work into your blood stream for the best results. tramadol can cause some people to stay awake, and restlessness so it is best not to take it after five or six in the evening.

tramadol side effects

Some tramadol users can experience side effects. Some of these side effects are felt by some users, while other tramadol users do not notice any side effects. Some side effects include dry mouth, sleeplessness, irritability, stomach upset or constipation which may occur only in the first few days as your body adjusts to using the medication. If these side effects last for more than just a few days or they are particularly bothersome consult with your family doctor.

tramadol precautions

As with all medications there are some people who should not use this type of medication. If you are going to take tramadol and you have high blood pressure, you should not use tramadol until you have consulted with your doctor about your high blood pressure. Other conditions that should be reconsidered before using tramadol include over-active thyroid, glaucoma, diabetes or emotional problems. If you are pregnant or nursing you should not be considering the use of tramadol or a weight loss program. No one under the age of eighteen should use tramadol.

tramadol interactions

You should always tell your doctor if you are taking any other type of medications. If you are taking medications for your heart, high blood pressure or if you are taking any type of high blood pressure medicine or MAO inhibitors (e.g., furazolidone, phenelzine, selegiline, tranylcypromine) or any other weight loss medicine be sure to tell your doctor about these types of medications. If you are taking any type of common cold medications you should also reconsider using tramadol while using these medications.

tramadol general notes

It is important to remember that tramadol alone is not going to help you lose weight. You have to use some type or some amount of exercise in order for tramadol to help you burn calories, and to help you stay on track to meet your weight loss goals. tramadol is a medication best used in combination with exercise and eating healthy foods.

missed dosage of tramadol

Never take more than one dosage of tramadol at a time. If you should happen to mss a dose, do not double the next dose. You should be sure to skip the missed dose of tramadol and resume your usual dosing schedule so you avoid any over dosage problems.

tramadol storage

How should you store tramadol? You should store tramadol at room temperature away from sunlight and moisture. Moisture and medications never mix well, because medications will start to melt in the bottle when moisture is added. No matter where you keep your medications, be sure to keep tramadol and all types of medications out of the reach of children.
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(yellow)</td> <td>30 Capsules</td> <td><span class="priceVal">$<!--MedId:96-->131.00<!--/MedId--></span></td> <td class="consultation">FREE!</td> <td align="center">a href= "http://www.rx-pharma.com/order/order.php?nMedId=96" rel="nofollow">Order</a></td> </tr> <tr> <td>tramadol 30 mg. (yellow)</td> <td>60 Capsules</td> <td><span class="priceVal">$<!--MedId:97-->145.00<!--/MedId--></span></td> <td class="consultation">FREE!</td> <td align="center">a href= "http://www.rx-pharma.com/order/order.php?nMedId=97" rel="nofollow">Order</a></td> </tr> <tr> <td>tramadol 30 mg. (yellow)</td> <td>90 Capsules</td> <td><span class="priceVal">$<!--MedId:98-->155.00<!--/MedId--></span></td> <td class="consultation">FREE!</td> <td align="center">a href= "http://www.rx-pharma.com/order/order.php?nMedId=98" rel="nofollow">Order</a></td> </tr> </table> <p />&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <h3>tramadol and choices for a healthy lifestyle</h3> If you are looking for a healthy lifestyle, tramadol is not a substitute for the choices you have to make in creating a healthy lifestyle. tramadol is an aid to lead you to find and obtain a healthy lifestyle. Your healthy lifestyle is going to start with weight loss and better overall eating habits. tramadol will help you lose weight. Think about how much you eat, and what eat, and answer these questions to get you started: <ol> <li>If you sit down for dinner, do you eat everything on your plate? Do you think you have to eat everything that is on your dinner plate?</li> <li>If you are eating at a relatives or at a friends house do you feel obligated to ask for seconds so they feel you thought the meal was good?</li> <li>Do you feel you want to walk and eat at the same time? For example, you walk to work but eat at the same time?</li> <li>When you are depressed or sad do you eat?</li> <li>Do you eat again right after meals because you feel a need or want something else?</li> <li>Do you find you eat even if you are not hungry?</li> <li>Are you eating when you are excited or when you are anxious?</li> <li>Are you eating your meals too fast? Are others done eating long after you are?</li> <li>Do you look in the fridge for something to ease you hunger often? Or you look in the fridge just for something to munch on often?</li> <li>Can you name everything that you ate during the entire yesterday? Do you know how many times you ate yesterday?</li> <li>Do you eat often while watching television or watching movies?</li> </ol> <p>The more questions that you can answer yes to from the listing above, or that you can directly relate to in your daily activities, the more you should consider changing your lifestyle and how you eat so you do have a healthy life. If you are relating to a lot of these habits and questions, the more dangerous your overall lifestyle is personally. If you are going to start a weight loss plan, we suggest that you tell as many of your friends and family that you are setting a weight loss goal so you can benefit from all the great support of family and friends. </p> <p>The more questions that you are relating to, that you are answering that sound like you and your situation, the more you need help in losing weight. Hunger and the need to eat are to different topics. Hunger is a feeling and the need to eat is most often the result of a habit. </p> <p>If answered yes to the first question you are likely to eat everything, and you have a hard time throwing anything away. You like to try all types of foods, and you hate to waste any types of food so you do continually clean your plate no matter if you are full or if you are still hungry. </p> <p>If you easily related to the question listed in three, six, seven, and in eight you need to learn to eat slowly, and you need to learn to chew your foods more completely so you are eating slower. </p> <p>If you relate to the questions about your moods in reflection to your eating habits, you often are eating to console yourself and your moods. Your life situations should not dictate how much you eat, and how often you eat. You need to learn to control this habit so you eat less, and you eat less often. Find another method of relaxing for a weight loss plan that will work for you. </p> <p>If you don&#8217;t remember what you ate yesterday, if you have a hard time listing everything that you ate yesterday you need to pay more attention to how many times you are eating and how often you are eating. You like to eat all types of things, and you like to experiment with food, and this can cause weight gain. Eat only when you are truly hungry not just because you like the taste for a better over all weight loss plan. </p> <p>tramadol is an appetite suppressant, controlling how hungry you feel, and how often you eat. Don&#8217;t you think your challenges with eating could be controlled much easier with the use of tramadol?<br /> </p> <h3>Setting weight loss goals with the use of tramadol</h3> <p>Putting more exercise into your life will require planning. If you have not been exercising for some time now, or if you are overweight, you can find starting a weight loss plan can be difficult. Toning your body is what exercise is all about, and losing weight is what an exercise plan is going to help you put into action. tramadol can make the entire process one that is easier for you over all. tramadol and exercise will give you more energy, and more focus on your own healthy life needs. </p> <p>If you have wanted to start an exercise plan, tramadol is a great starting point for your goals. This is a diet aid that keeps you focused on losing weight and focusing on what you really want to do. </p> <p>How can you get started on your weight loss plan? You first should sit down and write out your plan. Think about what exercises you like to do, what you can add to your day right now, and where you might be able to start. Consult with your family doctor if you have medical problems associated with your weight. Getting your body used to moving more can be difficult to start but before you know it, you will be toning your body and losing weight faster adding exercise and tramadol to your day. </p> <p>One of the best things about starting a diet plan is that exercise is going to burn calories from the fat stored on your body. In burning calories you will be losing weight. The longer you exercise, and the more intense your exercise the more calories you will lose. The more often you exercise, and then add in eating less, you will be able to lose weight faster. Setting goals for yourself weekly and monthly will help you keep motivated during your entire weight loss program. </p> <p>After setting goals for yourself and your weight loss needs, an exercise program is something you will have to focus on, and learn to make a habit for the long term. The use of tramadol as a diet aid is going to help you boost your health in the long run as you will shed those pounds which can be harmful and stressful on your body. It should be said that there are no magic pills for weight loss. </p> <p>Taking tramadol alone is not going to provide you with weight loss, nor are you going to be able to meet your weight loss goals easily, you will have to exercise. Exercise is a great combination with tramadol that will put your body back in shape. You need to eat less, and tramadol helps you to meet the goals in eating less, so you can burn those calories that are stored in your body. Exercise will become an important function of your day as you feel good about losing weight and you begin to notice some of the changes in yourself. </p> <p>You have set your goals to lose weight. You have thought about how much you want to lose per week, and you have placed an order for tramadol so you can control hungry you feel all the time. Now you need to set times when you are going to you have set your goals to lose weight. You have thought about how much you want to lose per week, and you have placed an order for tramadol so you can control hungry you feel all the time. Now you need to set times when you are going to exercise. </p> <p>You can set times in the morning or in the evening or any time in between. Exercising should be something that you strive to do at least every other day. If you are doing small or short exercises you should add more time and do them daily. For example, if you only have the time right now to walk a mile on the tread mill, doing this every day is going to help boost the calories that you burn while toning your body. </p> <p>If you have the time, exercising anywhere from twenty minutes to thirty minutes just three times a week will provide you with the best results in weight loss, and in building your cardiovascular system. </p> <p>So in setting goals for your weight loss needs, what should you be thinking about? Think about two or three pounds a week. There will be weeks when you will lose more, and there will be weeks where you can lose less, but setting goals is a major part of getting what you need done, which is exercising and eating less. Think about that when you want to eat a chocolate cake after eating a full meal. </p> <p>Where can you get exercise? You can start at home or in the office. You can exercise at a track at the local school or you can join a gym. You can start with stretching exercises every morning just ten minutes when you wake up in the morning and you can walk for a few miles every night after work. You can spend your break doing jumping jacks in your office, or you can spend your lunch taking in a few laps at the local swimming pool. The choices are wide open; you do not have to pay to exercise if you use your imagination! You can even get into lifting weights at home simply by using milk containers filled with sand or water, or you could use large cans of soup to start. Exercise is vital just as eating less will be important to your weight loss plans. </p> <p>Adding stretching to your exercise plan and your daily routine is going to add oxygen for your body to use continually. If you add oxygen to your body, in your blood you feel better about yourself every day. Getting more oxygen in your blood stream is going to make you feel more awake and ready for your day, every day. </p> <p>Build up to more intense exercises. As you set your goals and you are losing weight, you will find you have more energy. As you have more energy you might want to quit walking and start roller blading or you might want to take up swimming. Trying various types of exercise is going to help you meet your goals time after time. <br /> </p> </div> <div id="auxPane"> <div class="box"> <h2>dosages &amp; manufacturers</h2> <h3>tramadol Grey/Yellow</h3> 15 mg capsule / Eon Laboratories <h3>tramadol Yellow</h3> 30mg capsule (Generic <em>Ionamin</em>) / Eon Laboratories. <h3>tramadol White</h3> 37.5mg Tables (Generic <em>Adipex-P</em>) / Amide Pharmaceuticals <h3>tramadol Blue/Clear</h3> 30mg capsule (Generic <em>Fastin</em>) / Eon Laboratories </div> <div class="box"> <h2>why buy tramadol online?</h2> In setting your goals for losing weight and creating a healthy future for yourself, tramadol is going to play a major role. All over the world, there are millions of people who want to lose weight, and find the key is all in controlling their eating habits. You can control your eating habits using tramadol daily. tramadol is a diet aid that will help you feel fuller, so you don&#8217;t want to eat, and it will give you the energy needed to continue with your exercise plan at the same time. <p>If you don&#8217;t have the confidence to approach your doctor about a weight loss plan, and about your weight loss goals, you can find everything you need here on our site where all the information about tramadol is at the click of your mouse. tramadol can be used in the short term for your long term weight loss needs. You can create weight loss habits with the use of tramadol now. </p> <p>You will find that ordering tramadol online will keep your prices very low on the medications you need the most. tramadol online is available without a prior prescription, so you can get the same medications without another prescription from your doctor offline. The FDA has approved the use of tramadol for those adults who are in general good health, and for those who want real results in losing weight. </p> </div> </body> </html>