Active ingredient, group:
Tramadol (Tramadol), Analgesic opioid
Drops for oral administration, capsules, capsules of prolonged action, injection, solution for oral administration, rectal suppositories, tablets, coated tablets, tablets of prolonged action
The use of Tramadol is contraindicated in the following cases: hypersensitivity, conditions accompanied by respiratory depression or marked oppression of the central nervous system (alcohol poisoning, sleeping pills, narcotic analgesics and other psychoactive drugs and substances), pregnancy, lactation (in case of long-term use), childhood ( up to 1 year – for parenteral administration; up to 14 years – for oral administration), intake of MAO inhibitors, severe hepatic and / or renal failure (CC less than 10 ml / min).
It is necessary to use Tramadol with caution in drug addiction, confusion, intracranial hypertension, traumatic brain injury, epileptic syndrome (cerebral genesis), in patients with abdominal pain of obscure genesis.
Dosage and administration (instructions):
Tramadol can be used intravenously, intramuscularly, subcutaneously, inside, rectally.
Dosing: For single use for adults and children over 14 years old – at 0.05 g (tablets, capsules) with a small amount of liquid or 20 drops of the solution (or drops) for ingestion with a small amount of liquid or on sugar. After 30-60 minutes, you can repeat the reception in the same dose, but not more than 8 doses per day.
Retard tablets – 100-200 mg every 12 hours. Daily dose – 0.4 g (in exceptional cases, for example in cancer patients, a reduction in the interval to 6 hours and an increase in the daily dose is possible).
Rectal – 0.1 g. Reception frequency – up to 4 times per day.
In / in slowly, p / k or v / m: 0.05-0.1 g. If the effect is not sufficient, then 20-30 minutes after the intravenous route, infusion can be continued at a rate of 12 mg / h or additionally administered orally. Total daily dose – 0.4 g.
Children over the age of 1 year – inside, only drops or parenteral (iv, iv, p / c), at a dose of 1-2 mg / kg. The daily dose is 4-8 mg / kg (1 cap – 2.5 mg).
Elderly patients and patients with renal insufficiency require an individual dosage of Tramadol (possible prolongation of T1 / 2). When QA is less than 30 ml / min and in patients with liver failure, a 12-hour interval is necessary between taking the next dose of the drug.
Tramadol is an opioid synthetic analgesic that has a central action and action on the spinal cord (promotes the opening of potassium and calcium channels, causes membrane hyperpolarization and inhibits the conduction of pain impulses), enhances the effect of sedative drugs. Activates opiate receptors (mu, delta, kappa) on the pre- and postsynaptic membranes of the afferent fibres of the nociceptive system in the brain and gastrointestinal tract.
It slows down the destruction of catechol amines, stabilizes their concentration in the central nervous system.
The affinity of tramadol to opioid receptors is 10 times weaker than that of codeine, and 6000 times weaker than that of morphine. The severity of analgesic action is 5-10 times weaker than morphine.
The analgesic effect is due to a decrease in the activity of nociceptive and an increase in the antinociceptive systems of the body.
In therapeutic doses, Tramadol does not significantly affect hemodynamics and respiration, does not alter the pressure in the pulmonary artery, and slightly slows down intestinal motility, without causing constipation. It has some antitussive and sedative effects. Inhibits the respiratory center, stimulates the starting area of the vomiting center, the nucleus of the oculomotor nerve.
With prolonged use may develop tolerance.
Analgesic effect develops 15-30 minutes after ingestion and lasts up to 6 hours.