The Pros and Cons of Tramadol

It would be impossible to provide an exact number but according to top experts, approximately 20% of the world's population suffers from pain. Living with pain on any level has a direct impact on quality of life but when pain is severe, normal activities such as working, going to school, or trying to handle daily responsibilities become a major challenge.

Although there are a number of medical treatments, as well as prescription medications used to treat pain, one in particular has become a popular choice. Tramadol was first introduced to the market in 1977 by Grunethal GmbG, a German pharmaceutical company and as a type of synthetic codeine it works well on pain issues. Initially, Tramadol was called Tramal but today it is sold under a variety of brand names throughout the world with a few examples to include the following:

United States

• Conzip
• Ryzolt
• Ultracet
• Ultram

Canada

• Ralivia
• Zytram XL

Europe

• Adolonta
• Dolol
• Dromadol
• Ixprim
• Zydol

Asia

• Acugesic
• Exopen
• Tandol
• Ultramed

South America

• Calmador
• Tramal Gotas
• Zafin

Even though many people have achieved pain relief by taking Tramadol, a warning was issued by the FDA in 2009 stating that the German manufacturing company had not only exaggerated the drug's efficacy but also minimized potential risks. The outcome of testing confirmed that information provided specific to risk for habitual use had been diminished although the risk was not as significant as first thought.

As a result of this situation, a number of warnings are now listed in the Physicians' Desk Reference specific to both claims. However, when prescribed by a reputable doctor and the proper dose is followed most people find that Tramadol helps with pain relief while experiencing few side effects.

For the most part, Tramadol is administered in capsule and tablet form although there are a number of other delivery systems. For instance, there are times when this medication is administered in liquid and powder form, even given intravenously on rare occasions. As far as dose, the maximum a doctor can prescribe for oral use is 400 milligrams a day and for parenteral use, 600 milligrams. However, the maximum dose has been lowered by some manufacturing companies and for certain formulas.

How Does Tramadol Work?

Tramadol is sometimes referred to as a "centrally-acting opioid analgesic" and pseudo-opioid. For the first instance, the drug works within the central nervous system, producing effects very similar to morphine for pain relief. For the second term, Tramadol works somewhat at the mu-opioid receptor, which is the main receptor that that other opioids such as morphine bind to.

One of the key features of Tramadol is its antidepressant properties. Many people are unaware that certain antidepressants work effectively toward calming and preventing pain by reducing reuptake of two chemicals in the brain called serotonin and norepinephrine. In addition, Tramadol produces anti-inflammatory actions and is considered as a mild form of norepinephrine, which is a chemical capable of transmitting nerve impulses between the body's different nerve cells.

After years of development and multiple trials, Tramadol now has approval by the Food and Drug Administration or FDA as a treatment for pain that ranges from moderate to moderately severe, whether chronic or acute. In addition, while not the primary reason for taking Tramadol, it has also been successfully used for mild cases of depression.

Keep in mind that Tramadol is not a controlled substance like many other medications prescribed for pain today to include Demerol, oxycodone, morphine, methadone, and hydrocodone. That means in the United States, it is not under control of the Federal government. With that said, we do want to point out that in addition to several states in America putting restrictions on use by classifying Tramadol as a "schedule IV" drug, other countries have restrictions for Tramadol use as well. A few examples have been provided below:

• Bahrain - Medications containing Tramadol can only be dispensed on special prescriptions that have been issued by the Drug Control at the Ministry of Health and the Directorate of Pharmacy
• Morocco - Two components of Tramadol, Alatrofloxacin and Trovafloxacin are restricted whereby use is available only in university hospitals and while under professional control
• Philippines - Trovafloxacin has been reported to cause hepatic adverse reactions, leading to a full ban from the Department of Health Bureau of Food and Drugs
• Singapore - Trovafloxacin has not been given approval by the National Pharmaceutical Administration in the Ministry of Health due to cases of hepatic adverse reactions
• Spain - Due to Fluoroquinolone antibiotic and Trovafloxacin components of the Tramadol formula, the Spanish Medicines Agency has suspended use

Primary Benefits

Before going over some of the different risks associated with Tramadol, we wanted to discuss some of the main benefits. Although this prescription medication faced some scrutiny in 2010, it remains an effective treatment.

• Tramadol is effective for treating moderate to moderately severe levels of pain regardless of cause. However, studies show this drug tends to work best for nerve pain associated with Multiple Sclerosis, Motor Neuron Disease, Reflex Sympathetic Dystrophy, and Restless Leg Syndrome, among others but it is also commonly prescribed to treat other forms of pain in connection with Fibromyalgia and Rheumatoid Arthritis.
• Again, Tramadol is used effectively for both chronic and acute pain. Because of this, the drug offers a number of applications. For instance, along with being used to treat continuous pain caused by any number of the health-related issues it works effectively for temporary pain following surgery or injury.
• This medication is also beneficial to anyone over the age of 16. Typically, there are restrictions with narcotics but with Tramadol the age range for use is much broader.
• According to the latest statistics, approximately 70% of people who take this medication experience some degree of side effect but for the most part, these are minimal and short lasting.

Potential Side Effects

In addition to reasons that Tramadol is considered an effective drug for treating pain it poses potential risks. The information provided below shows why the use of Tramadol or any narcotic should be taken seriously and carefully researched prior to being taken. However, if someone on this prescription medication were to experience any of the following symptoms, the attending physician should be notified immediately.

• Breakout of Hives
• Dizziness
• Constipation
• Headache
• Swelling of the face, tongue, lips, or throat
• Upset Stomach

We also wanted to list some of the more serious side effects. In this case, this medication should be stopped immediately and the doctor notified. Of course, if symptoms were to become severe, the person should be taken to the emergency room or 911 called.

• Agitation
• Chronic Diarrhea
• Fainting
• Fast Heart Rate
• Fever
• Hallucinations
• Loss of Coordination
• Nausea
• Overactive Reflexes
• Peeling Skin Rash
• Seizure(s)
• Shallow Breathing
• Vomiting

Drug Interactions

Another potential risk of taking Tramadol has to do with negative drug interactions. In fact, risk of having seizures increases significantly for the medications listed, which is why an individual should always reveal every prescription, as well as over-the-counter medication to the doctor. The following list is incomplete although it contains information on drugs deemed the greatest risk.

• ADHD Medication
• Antibiotics
• Antidepressants
• Antifungal Medication
• Blood Pressure Medication
• Cancer Medication
• Carbamazepine Medication
• Cold/Allergy Medication
• Heart Rhythm Medication
• HIV/AIDS Medication
• Lithium
• MAO Inhibitors
• Mental Health Medication
• Migraine Medication
• Muscle Relaxers
• Narcotic Pain Medication
• Sedatives
• Sleeping Medication

Precautions

There are also a number of precautions in addition to possible side effects and drug interactions that an individual should be aware of. For instance, if someone is currently taking any of the following, Tramadol should be avoided.

• Alcohol
• Illicit Drugs

In addition, anyone with a history of the following would be at higher risk for having seizures.

• Alcohol or Illicit Drug Addiction
• Head Injury
• Metabolic Disorders
• Seizure Disorders

Finally, the conditions provided below are known for causing problems in connection with Tramadol:

• Depression or other Mental Illness
• Kidney Disease
• Liver Disease
• Stomach Disorders

Conclusion

The bottom line - for treating moderate to moderately severe pain Tramadol is an effective treatment option and in fact, some people consider this to be a "miracle drug". Because this medication is a narcotic and there are known side effects, drug interactions, and precautions, an individual should take time to learn everything possible and ask the doctor a lot of questions before taking it. However, for someone who suffers from pain, Tramadol provides hope.