• Trade name: Tramal®
  • Synonym: Tramadolum
  • English: tramadol

Definition

Tramadol is a drug that is one of the low-potency opioids.

Chemistry

Chemical name: (RR, SS) -2-Dimethylaminomethyl-1- (3-methoxyphenyl) cyclohexanol
Molecular formula: C16H25NO2

Pharmacology

Tramadol is an opiate agonist with a weak affinity for the M opioid receptor. The relative analgesic efficacy relative to morphine is given as 0.1, i. Tramadolol has only 1/10 of the efficacy of morphine.

In addition to the opioid agonist action, tramadol acts as a serotonin and norepinephrine reuptake inhibitor. This mechanism of action provides an additional analgesic and pain modulating effect via descending pathways in the spinal cord.

Tramadol is related to the also dual-acting analgesic tapentadol and the SNRI venlafaxine.

Indication

Moderate to severe pain, e.g. in orthopedic diseases, traumas, in the postoperative period.

see also: Pain Therapy, WHO Level Scheme

Side effects

The opioid-type adverse effects are slightly less pronounced with tramadol. Constipation and above all respiratory depression hardly occur in tramadol. Especially the hardly existing respiratory depression can be of advantage in patients with bronchial diseases such as asthma or COPD.

On the other hand, nausea is a side effect that is very typical of tramadol, especially when given intravenously. This is encountered with prior or simultaneous administration of metoclopramide (MCP).

In addition, tramadol may cause, among other things, the following side effects:

  • dizziness
  • Vomit
  • hyperhidrosis
  • unrest
  • sedation
  • a headache
  • paresthesia
  • tremor

Seizures (predominantly in high doses)

  • diarrhea
  • hypotension
  • hypertension
  • dependence

Interactions

Tramadol must not be taken with other serotonergic medicines because of a possible serotonin syndrome. These include, among others:

  • SNRIs
  • Tricyclic antidepressants
  • triptans
  • tryptophan

7 dosage forms

In Germany, tramadol is authorized in the following pharmaceutical preparations:

  • drops;
  • fast-acting capsules and tablets;
  • effervescent tablets;
  • Prolonged-release tablets and capsules;
  • suppository;
  • Injection solutions for i.v., i.m. and s.c. gift;
  • Tramadol is also available in combination with paracetamol under the name Zaldiar®.

BtMG

Like meptazinol, tramadolol is not covered by the Narcotics Act (BtMG) in Germany.

  • Tags: analgesic, opioid
  • Subjects: Medicines