Tramal is a narcotic analgesic, a synthetic analogue of opiates. By chemical structure, it is a derivative of phenanthrene. The pharmacological effect of the drug is mixed. Instructions for use with Tramalu will be presented in this article.
pharmachologic effect
The active components of the drug are able to bind to opiate receptors in some parts of the spinal cord, midbrain and in the central areas of the intermediate, and cause blockage of pain impulses, as well as a response to them. In the frontal and parietal convolutions, these substances reduce the excitability of pain centers and relieve negative emotional perception of the pain syndrome.
When these receptors are connected on the surface of the membranes, the active substance of the drug causes inhibition of adenylate cyclase and hyperpolarization, and also blocks the entry of calcium ions into the cells. As a result of this, there is a delay in the casting into the presynaptic cleft of mediators of pain, acetylcholine and norepinephrine. This confirms the instructions for use for Tramal tablets.
A drug inhibits the capture of norepinephrine and serotonin in neurons. At medium dosages, the respiratory center is not inhibited. There was also no effect of the drug at therapeutic doses on the activity of the circulatory system. The strength of the analgesic effect in comparison with the substance "Morphine" is 7 times weaker. It has a pronounced sedative effect, however, the substance can be addictive, excite the nuclei of the oculomotor areas and the vomiting center. The drug affects the intestinal motility insignificantly. The result after its application occurs in about half an hour, and its duration is about nine analgesia.
Release Forms
According to the instructions for use, Tramal is a mixed-dose analgesic opioid medication. This medication is available in the following dosage forms:
- Injection solutions, which look like a clear liquid, poured into glass ampoules of 1 or 2 ml. These ampoules are packed in special contour cells of 5 pieces and packs (1 cell each). Instructions for use for Tramal injections are very detailed.
- Rectal suppositories are white-yellowish suppositories with a homogeneous texture almost odorless, about 10 mm in diameter and 26 mm long. Suppositories are packaged in packs of 5 each. and boxes of 1 pack.
- Capsules - are slightly elongated gelatin capsules, consisting of a green cap and a light yellow body. The lid and body are marked with the logos of the manufacturer. Inside the capsules is a finely divided yellowish or white powder, odorless. Capsules are packaged in blisters of 10 pcs. and cardboard boxes of 2 blisters.
- Drops for oral administration. They are a slightly viscous transparent liquid, with the aroma of peppermint and anise, poured into bottles of dark glass, equipped with droppers. Bottles are in cardboard packs of 1 pc.
The composition of the drug
In accordance with the instructions for use with Tramal, as part of an injection:
- tramadol hydrochloride;
- water for injections;
- Sodium acetate trihydrate.
As part of a rectal suppository:
- tramadol hydrochloride;
- Witepsol W 35.
In the capsule:
- tramadol hydrochloride;
- magnesium stearate;
- sodium carboxymethyl starch;
- microcrystalline cellulose;
- colloidal silicon dioxide;
- indigo carmine;
- iron oxide yellow;
- titanium dioxide;
- gelatin;
- sodium lauryl sulfate;
- iron oxide is black.
In the composition of drops for oral administration:
- tramadol hydrochloride;
- glycerol;
- potassium sorbate;
- sodium saccharinate;
- sucrose;
- sodium cyclamate;
- propylene glycol;
- macrogol glyceryl hydroxystearate;
- artificial anise flavoring;
- dementolized peppermint oil;
- purified water.
Indications for the use of the medication
According to the instructions for use, the drug "Tramal" is used in case of pain syndromes of various etiologies of strong and medium intensity in the following diseases:
- Pathologies of oncological nature.
- Injuries.
- In the post-surgical period.
- Neuralgia.
- Myocardial infarction.
- Painful therapeutic or diagnostic procedures.
Contraindications
According to the instructions for use, Tramal is contraindicated for use in the following cases:
- Epilepsy - in cases not amenable to drug control.
- Concomitant use of MAO inhibitors.
- Acute poisoning with alcohol, analgesics, psychotropic or hypnotics, as well as a period of 14 days after stopping their use.
- Pregnancy.
- Cancellation syndrome after taking drugs.
- Childhood.
- Severe renal and hepatic failure.
- Hypersensitivity to opiates or other components of the drug.
Contraindications for the use of drops are rare diseases of a hereditary nature, accompanied by malabsorption of galactose and glucose, deficiency of sucrose and isomaltase, and fructose intolerance. So it says in the instructions for use.
The drug "Tramal" is used with caution in the following pathological cases:
- Craniocerebral disorders.
- Drug addiction.
- Disorders of consciousness of unknown etiology.
- Shock states.
- Disorder of the respiratory functions and activities of the respiratory centers.
- High intracranial pressure.
- Medically Controlled Epilepsy.
- High convulsive readiness.
- Severe cases of intolerance to opioids of allergic and other origin.
- Predisposition to the development of drug dependence and abuse of pharmacological drugs.
Dosage and administration for injection
Let us consider in more detail the instructions for use for Tramal injections.
A solution for injection of a medicinal product in the form of a solution is used for subcutaneous, intravenous drip, intramuscular and intravenous jet administration. With intravenous methods, the drug is additionally diluted in an injection solution and slowly injected in a stream or drip. The recommended dosage of the Tramal medication depends on the characteristics of the patient’s body, sensitivity to the medication and the severity of pain syndromes. In chronic forms of pain, the drug should be administered according to a specific schedule.
For children under 12 years of age, a single dose should be 1 or 2 mg per kilogram of weight. You should also select the minimum dosage, which will give a positive effect. The maximum dose of the active substance of the drug is 400 mg or not more than 8 mg per kilogram of body weight. For adult patients, as well as children after 12 years, a single dosage is approximately 50-100 mg of the substance. In the absence of a positive analgesic effect, an hour later after the initial injection, repeated administration of 50 mg of the drug is allowed.
What else does the application instruction for Tramalu in ampoules tell us?
The initial dose of a pharmacological drug with severe pain is 100 mg. The concentration of the solution is:
- 5 mg of substance per 1 ml: 1-2 ml + 9-18 ml of solvent;
- 4.8 mg of substance per 1 ml: 1-2 ml + 8-16 ml of solvent;
- 7.1 mg of substance per 1 ml: 1-2 ml + 7-14 ml of solvent;
- 7.2 mg of substance per 1 ml: 1-2 ml + 6-12 ml of solvent;
- 8.2 mg of substance per 1 ml: 1-2 ml + 5-10 ml of solvent;
- 10 mg of substance per 1 ml: 1-2 ml + 4-8 ml of solvent;
- 13.4 mg of substance per 1 ml: 12 ml + 3-6 ml of solvent;
- 17.6 mg of substance per 1 ml: 1-2 ml + 2-4 ml of solvent;
- 25 mg of substance per 1 ml: 1-2 ml + 1-2 ml of solvent.
To prepare the solution, add the solvent to the ampoule of the drug. The remaining solution is disposed of.
This will be confirmed by the instructions for use with Tramal.
Intramuscular injections should be carried out by a person with experience.
Dosage and administration of rectal suppositories
In this dosage form, the medication is used as follows: adolescents after 14 years of age, as well as adult patients, are prescribed 1 suppository 2 times a day. In case of insufficient analgesic effect, it is possible to use 1 suppository after another 1-2 hours. The initial dosage for severe pain syndromes may be increased. After the introduction of a rectal suppository, it is necessary to maintain a horizontal position of the body for about half an hour.
Use of medication capsules
This capsule medication is taken orally regardless of meals. Chewing or opening is prohibited - they should be swallowed and washed down with a large amount of any liquid.
A single dose of the drug for adolescents from 14 years of age, as well as adults, is 1 capsule. If the analgesic effect is insufficient, it is possible to reuse the medicine - 1 capsule in an hour. If severe pain occurs, a single dose can be increased to 2 Tramal tablets. Instructions for use contain information about this.
Application of drops
Drops for oral use are taken regardless of food on a piece of sugar or with a small amount of any liquid. The drug solution is in vials with a screw cap, which is equipped with protection against children. To open the vial, press the lid and then unscrew it. The field of this, in order to extract the medicinal fluid, the bottle should be turned over and, slightly tapping the bottom, drip the dosage of the product.
For children under 12 years of age, a single dosage is 1-2 mg of the drug per kilogram of mass. The maximum dose is 400 mg. When calculating the dosage of a drug, it must be taken into account that 2 mg of the substance is contained in one drop of liquid. In the treatment of children, a single dose of the drug depends on the body weight and age of the patient.
Adolescents are 12 years old, as well as adult patients, 25-40 drops of tramadol are prescribed every 6 hours. If the analgesic effect is insufficient, 20 drops of the drug can be reused after 60 minutes.
The analgesic effect of the use of the medication of the drug lasts about eight hours, which directly depends on the intensity level of the pain syndrome.
Long-term use of the Tramal medication implies regular monitoring of the patient’s condition, which allows optimizing the duration of such therapy and adjusting the dosages used.
Adverse reactions
According to the instructions for use and reviews for Tramal tablets and injections, the following conditions are included in the list of undesirable side effects from the use of this pain medication:
- Nervous system: dizziness, drowsiness, cephalalgia, epileptiform seizures, impaired coordination, involuntary muscle contractions, tremors, speech disorders, paresthesia, fainting.
- Cardiovascular system: palpitations, orthostatic hypotension - collapse, increased pressure, tachycardia, bradycardia.
- Respiratory system: dyspnea and respiratory depression.
- Digestive system: vomiting, nausea, dry mouth, constipation, diarrhea, vomiting, heaviness in the epigastrium.
- Urinary system: urinary retention or dysuria.
- Bile ducts and liver: increased activity of enzymes produced by the liver.
- Immune system: anaphylaxis, bronchospasm, shortness of breath, angioedema, wheezing.
- Musculoskeletal system: muscle weakness.
- Nutrition and metabolism: a change in appetite.
- Mental changes: sleep disturbances, nightmares in dreams, hallucinations, confusion, anxiety, delirium, changes in mood and activity, impaired perception and weakness of cognitive functions, the occurrence of drug dependence.
- Visual organs: blurred vision.
- Skin: sweating, hives, rashes, itching.
- Common disorders: fatigue, development of symptoms similar to drug withdrawal syndrome (sleep disturbance, agitation, nervousness, anxiety, hyperkinesia, tremors, paresthesias, panic attacks, tinnitus, hallucinations, derealization, paranoia, depersonalization).
- Other disorders: sweating, difficulty swallowing.
special instructions
Patients with epilepsy "Tramal 200" according to the instructions for use is prescribed only when vital signs occur. Its prolonged use can lead to addiction, physical or mental dependence. Patients prone to abuse of drugs or to develop dependence on them should use Tramal in the form of short courses and be under the supervision of specialists during this period. The appointment of this drug during pregnancy and lactation is possible only in extreme situations, when significant analgesia is necessary. A single dose of the drug during pregnancy does not affect the fetus.
This is indicated in the instructions for use. Reviews of "Tramal" consider below.
Analogues of the drug
Similar medications include:
- "Tramadol";
- "Tramadol STADA";
- "Tramal retard";
- "Tramadol-Acre";
- "Tramoline";
- "Tramaclosidol".
Reviews
The opinion of patients using this anesthetic is generally positive. They note that when a severe pain syndrome arises as a result of pathological conditions such as trauma, as well as painful therapeutic and surgical procedures, the Tramal medication acts almost instantly, especially when administered intravenously or intramuscularly.
The medicine quickly relieves severe pain, which has proven itself in a very favorable way. People often look at Tramal ointment in pharmacies. Instructions for use indicate that this form of release does not exist.
Negative reviews about this medication reflect mainly unpleasant consequences after its use, which are numerous adverse reactions and addiction.
Experts indicate that this medication should not be taken regularly, since there is a huge risk of getting used to the active substance. It is used mainly when pain occurs during cancer pathologies and after surgery.
We reviewed the instructions for use and reviews of “Tramalu” - injections, tablets, drops.