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Tramadol exists as a racemic mixture consisting of two pharmacologically active enantiomers that both contribute to its analgesic property through different mechanisms and are also themselves metabolized into active metabolites

Tramadol has also been shown to affect a number of other pain modulators within the central nervous system as well as non-neuronal inflammatory markers and immune mediators. Buy Tramadol Online Without Prescription here.


Tramadol is an opioid pain medication used to treat moderate to moderately severe pain. When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour. It is also available by injection. It may be sold in combination with paracetamol (acetaminophen) or as longer-acting formulations. This medication is used to help relieve moderate to moderately severe pain. Tramadol is similar to opioid (narcotic) analgesics. It works in the brain to change how your body feels and responds to pain. Tramadol works by changing how your brain senses pain. Tramadol is similar to substances in your brain called endorphins. Endorphins bind to receptors (parts of cells that receive a certain substance). The receptors then decrease the pain messages that your body sends to your brain. Tramadol works in a similar way to decrease the amount of pain your brain thinks you’re having. Tramadol is a narcotic-like pain reliever. Tramadol is used to treat moderate to severe pain in adults. The extended-release form of tramadol is for around-the-clock treatment of pain. The extended-release form of tramadol is not for use on an as-needed basis for pain. Tramadol oral tablet is a drug that is available as an immediate-release and extended-release tablet. Tramadol also comes as an extended-release oral capsule. Immediate-release drugs are released into the body right away. Extended-release drugs are released into the body slowly over time. Tramadol is used to relieve moderate to moderately severe pain. Tramadol extended-release tablets and capsules are only used by people who are expected to need medication to relieve pain around-the-clock. Tramadol is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain. Tramadol is available only on prescription. It comes as tablets, capsules and liquid drops that you swallow. It can also be given by injection but this is usually only done in hospital. Tramadol works by blocking pain signals from travelling along the nerves to the brain. Tramadol is a strong painkiller. It’s used to treat moderate to severe pain, for example after an operation or a serious injury. It’s also used to treat long-standing pain when weaker painkillers no longer work. Tramadol belongs to the group of medicines called opioid analgesics. It acts in the central nervous system (CNS) to relieve pain. Tramadol is used to relieve moderate to moderately severe pain, including pain after surgery. The extended-release capsules or tablets are used for chronic ongoing pain. Both tramadol oral tablets are also available as generic drugs. The immediate-release tablet is also available as the brand-name drug Ultram. Tramadol is used to treat moderate to severe pain. Tramadol belongs to a class of drugs called opioid agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. Tramadol may be used as part of a combination therapy. This means you may need to take it with other medications. Tramadol differs from other traditional opioid medications in that it doesn’t just act as a μ-opioid agonist, but also affects monoamines by modulating the effects of neurotransmitters involved in the modulation of pain such as serotonin and norepinpehrine which activate descending pain inhibitory pathways

Indication and usage

Tramadol is used primarily to treat mild  to severe pain, both acute and chronic.

Its analgesic effects take about one hour to come into effect and 2 h to 4 h to peak after oral administration with an immediate-release formulation.

For pain moderate in severity, its effectiveness is equivalent to that of morphine; for severe pain it is less effective than morphine. These painkilling effects last for approximately 6 hours. Buy Tramadol Online Without Prescription now and manage the pain your are experiencing. Visit wikipedia for more information.

Available dosage forms include liquids, syrups, drops, elixirs, effervescent tablets and powders for mixing with water, capsules, tablets including extended release formulations, suppositories, compounding powder, and injections. Buy Pain Pills Online


Tramadol is available in several forms:  tablet, orally disintegrating tablet, extended-release capsule and extended-release tablet, orally disintegrating tablet and suspension. The extended-release tablets and capsules are prescribed for patients who need round-the-clock pain relief.

Usual Adult Dose for Pain

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain

-For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days

Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain

Extended-Release (ER):

18 years or older (tramadol-naive): 100 mg orally once a day

-Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions

-Maximum Dose: 300 mg/day

Oral Dose

Tincture: 5-15 drops or 1-3 drops of fluid extract.

Suspension: 10 mg/mL

Tramadol is an opioid agonist indicated for the management of pain

severe enough to require daily around-the-clock, long-term opioid treatment

and for which alternative treatment options are inadequate.

Limitations of Use

-Because of the risks of addiction, abuse, and misuse with opioids, even

at recommended doses, and because of the greater risks of overdose and

death with extended-release opioid formulations, reserve Tramadol

for use in patients for whom alternative treatment options (e.g., nonopioid

analgesics or immediate-release opioids) are ineffective, not

tolerated, or would be otherwise inadequate to provide sufficient

management of pain.

-Tramadol is not indicated as an as-needed (prn) analgesic.

Indications Dosage regimen Pain (moderate to severe).

Lower Back Pain:

Immediate-release 50 to 100 mg orally,up to 4 times daily as necessary. For pain persisting for more than 5 days sustained-release 100 to 150 mg orally, twice daily.

Post Operative Pain

100 mg initially then 50 mg every 10-20 minutes if necessary during first hour to total maximum 250 mg (including initial dose) in first hour, then 50-100 mg every 4-6 hours; max 600 mg daily.

Rotator Cuff Disease

Immediate-release 50 to 100 mg orally, as necessary up to 4 times daily For pain persisting for more than 5 days Tramadol sustained-release 100 mg to 150 mg orally, twice daily.

Tramadol Side Effects

More common side effects of Tramadol include; noisy breathing, sighing, shallow breathing, breathing that stops during sleep; dry mouth, lack of energy, a slow heart rate or weak pulse; constipation, seizure (convulsions); missed menstrual periods; impotence, sexual problems, loss of interest in sex; a light-headed feeling, like you might pass out; drowsiness, headache sweating.

Less common Tramadol side effects include;

Abnormal or decreased touch sensation, bloating, dark urine, blood in the urine, blisters under the skin, blurred vision, chest pain or discomfort, chills, blood pressure increased, difficult urination, change in walking and balance, worsening tiredness or weakness. Consult your doctor for more on this.

The most common adverse effects of tramadol include nausea, dizziness, dry mouth, indigestion, abdominal pain, vertigo, vomiting, constipation, drowsiness and headache.


Tramadol is contraindicated in any situation where opioids are contraindicated, including acute intoxication with any of the following: alcohol, hypnotics, narcotics, centrally acting analgesics, opioids or psychotropic drugs.

Tramadol is contraindicated in persons with the following conditions; decreased lung function, seizures, suicidal thoughts, decreased function of the adrenal gland, suicidal behavior, symptoms from alcohol withdrawal, alcoholism, alcohol intoxication, depression, asthma, blockage of the stomach or intestine, hardening of the liver.

Tramadol’s use in pregnancy is generally avoided, as it may cause some reversible withdrawal effects in the newborn.

The use of Tramadol as an analgesic during labor is not advised due to its long onset of action (1 hour).

The use of Tramadol in children is not advisable. Consult your doctor for more details.

Tramadol is contraindicated:

– in hypersensitivity to tramadol hydrochloride or any of the excipients.

– in patients with epilepsy not adequately controlled by treatment.

– in acute intoxication with alcohol, hypnotics, analgesics, opioids, or psychotropic medicinal products.

– for use in narcotic withdrawal treatment.

– in patients who are receiving MAO inhibitors or who have taken them within the last 14 days.

Before taking Tramadol, tell your doctor or pharmacist if you are allergic to it.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders, breathing problems, kidney disease, liver disease, mental/mood disorders, stomach/intestinal problems, difficulty urinating, gallbladder disease, pancreatitis and obesity.

It is contraindicated in patients hypersensitive to Tramadol, intoxication with alcohol, hypnotics, centrally acting analgesics, opioids orpsychotropic drugs.

Pregnancy and Lactation

Tramadol’s use in pregnancy is generally avoided as it may cause some reversible withdrawal effects in the newborn.

Labour and Delivery

Its use as an analgesic during labour is generally advised against due to its long-onset of action (one hour).


Its use in children is generally advised against, although it may be done under the supervision of a specialist.


There is an increased risk of opioid-related adverse effects such as respiratory depression, falls, cognitive impairment and sedation.


Tell your doctor and pharmacist if you are allergic to tramadol, other opiate pain medications, any other medications, or any of the ingredients in tramadol tablets, extended-release tablets, or extended-release capsules.

Care should be taken when treating patients with respiratory depression, or if concomitant CNS depressant drugs are being administered

Convulsions have been reported in patients receiving tramadol at the recommended dose levels.

Tramadol may only be used with particular caution in opioid-dependent patients, patients with head injury, shock, a reduced level of consciousness of uncertain origin, disorders of the respiratory center or function, increased intracranial pressure.

Tell your doctor if you are breastfeeding. You should not breastfeed while taking tramadol.

Tramadol may be habit forming, especially with prolonged use. Take tramadol exactly as directed. Do not take more of it, take it more often, or take it in a different way than directed by your doctor.

-Risk of Seizure: Present within recommended dosage range. Risk is

increased with higher than recommended doses.

-Risk of Suicide: Do not use Tramadol in suicidal or addiction-prone

patients. Use with caution in those taking tranquilizers, anti depressants

or abuse alcohol.

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