This medication is classified as an opioid used for pain relief (specifically moderate to severe pain) and is an FDA approved medication. It is available in two forms: immediate release and extended-release.
For pain lasting less than a week, immediate release is recommended, and for pain more severe and lasting for more than a week, the extended-release form is the recommended choice. Unlike other opioids, the risk of addiction is lower when using this painkiller. However, prolonged use may lead to opioid withdrawal.
The central nervous system, cardiovascular system, dermatological system, visual system, neuromuscular, gastrointestinal, and the endocrine are the most commonly affected areas of the body when using this medication.
During initial treatment, nausea, dizziness, somnolence, vomiting, constipation, and headaches are the most prevalent side effects of the therapeutic. Respiratory depression tends to occur as a more serious side effect. In addition, if this therapeutic is combined with serotonergic or proconvulsant agents (such as antidepressants), serotonin syndrome or generalized seizures may occur.
This article discusses the side effects of Tramadol as well as other important areas.
Overview of side effects when using Tramadol
The side effects of Tramadol depend on a patient’s age, underlying health issues, tolerance to medication, medical history, as well as dosage, among other factors. It is therefore important that a patient consults his/her doctor before administration of the medication in order to be given the correct information and dosage.
Some of the mild side effects, as mentioned previously, include headaches, dizziness, anxiety, nausea and vomiting, etc. These effects usually last for about a week or two, but if persistent it can be treated simply by lowering the dosage or seeking advice from your doctor.
Symptoms of more serious related Tramadol side effects include:
- Serious breathing problems: shortness of breath or shallow breathing.
- Serotonin syndrome: Nausea, vomiting, agitations, hallucinations, high BP, fast heart rate and lack of control of movement.
- Adrenal insufficiency: abdomen pain, muscle weakness and tiredness.
- Androgen deficiency: decreased energy and trouble sleeping.
These serious side effects should be treated immediately and medical assistance is advised. As mentioned above, these side effects are not guaranteed for every patient using this medication, but may vary according to each individual.
Prolonged use of this painkiller
- According to Thiels et al. (2019), the results of a cohort study conducted, titled “The side effects of chronic use of tramadol after acute pain episodes”, showed that even though the therapeutic is considered safer than other short acting opioids, this medication, when prescribed alone post-surgery, was linked to a higher risk of prolonged opioid use by patients with acute pain episodes.
- Some patients develop a physical and mental dependence to the therapeutic and end up forming a habit of using it whenever pain is present, while others may intentionally increase their dosage with the hope of relieving the pain faster. This prolonged use at a high dosage may cause severe effects such as seizures in some patients and those with existing seizure disorders are at higher risk for adverse effects. The seizures occur when patients use 400mg or more of this medication on a daily basis.
- In an article by Randy. A et al (2009), a research studying the effects of this medication on seizures reported that out of 386 seizure cases, only 29 (7.5%) was related to this painkiller’s use. In a separate study, researchers found out of 126 patients overusing this medication, only 8% experienced brief seizures. Seizures have also proven to be prevalent among patients who co-administer the painkiller with antidepressants.
- It is important to note that there is a speculation that this medication’s neurotoxicity is not related its opioid effects but rather to serotonin and norepinephrine reuptake inhibitors.
- The medication is a synthetic opioid that is considered weaker than traditional synthetic opioids, such as fentanyl. However, over time there has been an increase in the number of patients in the emergency room for overusing or abusing the therapeutic. When such incidents occur, most patients are either asked to reduce dosage or withdraw from using it.
- One of the side effects of Tramadol after chronic use is noted to be opioid withdrawal. Opioid withdrawal occurs when there is a sudden reduction or withdrawal from previous prolonged opioid use. The set of symptoms that are commonly reported are nausea, vomiting, headaches, anxiety, irritability, and an increased heart rate. However, Tramadol’s affects are very mild on the opioid receptors, therefore the brain is able to adapt to the absence of the therapeutic much faster than other opioids.
- It is important to note that these withdrawal symptoms occur not only after using this medication, but is prevalent in most uses of medication. Overuse or abuse of a therapeutic is not caused by the medication itself, but by patients who form a dependency or reliance towards them. Therefore, it is important for patients to administer the correct dosage and use therapeutic medication in moderation.
General precautions when using Tramadol
Below are a few of the general precautions patients should be aware of when using this medication:
- It is not recommended for patients under the age of 12, as well those under the age of 18 who have a history of adenoidectomy or tonsillectomy.
- Patients who have a history of bronchial asthma or respiratory depression are advised to avoid this medication as it may cause adverse effects.
- This painkiller may also cause seizures when co-administered with anti-depressants, therefore patients using benzodiazepines, such as lorazepam, should consult their doctor before starting treatment with this medication.
- Alcohol or other central nervous system depressants should not be taken at the same time as this painkiller due to the effects on the respiratory system.
- Before prescription, a patient should undergo psychiatric evaluation to determine previous abuse or misuse of medication or suicidal ideation.
- During the use of this medication, dosage should be monitored and patients need to be informed about the risks and benefits of the therapeutic.
- Patients, who suffer mild side effects or even those who begin to develop a dependency on this medication, should withdraw, reduce their dosage or seek medical assistance from their doctor.
- Patients with more serious Tramadol side effects, as mentioned previously, should immediately be taken to the emergency room or seek advice from their doctor if effects worsen.