UK Edition. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Keep this leaflet. If you have any further questions, ask your doctor or your pharmacist. This medicine has been prescribed for you.

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What is tramadol and what is it used for? Tramadol is a synthetic man-made pain reliever analgesic. Researchers and doctors do not know the exact mechanism of action of tramadol, but it is similar to morphine. Like morphine, tramadol binds to receptors in the brain narcotic or opioid receptors that are important for transmitting the sensation of pain from throughout the body to the brain. Like other narcotics used to treat pain, patients taking tramadol may abuse the drug and become addicted to it. Doctors prescribe tramadol to manage moderate to moderately severe pain. Extended release tablets are used for moderate to moderately severe chronic pain in adults who require continuous treatment for an extended period. Children between 12 and 18 years of age who are overweight or have breathing problems such as obstructive sleep apnea or severe lung disease should not receive tramadol.

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Prior to starting treatment with opioids, a discussion should be held with patients to put in place a strategy for ending treatment with tramadol in order to minimise the risk of addiction and drug withdrawal syndrome see section 4. The dose should be adjusted to the intensity of the pain and the sensitivity of the individual patient. The lowest effective dose for analgesia should generally be selected. The usual daily dose is 50 to mg 20 to 40 drops, 3 to 4 times a day. In children from 12 to 14 years, it is recommended to use the lowest dose.

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It does tramadol 100mg 20 take the place of talking to your doctor or pharmacist. All medicines have risks and benefits. Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason. Do not give this medicine to a child under the age of 12 years. Safety and effectiveness in children younger than 12 years have not been established.

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Life-threatening respiratory depression and death have occurred in children who received tramadol. Tramadol is subject to variability in metabolism based upon CYP2D6 genotype, which can lead to tramadol 100mg 20 exposure to an active metabolite. Serotonin syndrome may occur; may be life-threatening; may occur with use of tramadol alone, with concomitant use of serotonergic drugs, with drugs that impair metabolism of serotonin or tramadol. Women who are ultra-rapid metabolizers of tramadol achieve higher than expected serum levels of opioids, potentially leading to higher levels of M1 in breast milk that can be dangerous in their breastfed infants. In women with normal tramadol metabolism normal CYP2D6 activity, the amount of tramadol secreted into human milk is low and dose-dependent.

It is intended to work by changing the way the central nervous system responds to pain. Tramadol is effective on two fronts: About 20 percent of its painkilling effects come from opioids, and 80 percent from ingredients that inhibit the reuptake of serotonin and norepinephrine, two chemicals in the brain associated with mood and responsiveness to pain, said Dr. But tramadol carries risks: People can still abuse and overdose on tramadol because of its opioid component. Its interaction with serotonin can also affect people taking other serotoninlike drugs, such as antidepressants, he said. However, tramadol's opioid and serotonergic effects are important because they allow tramadol to treat both pain and the psychological components of pain, he said.

Psychoses are a group of disorders in which patients have a distorted perception of reality and they include reactive psychosis, paranoiddelusional psychosis, some types of mania and schizophrenia. Schizophrenia is the most common psychosis, affecting about It often affects people in late adolescence and can be chronic and disabling. Schizophrenia has a number of sub-types and there have been attempts at classifying them, but this has proved difficult. Modern diagnostic classifications depend on the presence or absence of positive or negative symptoms as well as the duration of symptoms according to either the ICD- Negative symptoms are social withdrawal, lack of emotional responsiveness and apathy; positive symptoms are hallucinations, thought disturbances, delusions, restlessness and aggression. Some psychoses can be secondary to other diseases such as infection and peripheral vascular disease or intoxication with drugs or alcohol, but most often the aetiology is unknown.

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