side effects, what is it for?

Tramadol is a powerful painkiller that should be taken with caution due to its possible side effects and high risk of dependence. It is the first analgesic implicated in deaths linked to the use of analgesics, ahead of morphine, and the second analgesic most frequently found on falsified prescriptions presented in pharmacies, behind codeine (OSIAP** survey).

What is Tramadol?

Tramadol is a synthetic opioid analgesic medication prescribed for the treatment of moderate to severe pain. This is its main role: to relieve pain. It was developed in the 1970s. Its action is central, it influences the way in which the brain and the nervous system respond to pain. Tramadol is a so-called “weak” opioid analgesic while morphine is one of the “strong” opioids. They are present in different medicines

In which medications?

• Tramadol alone: ​​Biodalgic®, Contramal®, Monoalgic®, Monocrixo®, Orozamudol®, Takadol®, Topalgic®, Zamudol®, Zumalgic® and Generic Tramadol.
• In combination with paracetamol: Ixprim®, Zaldiar®, generic Tramadol/Paracetamol.
• In combination with dexketoprofen: Skudexum®.

What are the side effects of Tramadol?

The most common side effects when taking tramadol are nausea and feeling dizzy. May also occur:

• Headaches, drowsiness,
• Fatigue,
• Constipation, dry mouth, vomiting,
• Excessive sweating (hyperhidrosis).

Among the “uncommon” side effects:

• palpitations,
• Acceleration of heartbeat,
• Feeling faint
• Reach out,
• Stomach problems (heaviness in the stomach, bloating), diarrhea.
• Skin reactions (itching, rash).

Among the “rare” side effects:

• Allergic reactions (breathing difficulties, wheezing, skin swelling)
• Sudden circulatory failure
• Slowing of heartbeat.
• Increased blood pressure
• Tremor, epileptic seizures, muscle contractions,
• Uncoordinated movements,
• Transient loss of consciousness (syncope),
• Speech disorders.
• Change in appetite.
• Hallucinations, delusions, anxiety and nightmares.
• Mood disorders (most often euphoria, sometimes irritability),
• Changes in activity (usually decrease, sometimes increase)
• Decreased cognitive functions
• Drug dependence.
• Blurred vision, narrowing of the pupil (miosis), excessive dilation of the pupil (mydriasis).
• Slow breathing, shortness of breath (dyspnea).
• Muscle weakness.
• Difficulty urinating (dysuria) or pain when urinating, decrease in urine volume.

Among the “very rare” side effects: increase in liver enzymes.

Among the side effects whose frequency is unknown: reduction in blood sugar level (hypoglycemia), hiccups and serotin syndrome. A withdrawal syndrome may occur when treatment is abruptly stopped.

What are the dangers of Tramadol?

The main danger of tramadol is its risk of dependence. It is a “very addictive” drug, confirms the Drogues-Info-Service site: “Its action targets the brain and stimulates opioid receptors in order to produce more dopamine in the brain, which generates a feeling of calm and reduces pain by blocking the painful messages conveyed to the brain”. The desire to continue taking the medication after stopping and the feeling of withdrawal “can continue for several weeks, or even several months in certain cases”.

What medications should you not take with Tramadol?

Tramadol should not be taken simultaneously with other medications. For example :

• With tranquilizers, sleeping pills, painkillers such as morphine or codeine (increased risk of drowsiness or feelings of fainting).
• With anticoagulants: the effects of anticoagulants derived from coumarin, which thin the blood, may be increased (risk of hemorrhage).
• With serotonergic medications such as SSRI antidepressants (selective serotonin reuptake inhibitors such as Prozac®) or MAO inhibitors taken during depression.
• With carbamazepine, nalbuphine, buprenorphine, pentazocine, ondansetron, bupropion or triptans (migraine).
• With other opiate medications (painkillers, cough suppressants).

Is tramadol authorized for children?

Tramadol can be prescribed to children aged 3 and over, with a dosage based on weight. It currently comes in drinkable form in a dropper bottle (100mg/ml).

It can also be prescribed from the age of 12 or 15 in oral form. The injectable form of tramadol is contraindicated before the age of 15.

To avoid any medication errors, the authorities remind parents:

• to respect the doctor’s prescription,
• to seek medical advice in case of doubt about the prescription or the functioning of the drop bottle,
• to keep the medicine out of the reach and sight of children,
• to immediately consult a doctor or emergency service if signs of overdose appear: vomiting, impaired consciousness, breathing difficulties, etc.

Can you get Tramadol without a prescription?

No. Tramadol can only be obtained with a medical prescription and only with a “secure prescription” from a doctor since December 1, 2024 (to reduce the risk of falsification and misuse). From 2020medicines based on tramadol taken orally cannot be prescribed for more than 3 months, without new prescription.

What precautions should be taken with Tramadol?

For safe use of tramadol-based medications:

• Follow the dosage indicated on the prescription, as well as the duration of treatment.
• If the pain is not sufficiently or quickly relieved by your treatment, consult your doctor again.
• Do not stop your treatment suddenly: your doctor or pharmacist will tell you how to gradually reduce the doses.
• It must be delivered in the smallest possible packaging, adapted to the prescription.
• Opioids should be used with caution in patients with epilepsy, given their ability to reduce the seizure threshold.

If you experience any side effects from taking these treatments, consult your doctor and report them to the reporting portal.

• Topalgic 100 mg/mL and Contramal 100 mg/mL oral solution (Tramadol) – Reminders of proper use and changes to the boxes to limit the risk of overdose. ANSM. September 17, 2021
• *Toxic Deaths from Painkillers (2017 data): survey which collects cases of deaths linked to the use of painkillers and reported to expert toxicologists, volunteer analysts and the addictovigilance network.
• **Retrospective analysis reveals significant association of hypoglycemia with tramadol and methadone in contrast to other opioids. Tigran Makunts, Andrew U, Rabia S. Atayee & Ruben Abagyan Scientific Reports. volume 9, Article: 12490 (2019).
• Public drug database, ANSM.