Tramadol chemical structure
Find information on thousands of medical conditions and prescription drugs.

Ultram


Tramadol is an opioid used as an analgesic for treating moderate to severe pain. It is a synthetic agent, unrelated to other opioids, and appears to have actions on the GABAergic, noradrenergic and serotonergic systems. Tramadol was developed by the German pharmaceutical company Grünenthal GmbH and marketed under the trade name Tramal®. Grünenthal has also cross licensed the drug to many other pharmaceutical companies that market it under various names, some of which are listed below. more...

Home
Diseases
Medicines
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
Ubidecarenone
Ultram
Unasyn
Unipen
Uniphyl
Unisom
Urethane
Urofollitropin
Urokinase
Uroxatral
Ursodeoxycholic acid
V
W
X
Y
Z

Tramadol is available in both injectable (intravenous and/or intramuscular) and oral preparations. It is usually marketed as the hydrochloride salt (tramadol hydrochloride). Dosages vary depending on the degree of pain experienced by the patient, and should be decided on the basis of need by the prescriber.

Mechanism of action

The mechanism of action of tramadol has yet to be fully elucidated, but it is believed to work through modulation of the GABAergic, noradrenergic and serotonergic systems. Tramadol have been found to bind to μ-opioid receptors (thus exerting its effect on GABAergic transmission), and to inhibit reuptake of 5-HT and noradrenaline. The second mechanism is believed to contribute since the analgesic effects of tramadol are not fully antagonised by the μ-opioid receptor antagonist naloxone.

Although irrelevant to its mechanism of action, tramadol, unlike morphine, has not been found to induce histamine release.

The serotonergic modulating properties of tramadol mean that it has the potential to interact with other serotonergic agents. There is an increased risk of serotonin syndrome when tramadol is taken in combination with reuptake inhibitors (e.g. SSRIs), agents that potentiate the effect of 5-HT (e.g., MAOIs), or 5-HT agonists.

Dependence

Some controversy exists regarding the dependence liability of tramadol. Grünenthal has promoted it as an opioid with "little" risk of dependence, claiming little evidence of such dependence in their clinical trials. They offer the theory that since the M1 metabolite is the principal agonist at μ-opioid receptors, the delayed agonist activity reduces dependence liability.

Despite these claims it is apparent, in community practice, that dependence does occur to this agent. This would be expected since analgesic and dependence effects are mediated by the same μ-opioid receptor. However, this dependence liability is considered relatively low by health authorities, such that tramadol is classified as a Schedule 4 in Australia, rather than as a Schedule 8 like other opioids (Rossi, 2004).

Proprietary preparations

Grünenthal, which still owns the patent to tramadol, has cross-licensed the agent to various pharmaceutical companies internationally. Thus tramadol is marketed under many trade names including: Adolonta, Contramal, Crispin, Nobligan, Siverol, Tiparol, Toplagic, Tradolan, Tralgit, Tramacet, Tramadin, Ultracet, Ultram, Zamadol and Zydol.

Read more at Wikipedia.org


[List your site here Free!]


Reactions, misuse with pain medication - new labeling for Ultram, or tramadol - Brief Article
From FDA Consumer, 7/1/96

Reports of serious adverse reactions and potential misuse have led to revised labeling for the prescription pain reliever Ultram (tramadol). FDA also has sent a letter to health-care professionals on the drug's safety.

Since Ultram was approved March 3, 1995, FDA has received 115 reports of drug abuse, dependence, withdrawal symptoms, and intentional overdose by people taking the drug. In addition, postmarketing surveillance revealed 83 cases of seizures in patients who used Ultram while on other medications, such as tricyclic antidepressants (for example, Elavil, or amitriptyline) and selective serotonin uptake inhibitors (for example, Prozac, or fluoxetine).

FDA worked with the company that markets Ultram, Ortho McNeil, to develop new labeling that discourages doctors from prescribing the drug to patients with a history of opioid addiction or dependence. The labeling also gives a detailed explanation of the risk of seizure and advises against the use of Ultram by patients allergic to codeine. Some patients with this allergy have had severe reactions while taking Ultram.

FDA highlighted these warnings in its letter last March 20 to health-care professionals. In the letter, the agency urged the professionals:

* to adhere to the dosing and administration in the Ultram labeling not to exceed the labeled recommendations

* to report patients' adverse reactions to Ortho McNeil or to FDA's MEDWATCH program.

COPYRIGHT 1996 U.S. Government Printing Office
COPYRIGHT 2004 Gale Group

Return to Ultram
Home Contact Resources Exchange Links ebay