Chemical Name: hydrochloride is (±)cis-2- [(dimethylamino)methyl]-1-(3-methoxyphenyl) cyclohexanol hydrochloride
Chemical Structure
Chemical Information
The molecular weight of tramadol hydrochloride is 299.8. Tramadol hydrochloride is a white, bitter, crystalline and odorless powder. It is readily soluble in water and ethanol and has a pKa of 9.41. The n-octanol/water log partition coefficient (logP) is 1.35 at pH 7. ULTRAM tablets contain 50 mg of tramadol hydrochloride and are white in color. Inactive ingredients in the tablet are corn starch, hypromellose, lactose,magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, titanium dioxide and wax.
Drug Interactions
In vitro studies indicate that Tramadol (Ultram) is unlikely to inhibit the CYP3A4-mediated metabolism of other drugs when Tramadol (Ultram) is administered concomitantly at therapeutic doses.Tramadol (Ultram) does not appear to induce its own metabolism in humans, since observed maximal plasma concentrations after multiple oral doses are higher than expected based on single-dose data. Tramadol (Ultram) is a mild inducer of selected drug metabolism pathways measured in animals.
Tramadol Storage
Store at 25?C (77?F); excursions permitted to 15 - 30?C (59 - 86?F).
Use With Carbamazepine
Patients taking carbamazepine may have a significantly reduced analgesic effect of ULTRAM. Because carbamazepine increases tramadol metabolism and because of the seizure risk associated with tramadol, concomitant administration of ULTRAM and carbamazepine is not recommended.
Use With Quinidine
Tramadol (Ultram) is metabolized to M1 by CYP2D6. Quinidine is a selective inhibitor of that isoenzyme, so that concomitant administration of quinidine and ULTRAM results in increased concentrations of Tramadol (Ultram) and reduced concentrations of M1.The clinical consequences of these findings are unknown. In vitro drug interaction studies in human liver microsomes indicate that Tramadol (Ultram) has no effect on quinidine metabolism.
Use With Inhibitors of CYP2D6
In vitro drug interaction studies in human liver microsomes indicate that concomitant administration with inhibitors of CYP2D6 such as fluoxetine, paroxetine, and amitriptyline could result in some inhibition of the metabolism of Tramadol (Ultram)..
Use With Cimetidine
Concomitant administration of ULTRAM with cimetidine does not result in clinically significant changes in Tramadol (Ultram) pharmacokinetics. Therefore, no alteration of the ULTRAM dosage regimen is recommended.
Use With MAO Inhibitors
Interactions with MAO Inhibitors, due to interference with detoxification mechanisms, have been reported for some centrally acting drugs (see WARNINGS, Use With MAO Inhibitors).
Use With Digoxin and Warfarin
Post-marketing surveillance has revealed rare reports of digoxin toxicity and alteration of warfarin effect, including elevation of prothrombin times.
Children
There is no specific information on the relationship of age to the effects of Tramadol (Ultram) in patients less than 16 years of age.
Precautions for Taking Tramadol
It is important to note that Tramadol is a narcotic and therefore can be habit forming. It is absolutely imperative that you take this drug as prescribed by your doctor and only as prescribed. Do not take more than what is your recommended dosage. You should also tell your doctor if you have any other health conditions such as kidney disease or liver problems. Tramadol often causes drowsiness and so you should avoid driving before you know how it will affect you. You absolutely must not take alcohol while taking Tramadol either. Alert your doctor to any other medications or remedies you are taking, and this includes homeopathic remedies such as St. John's Wort.
Tramadol has been shown to be very effective for those suffering from chronic pain who take this medicine. It does seem to have some side effects that include nervousness, sweating, chills, dry mouth, dizziness, itching, rashes, changes in mood, heartburn, constipation, headache, sleepiness, and others, but these are usually not so severe that it would warrant the stoppage of this medicine.
If you are considering taking Tramadol or have already been prescribed this medication by your doctor, be sure to follow his or her instructions completely.
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