Tramadol

What is Tramadol?

Tramadol hydrochloride is a centrally acting opioid analgesic for moderate to severe pain. The references are Spanish Adolonta capsules and Adolonta retard tablets. Immediate and prolonged release have different dosing schedules and must not be interchanged independently.

How does Tramadol work?

Tramadol and its active metabolite act at opioid receptors. Inhibition of noradrenaline reuptake and increased serotonin release also contribute to analgesia. CYP2D6 and CYP3A4 take part in metabolism; CYP2D6 variation affects the opioid response. These mechanisms do not establish a general recommendation for neuropathic pain or superiority over another analgesic.

Who is Tramadol for?

This article covers adults. The cited labels also include certain uses from age 12; this does not change platform access criteria. Musculoskeletal, postoperative, cancer-related or persistent pain needs assessment of its cause and other options. No general recommendation for neuropathy or fibromyalgia is made.

Uncontrolled epilepsy is a contraindication. Seizure history, even with controlled epilepsy, needs particular assessment. Tramadol is not a treatment for opioid withdrawal.

Dosage

Adult summary of the cited Spanish formulations, not a substitute for a prescription.

Renal or hepatic impairment may require longer intervals; there is no universal schedule for all degrees of impairment. Use the lowest effective dose for the shortest necessary time. Adolonta retard tablets must be swallowed whole, not split, crushed or chewed. Manipulation can change release and cause toxicity.

Adolonta retard is not recommended in severe renal or hepatic impairment.

Side effects

Very common side effects (may affect more than 1 in 10 people)

• Nausea and dizziness.

Common side effects (may affect up to 1 in 10 people)

• Headache, drowsiness, constipation, vomiting, dry mouth and sweating.

Serious risks

Seizures, respiratory depression, dependence and withdrawal can occur. Serotonin syndrome can occur with tramadol alone or with serotonergic medicines; agitation, confusion, fever and muscle rigidity need immediate assessment. Slow breathing or difficulty waking is an emergency. Hypoglycaemia has been reported. Do not abruptly stop regular use without an agreed medical taper. This list is not exhaustive.

Online assessment for Tramadol

Prescrivia is a technology intermediary connecting patients with independent doctors and licensed pharmacies. It does not provide medical services, prescribe, employ doctors, sell or dispense medicines.

1. Health assessment: Provide your symptoms, medical history and all current medicines for independent clinical assessment.
2. Doctor review: An independent doctor decides whether any treatment is appropriate. Prescrivia does not guarantee that a prescription will be issued.
3. Pharmacy responsibility: Any lawful dispensing is the responsibility of a licensed pharmacy, subject to the applicable prescription and national rules. This article does not establish product availability or a right to delivery.

In Spain, distance sale of prescription medicines is prohibited under Article 3.5 of Royal Legislative Decree 1/2015. An online assessment does not remove this restriction. Access depends on the specific product and jurisdiction.

Important safety information

Do not take tramadol with allergy to its components, inadequately controlled epilepsy, acute intoxication with alcohol, hypnotics, opioids or psychotropic medicines, or with MAO inhibitors or within 14 days of stopping them. It must not be used to treat opioid withdrawal.

Tell your doctor about any seizure history, breathing problems, sleep apnoea, liver or kidney disease, head injury, raised intracranial pressure, depression, dependence history, adrenal insufficiency, hypothyroidism or urinary problems. Controlled epilepsy still requires particular caution. CYP2D6 ultra-rapid metabolism can cause opioid toxicity; this is distinct from serotonin syndrome. Do not use during pregnancy. Do not take while breastfeeding without agreeing an appropriate alternative with the doctor; breastfeeding may need to be interrupted during treatment. After a single dose, interruption is generally unnecessary: seek advice on how to proceed without stopping regular treatment yourself.

Interactions: Serotonergic antidepressants, including SSRIs and SNRIs, require assessment; MAO inhibitors are contraindicated. Antiepileptics such as carbamazepine, CYP2D6/CYP3A4 modifiers and anticoagulants such as warfarin can interact. Avoid alcohol. Combining benzodiazepines or other CNS depressants can cause respiratory depression, coma or death and requires specific medical assessment. Do not drive with dizziness or drowsiness.

Sources

• AEMPS: Adolonta 50 mg cápsulas, ficha técnica
• AEMPS: Adolonta retard, ficha técnica
• BOE: Real Decreto Legislativo 1/2015, artículo 3.5

The update date records an editorial edit, not a clinical review. This information does not replace the product leaflet or individual advice from a qualified healthcare professional.