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amadol is a potent drug and the risk of developing reactions or side effects is a fair concern for clinicians as well as patients. Tramadol exerts its action by affecting opioid receptors and although the mechanism of action is pretty similar to morphine and other opioids, tramadol also inhibits the uptake of serotonin and norepinephrine (neurochemicals in the brain) which are in part responsible for superior therapeutic efficacy when compared to morphine and codeine.

The most common side effects observed with tramadol include nausea, vomiting, dizziness, dry mouth, and sedation. These are generally well-tolerated and do not require any dose modification. However, the severity can be minimized by dose adjustment. For example, M. Cossmann[1]suggested in his report that the overall risk of developing nausea and vomiting are 17.8% and 7.0% respectively when the drug is administered intravenously. However, with oral intake the risk is only 4.2% and 0.5% respectively. He further suggested that the overall risk of complications with tramadol is only 1% to 6% (depending upon the dosage and manner of administration).

If you are prescribed tramadol, you may want to acquaint yourself with some potential but uncommon side effects of tramadol:

Allergic Reactions: The risk of an allergic reaction is mild to moderate with tramadol in most individuals. The allergic reaction may be limited to trivial itching to as severe as development of hives, swelling of the face and mouth, difficulty in breathing and in extreme cases angioedema (life-threatening swelling of vocal cords).

In case of any such response, speak to your healthcare provider immediately. In most cases, the cause of allergy is genetic susceptibility to opioid active chemicals, therefore suggesting the likelihood of an allergic response to all other opioids as well.

Cardiac abnormalities: The symptoms may range from agitation and palpitation to rhythm abnormalities and conduction defects. However, A Whelton[2] suggested in his report published in The American Journal of Therapeutics

 



that the risk of such side effects is minimal if tramadol is consumed within the recommended dosage.CNS (Central Nervous System) defects:Despite the fact that the primary action of tramadol is on brain receptors, the risk of CNS side effects is quite low. In his research paper published in Drugs, CR Lee

[3] suggested that the dependence or addiction potential with regular intake (For a period of about 6 months) is fairly low; however, with prolonged consumption, the probability of addiction becomes fairly high, as with other opioids. With prolonged use, some people may also report hallucinations, vivid dreaming and mood alterations.Respiratory defects: Respiratory depression is one well-defined complication when tramadol is consumed via the infusion route (as part of anesthesia protocol). However, the risk of depression is minimal when tramadol is consumed via a controlled intravenous route during childbirth[4]. Other respiratory side effects are not commonly reported. The vast majority of moderate to severe side effects can be minimized or prevented by adjustment of dosage and drug administration. A rapid rise of the active drug level in the serum is associated with a much higher risk of complications.Gastric symptoms: Due to its receptor mediated effects, the use of tramadol carries risk of gastric complications. Many individuals report constipation within the first few weeks (or months) after starting oral therapy with tramadol. However, with prolonged use, constipation and other gastric issues like nausea and vomiting are ameliorated.

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