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Tramadol is indicated for the management of moderate to moderately severe pain . Tramadol is given by intramuscularly , intravenously & intravenous infusion .


* Hypersensitivity to tramadol or any other component of this drug or opioids : Anaphylactoid reactions often occure following the first dose . Patient with a history of anaphylactoid reactions to codeine & other opioids may be increased the seizure risk and therefore should not receive tramadol . *Acute intoxication with alcohol , hypnotics , centrally acting analgesic , opioid or psychotropic drugs.

Adverse reactions:

Tramadol may produce a constellation of symptoms including dizziness , somnolence , nausea , constipation , sweating , prurites ( similar to that of an opioid ) ; orthostatic changes in blood pressure . The most frequently reported events were in the central nervous system ( such as convulsion ) and gastrointestinal system ( such as abdominal pain ) . In addittion , respiratory depression ( less than with morphine ) , seizures , anaphylactoid reactions and psychiatric reaction ( such as hallucination ) may occure.


CNS depressant : Use with caution and in reduced dosage when administering to patient receiving CNS depressants such as anesthetic agent , antidepressants , phenothiazine , tranquilizers and sedative hypnotics . * MAO inhibitors :Use with great caution in patient taking monoamino oxidas inhibitors, because concurrent use may decrease seizure threshold . * Carbamazepine : Concomitant adminsitration causes a significant increase in tramadol metabolism . Patient receiving chronic carbamazepine doses of up to 800 mg daily may require up to twice the recommended doses of tramadol . * Anticoagulant : Tramadol is reported to have potentiated the anticoagulant effect of warfarin and of phenprocoumon . *Quinidine .


An injection of tramadol is reported to be incompatible with injections of diazepam , diclofenac sodium , indometacine , midazolam and piroxicam if mixed in the same syringe . Tramadol may impairment or physical abilites or coordination required for the performance of potentially hazardous tasks such as driving a car or operating machinery . Pregnancy : Category C . Don’t use in pregnant women prior to or during labor unless the potential benefits out weight the risk . Tramadol has been shown to cross the placenta . Breast – feeding : Tramadol is not recommended for post-delivery analgesia in nursing mothers . Following a single IV 100 mg dose of tramadol , the cumulative excretion in breast milk within 16 hours post-dose was 100 mcg of tramadol and 27 mcg of M1. Pediatrics :Not recommended in children , because safety & efficacy in patient under 16 years age have not been established . Administer cautiously in patients at.



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