Since the effective painkiller, tramadol tablets, are available in two convenient forms, the dosage schedule slightly differs. This is due to the form's time to take effect, as one works instantly (fast-acting tramadol) and one works slower over a period (slow-acting tramadol).
These forms do not differ in terms of its potency and safety profiles, only in the time it takes to work. The availability of these forms helps patients choose a therapy that will treat their condition in the most convenient, effective manner.
To ensure the best results from the medication, patients are encouraged to follow a strict tramadol dosage routine. Having a schedule will help patients take all their required doses in the necessary times of the day.
A general tramadol dosing plan is as follows:
|ACUTE PAIN||CHRONIC PAIN|
|1. Fast-acting tramadol||A 50 mg to 100 mg single tablet taken every 4 to 6 hours, as needed.||One 25 mg tablet should be taken every morning at first. It must be taken four times a day. Thereafter, the dose can be increased to 50 mg to 100 mg.|
|2. Slow-acting tramadol||This form is not recommended for use in acute pain.||The dose can start at 100 mg taken once every day. It can be increased by 100 mg every five days.|
*Maximum daily dose recommended is 400 mg.
The use of slow-acting tramadol is especially beneficial in the older population, as they have chronic pain conditions. A study posted by JPSM proved tramadol's efficacy in treating osteoarthritis with a once-a-day formulation.
For improved tramadol effects, patients should follow these tramadol dosage instructions:
Tramadol's durational effects vary with its two forms. This is due to the different design and release-technology of these forms. The durational effects of tramadol are influenced by the number of tramadol dosage times and adherence to guidelines.
However, tramadol (fast-acting) shows its effects 30 to 60 minutes post-ingestion. This is a quick-acting formulation which lasts for 4 to 6 hours. This form is prefered by patients who need quick, targeted pain relief, as it can be used as soon as the pain is felt.
Tramadol (slow-acting) shows its effects some time after it is taken. The active ingredient is released over 12 to 24 hours in the day, eliminating the need for multiple doses during the day. Slow-acting tramadol is considered an around-the-clock pain reliever. The formulation is designed to have 20% of its dose released over 12 hours and the rest released over 24 hours. This form only needs to be taken once a day.
The breaking down of tramadol happens in the liver by the help of enzymes. This creates active compounds (metabolites) which stay in the body to continue producing the pain-relieving effects. Afterwards, the kidneys excrete the treatment through normal functions of the body, such as urination.
The half-life of tramadol is 6.3 hours, with its primary active metabolite having a half-life of 8 hours. Half-life involves the time it takes for the body to eliminate half of a specific medication dose. Various factors affect how long a tramadol dosage stays in the system.
These factors include:
The process of discontinuing tramadol is slightly different from other opioid medications, partly due to its complementary process of inhibiting neurotransmitters. According to the Drug Enforcement Agency, patients may face one of two types of withdrawal.
The first type is the typical withdrawal symptoms of opioids, including flu-like symptoms. The second type of withdrawal is referred to as atypical withdrawal.
These symptoms are:
|TYPICAL WITHDRAWAL SYMPTOMS||ATYPICAL WITHDRAWAL SYMPTOMS|
|Restlessness or nervousness||Confusion|
|Body aches and pains||Paranoia and anxiety|
|Diarrhoea||Numbness and tingling|
Atypical withdrawal symptoms are rare and will hardly occur if the patient correctly comes off tramadol. The common withdrawal symptoms will last between 4 to 10 days. Based on how the patient feels, the best length of time between tramadol dosage reductions is determined.
Patients must not suddenly stop the use of tramadol 50 mg. This is often referred to colloquially as quitting 'cold turkey' which is advised against. This can be challenging as they can experience symptoms that may require emergency care, or cause them to start abusing tramadol. The cravings that may arise results in the patients going back on tramadol to stop these symptoms.
To prevent these unpleasant feelings, patients need to stop using tramadol gradually over time. This allows the body to regulate to the lower doses of tramadol until its use is entirely and safely stopped. The Drug Withdrawal Research Foundation says that it will not prevent typical withdrawal symptoms entirely, however, it will subside them.
Those who have used tramadol short-term will require to decrease their dosage by a small amount each day. However, this process is done slowly over weeks for long-term users until they are completely detoxed from tramadol.
A time cannot be put on the tapering off schedule of tramadol, as it is based on various factors. These factors include the duration of treatment, the amount they were taking and the frequency of doses in the day. However, it is strongly advised to follow a tapering off process whenever a patient wants to terminate tramadol use.
Check out the following link for more information about painkillers - or read more in the blogs below!
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Updated: 27th January 2021
Review Due: January 2022
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