PROCTOHEAL Price

Overview

Welcome to Dwaey, specifically on PROCTOHEAL page.
This medicine contains an important and useful components, as it consists of
Bismuth subgallate, Fluocinolone acetonide, Lidocaine HCl, Mentholis available in the market in concentration

Name

Tramadol Hydrochloride

Precaution

Before starting **Tramadol Hydrochloride**, it is essential for patients to consult with their healthcare provider, particularly if they have the following conditions or concerns: - **History of Substance Abuse**: **Tramadol** has the potential for abuse, dependence, and addiction, particularly in individuals with a history of substance use disorders. Close monitoring is required. - **Central Nervous System (CNS) Disorders**: Patients with conditions like **seizure disorders** (epilepsy) or those prone to seizures should be cautious, as **Tramadol** may lower the seizure threshold, increasing the risk of seizures. - **Respiratory Issues**: **Tramadol** can depress respiration, so it should be used cautiously in patients with **respiratory depression**, **asthma**, or **chronic obstructive pulmonary disease (COPD)**. - **Liver or Kidney Impairment**: **Tramadol** is metabolized in the liver and eliminated by the kidneys, so individuals with **hepatic** or **renal impairment** should use this drug under close medical supervision, with possible dose adjustments. - **Elderly Population**: Older adults may have an increased sensitivity to the drug and may require lower doses to avoid adverse effects such as dizziness, confusion, or sedation. - **Pregnancy and Lactation**: **Tramadol** is categorized as **Pregnancy Category C**, meaning its safety during pregnancy has not been fully established. It should only be used when the potential benefits outweigh the risks. It is also excreted in breast milk, and therefore, breastfeeding mothers should consult a healthcare provider before using it. - **Risk of Serotonin Syndrome**: **Tramadol** can increase serotonin levels, so patients taking other serotonergic medications (e.g., **SSRIs**, **SNRIs**, **MAO inhibitors**) should be monitored for signs of **serotonin syndrome**, a potentially life-threatening condition.

Indication

**Tramadol Hydrochloride** is used to manage moderate to severe pain, especially when other pain medications are not appropriate. It is often prescribed for: - **Postoperative Pain**: After surgical procedures, **Tramadol** can help alleviate moderate pain. - **Chronic Pain**: It is also used to treat long-term conditions such as **osteoarthritis** and **back pain**. - **Acute Pain**: For conditions such as **musculoskeletal injuries**, **fractures**, or **sprains**. - **Neuropathic Pain**: **Tramadol** can be prescribed for nerve-related pain (e.g., **diabetic neuropathy**), though it is usually a second-line treatment. - **Cough Relief**: Although less common, **Tramadol** may be used in some cases for persistent cough, particularly when it is severe and other treatments have failed.

Contra indication

**Tramadol** is contraindicated in the following situations: - **Hypersensitivity**: Known allergic reactions to **Tramadol** or any of its components contraindicate its use. - **Acute or Severe Respiratory Depression**: In patients with severe **respiratory depression** or those at risk for it, such as those with **severe asthma** or **chronic respiratory disease**, **Tramadol** should be avoided. - **Concurrent Use with Monoamine Oxidase Inhibitors (MAOIs)**: The use of **Tramadol** within **14 days** of taking **MAO inhibitors** (e.g., **phenelzine**) can lead to severe interactions, including **serotonin syndrome**. - **Severe Liver or Kidney Disease**: In cases of **severe hepatic** or **renal impairment**, **Tramadol** should not be used unless prescribed by a healthcare provider with careful monitoring. - **Acute Alcohol Intoxication**: **Tramadol** should not be taken by individuals who are intoxicated or have **alcohol use disorder** due to the increased risk of respiratory depression and CNS effects. - **Children under 12 years**: **Tramadol** should not be used in children younger than 12 years due to an increased risk of **life-threatening respiratory depression**. - **Post-tonsillectomy and adenoidectomy** in children: It is also contraindicated for children aged 12-18 years who are obese or have conditions such as **obstructive sleep apnea**, as they are at increased risk for breathing difficulties.

Side Effect

Common side effects of **Tramadol** include: - **Nausea** and **vomiting**: These are the most frequent side effects of **Tramadol**, especially when starting treatment. - **Dizziness** and **drowsiness**: Commonly reported, particularly at higher doses. - **Constipation**: Like many opioids, **Tramadol** can cause constipation, and patients may need to use a stool softener or laxative. - **Headache**: This is another common side effect. - **Dry mouth**: Some patients may experience dryness of the mouth. - **Sweating**: Increased sweating can occur during treatment. - **Mood changes**: Some individuals report feelings of anxiety, agitation, or even euphoria, and in some cases, **depression**. Serious side effects that require immediate medical attention: - **Seizures**: **Tramadol** can lower the seizure threshold, leading to an increased risk of seizures. - **Serotonin Syndrome**: Symptoms include **agitation**, **hallucinations**, **fever**, **tachycardia**, **hypotension**, **muscle rigidity**, **tremors**, and **incoordination**. This is a life-threatening condition and requires immediate treatment. - **Respiratory Depression**: **Tramadol** can cause breathing difficulties, especially when taken with other CNS depressants or in overdose situations. - **Allergic Reactions**: Severe reactions like **swelling**, **hives**, **difficulty breathing**, or **anaphylaxis** may require emergency intervention.

Pregnancy Category ID

3

Mode of Action

**Tramadol** is a **synthetic opioid analgesic** that works through multiple mechanisms to provide pain relief: - **Opioid Receptor Agonist**: **Tramadol** binds to **mu-opioid receptors** in the brain and spinal cord, similar to other opioids, which helps reduce pain perception. - **Inhibition of Norepinephrine and Serotonin Reuptake**: **Tramadol** also inhibits the reuptake of **norepinephrine** and **serotonin** in the brain, which enhances its analgesic (pain-relieving) effects and contributes to its ability to treat moderate pain. - **Dual Mechanism**: This combination of opioid and non-opioid actions makes **Tramadol** effective for various pain conditions, including neuropathic pain, while having a lower risk of respiratory depression and addiction compared to traditional opioids.

Interaction

**Tramadol** interacts with several medications, increasing the risk of adverse effects or reducing its effectiveness: - **Central Nervous System Depressants**: Combining **Tramadol** with other CNS depressants (e.g., **benzodiazepines**, **barbiturates**, **alcohol**) can result in severe sedation, respiratory depression, or even coma. - **Serotonergic Drugs**: **Tramadol** can increase the risk of **serotonin syndrome** when taken with other **serotonergic medications** (e.g., **SSRIs**, **SNRIs**, **tricyclic antidepressants**, **MAO inhibitors**, **certain anti-migraine medications**). - **Antiepileptic Drugs**: The concomitant use of **Tramadol** with **antiepileptic drugs** (e.g., **phenytoin**, **carbamazepine**) may reduce **Tramadol's** efficacy, as these medications may induce the metabolism of **Tramadol**. - **Warfarin**: **Tramadol** can alter the effects of **warfarin**, leading to an increased risk of bleeding. Close monitoring of **INR** is recommended when both medications are used together. - **Digoxin**: The combination of **Tramadol** with **digoxin** can increase the risk of **serotonin syndrome** and should be avoided or closely monitored. - **MAO Inhibitors**: **Tramadol** should not be used within **14 days** of taking an **MAOI**, as this combination can result in severe reactions, including **serotonin syndrome**, agitation, and **hypertensive crisis**.

Pregnancy Category Note

Information not available

Adult Dose

For **Tramadol Hydrochloride** in adults: - **Initial Dose**: The usual starting dose is **50 mg to 100 mg** orally every **4 to 6 hours** as needed. - **Maintenance Dose**: The dose can be adjusted depending on the patient's needs, with a maximum daily dose typically not exceeding **400 mg**. - **Severe Pain**: In some cases, patients may require higher doses or additional pain management strategies. For patients with more severe pain, **Tramadol** can be combined with other pain relievers, such as **acetaminophen**.

Child Dose

**Tramadol** is **not recommended** for children under 12 years old due to the increased risk of **respiratory depression**. In children aged 12 to 18 years, it should be prescribed with caution and only when other pain management options are not effective. As always, patients should consult their healthcare provider before initiating **Tramadol** to ensure proper dosing and avoid potential risks.

Renal Dose

For patients with **renal impairment**, dosing adjustments are necessary: - **CrCl ≥ 30 mL/min**: Standard dosing is usually safe. - **CrCl < 30 mL/min**: **Tramadol** should be used with caution, and the dose may need to be reduced by half. Frequent monitoring of kidney function and side effects is essential.

Administration

Information not available