Tramadol
When ATH:
N02AX02
Characteristic.
The white crystalline powder, without smell, bitter taste, soluble in water and ethanol.
Pharmacological action.
Analgesic (opioid).
Application.
Pain syndrome of average intensity of malignancy, acute myocardial infarction, injuries, diagnostic and therapeutic procedures, neuralgia.
Contraindications.
Hypersensitivity, acute alcohol poisoning and intoxication deprimiruyuschie and drugs, CNS depressants, epilepsy, the liver and kidneys, pregnancy, lactation, children early age (to 2 years).
Pregnancy and breast-feeding.
Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)
Side effects.
Dependence, syndrome "cancel", adaptation, dizziness, lethargy, respiratory depression, disforija, euphoria, cognitive decline, convulsions, vomiting, tachycardia, heartbeat, gipotenziya, collapse, nausea, epigastric pain, vomiting, constipation, strangury, allergic reactions.
Cooperation.
Do effects of tranquilizers, hypnotics, sedative and anesthetic agents, alcohol.
Activity decreases analeptics and psychostimulants, completely block-naloxone n naltrexone (direct antagonists). In combination with neuroleptics can cause convulsions.
Overdose.
Symptoms: respiratory depression, until apnea, convulsions, myosis, anurija, coma.
Treatment: naloxone (specific antagonist) I /, gastric lavage, maintaining vital functions.
Dosing and Administration.
B /, / m, n / a, inside, rectally. The dosage of the individual, depending on the intensity and nature of pain, the duration and treatment regimen determined by a physician. Inside adults and children over 14 years - 50 mg (again not earlier, than after 30-60 min). Parenteral (I /, / m, n / a) is 50-100 mg, rectally - 100 mg (possible re-introduction of candles in 3-5 hours). The maximum daily dose - 400 mg. Children aged 2 to 14 years inside (drops) or dropped is a single dose of 1-2 mg/kg.
Cooperation
| Active substance | Description of interaction |
| Alprazolam | FMR. Strengthens (mutually) effect; the combined appointment increases the risk of seizures. |
| Amitriptyline | FKV. FMR. Конкурирует за CYP2D6, zamedlyaetbiotransformatsiyu; with a joint appointment increases the risk of seizures. |
| Buprenorphine | FMR: synergism. Strengthens (mutually) CNS depression. The joint appointment increases the risk of seizures (caution and a dose reduction). |
| Buspirone | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment is necessary to reduce the dose. |
| Haloperidol | FMR: synergism. It increases the risk of seizures. |
| Gidroksizin | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment is necessary to reduce the dose. |
| Diazepam | FV. FMR: synergism. Strengthens (mutually) effect; the combined appointment increases the risk of seizures (you can not mix solutions, enter "into the same syringe"). |
| Diclofenac | FV. You can not mix solutions (enter "into the same syringe"). |
| Droperidol | FMR: synergism. It increases the risk of seizures; with a joint appointment requires caution. |
| Zolpidem | FMR: synergism. Strengthens (mutually) CNS depression; with a joint appointment caution (and a smaller dose). |
| Izofluran | FMR: synergism. Strengthens (mutually) effect; the combined appointment of caution. |
| Indomethacin | FV. You can not mix solutions (enter "into the same syringe"). |
| Carbamazepine | FMR: synergism. Accelerates biotransformation; with a joint appointment requires a two-fold increase in dose. |
| Quetiapine | FMR: synergism. It increases the risk of seizures; with a joint appointment requires caution. |
| Ketamine | FMR: synergism. Strengthens (mutually) effect; simultaneously or sequentially appointment caution. |
| Klozapyn | FMR: synergism. It increases the risk of seizures; with a joint appointment requires caution. |
| Clomipramine | FMR: synergism. Strengthens (mutually) effect, incl. side; concomitant use may increase the risk of seizures. |
| Codeine | FMR: synergism. Enhances the effect of, increases deprimatsiya; combined use increases the risk of seizures (caution and dose reduction). |
| Lorazepam | FMR: synergism. Strengthens (mutually) effect; concomitant use increases the risk of seizures. |
| Maprotilin | FMR: synergism. Strengthens (mutually) effect, incl. side; combined use may increase the risk of seizures. |
| Midazolam | FMR: synergism. Strengthens (mutually) CNS depression; with a joint appointment caution (and a smaller dose). |
| Moclobemide | FMR: synergism. Inhibits MAO and increases the risk of serotonin syndrome (fever, excitation, tremors and anxiety, seizures). |
| Morphine sulfate | FMR: synergism. Enhances the effect of, increases deprimatsiya; combined use increases the risk of seizures (caution and dose reduction). |
| Naloxone | FMR: antagonizm. Blocks analgesic effect. |
| Naltrexone | FMR: antagonizm. Blocks analgesic effect. |
| Nitroglycerin | FV. You can not mix solutions (enter "into the same syringe"). |
| Oxazepam | FMR: synergism. Strengthens (mutually) effect; concomitant use increases the risk of seizures. |
| Olanzapine | FMR: synergism. It increases the risk of seizures; with a joint appointment requires caution. |
| Paroxetine | FKV. FMR. Slows biotransformation (competes for CYP2D6); while the appointment increases the risk of seizures. |
| Perfenazyn | FMR: synergism. It increases the risk of seizures. |
| Procarbazine | FMR: synergism. Inhibits MAO and increases the risk of serotonin syndrome (fever, excitation, tremors and anxiety, seizures). |
| Propofol | FMR: synergism. Strengthens (mutually) effect; with concomitant or sequential use caution. |
| Risperidone | FMR: synergism. Strengthens (mutually) CNS depression; combined appointment requires caution. |
| Selegiline | FMR: synergism. Inhibits MAO, combined assignment can cause serotonin syndrome (fever, excitation, tremors and anxiety, seizures). |
| Sertraline | FMR: synergism. It inhibits the reuptake of serotonin; joint application may cause serotonin syndrome (fever, excitation, tremors and agitation, seizures). |
| Tioridazin | FMR: synergism. It increases the risk of seizures. |
| Trazodone | FMR: synergism. It inhibits the reuptake of serotonin; the combined appointment increases the risk of seizures. |
| Trifluoperazine | FMR: synergism. It increases the risk of seizures. |
| Phenylbutazone | FV. You can not mix solutions (enter "into the same syringe"). |
| Phenobarbital | FMR: synergism. Strengthens (mutually) CNS depression; the combined use caution (a smaller dose). |
| Fentanyl | FMR: synergism. Enhances the effect of, increases deprimatsiya; combined use increases the risk of seizures (caution and dose reduction). |
| Fluvoxamine | FMR: synergism. It inhibits the reuptake of serotonin; joint application may cause serotonin syndrome (fever, excitation, tremors and anxiety, seizures). |
| Flunitrazepam | FV. Strengthens (mutually) CNS depression; the combined appointment of caution (and reduced doses). |
| Fluoxetine | FKV. FMR. Slows biotransformation (competes for CYP2D6); simultaneous use may increase the risk of seizures. |
| Flufenazin | FMR: synergism. It increases the risk of seizures. |
| Quinidine | FKV. Inhibits the biotransformation and increases the blood concentration. |
| Xlordiazepoksid | FMR: synergism. Strengthens (mutually) effect; concomitant use may increase the risk of seizures. |
| Chlorpromazine | FMR: synergism. It increases the risk of seizures. |
| Chlorprothixene | FMR: synergism. Enhances CNS depression; with a joint appointment caution. |
| Citalopram | FMR: synergism. It inhibits the reuptake of serotonin; joint application may cause serotonin syndrome (fever, excitation, tremors and anxiety, seizures). |
| Ethanol | FMR: synergism. Against the background of tramadol (contraindicated in acute alcohol intoxication) enhanced effects deprimiruyuschie. |
