Tramadol

Name

• Tramadol hydrochloride.

Class of drug

• Analgesic drug with both an opioid and non-opioid mediated mechanisms of analgesic action.

Uses

Action

• Tramadol is a unique analgesic with opioid and non-opioid properties. Tramadol itself has relatively low affinity for opioid receptors and the mechanism of action of tramadol is thought to come about through reduction in neuronal re-uptake of norepinephrine and serotonin. Tramadol exists as a racemic mixture and there is individual selectivity between the enantiomers in their selectivity for each pathway (norepinephrine or serotonin). When given together (as in racemic tramadol) synergism occurs, producing greater pain relief.

Indications

• Mild to moderate acute pain.
• Adjunctive analgesic agent in management of chronic pain from cancer or OA.
• The efficacy, pharmacokinetics and pharmacodynamics of tramadol are not well described in dogs, therefore tramadol should not be used as a first line analgesic drug. Due to the oral tablet formulation and fact that it can be dispensed to owners, it is useful for provision of medium to long-term analgesia in the home environment. It is an alternative analgesic drug for animals that are intolerant of NSAIDs, or it can be given in combination with NSAIDs to animals that remain painful despite NSAID therapy. Tramadol appears to be efficacious for the management of both acute and chronic pain.

Adverse reactions

Effects of overdosage

• Tramadol may cause sedation in some animals, particularly at higher doses or if given concurrently with other µ opioid agonists.
• Nausea.

Antidote for overdose

• Due to the opioid effects of tramadol, naloxone (0.015-0.02 mg/kg IV) can be given in the event of overdose.