Tramadol is used to find relief from moderate to severe pain. It also may be used to treat pain caused by surgery and chronic conditions such as cancer, joint and back issues. This medication may also be prescribed for additional uses; ask your doctor or pharmacist for more information.
TRAMADOL DRUG INFO
IMPORTANT NOTE: The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be assumed that the use of the drug is safe, appropriate, or effective for your needs. Consult your physician or other healthcare professional before utilizing this drug.
TRAMADOL - ORAL (TRAH-muh-dall)
COMMON BRAND NAME(S): Ultram
USES: Tramadol is used for pain relief.
HOW TO TAKE TRAMADOL
Take tramadol exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label. Do not take more than 300 milligrams of tramadol in one day.
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Each dose should be accompanied with a partial to full glass of fluid.
Tramadol can be taken with or without food, but make an effort to consume it the same way each time.
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Avoid crushing the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhlation or injection can cause life-threatening side effects, overdose, or death.
Avoid crushing, chewing, or breaking an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.
If you use the tramadol extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is completely normal and should not cause concern that the medicine is not at it's full dose.
Tramadol may be habit-forming and could result in withdrawl symptoms if stopped abruptly. Inform your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor.
Do not cease this medication without talking to your orginal prescriber first. You may need to gradually titrate down the dose. Withdrawal symptoms may occur when you stop using tramadol. These ymptoms include, but are not limite to anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Call your doctor at once if you have any of these withdrawal symptoms after you stop using tramadol.
Store tramadol at room temperature away from moisture and heat.
MORE ON DOSAGE AND ADMINISTRATION: For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, the tolerability of Tramadol can be improved by initiating therapy with the following titration regimen: Tramadol should be started at 25 mg/day qAM and titrated in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg q.i.d.).Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg q.i.d.).After titration, Tramadol 50 to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.
For the subset of patients for whom rapid onset of analgesic effect is required and for whom the benefits outweigh the risk of discontinuation due to adverse events associated with higher initial doses, Tramadol 50 mg to 100 mg can be administered as needed for pain relief every four to six hours, not to exceed 400 mg per day.
SIDE EFFECTS: Tramadol may cause dizziness, weakness, incoordination, nausea or vomiting, stomach upset, constipation, headache, drowsiness, anxiety, irritability, dry mouth, or increased sweating. If any of these effects persist or worsen, inform your doctor. Notify your doctor if you develop any of these serious effects while taking this medication: chest pain, rapid heart rate, skin rash or itching, mental confusion, disorientation, seizures, a sensation of tingling in your extremities, trouble breathing. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, breathing trouble. If you notice other effects not listed above, contact your doctor or pharmacist.
PRECAUTIONS: Tell your doctor your medical history, especially if the following conditions are present: kidney disease, liver disease, seizure disorder, lung disease, history of drug or alcohol dependency, any allergies you may have. Limit alcohol as it may add to the dizziness or drowsiness effects caused by the medication. Because this drug may make you dizzy/drowsy, be sure to practice caution when driving or while doing other tasks that require a quick reaction time or an alert state. This medication should be used only when clearly needed during pregnancy. As with all medications, you may need to weigh the benefits against the risks. Tramadol is excreted into breast milk. Because the effects on a nursing infant are not known, talk with your physician first before breast- feeding.
DRUG INTERACTIONS: Tell your doctor of all prescription and nonprescription medications you may use, especially of: carbamazepine, narcotic pain relievers (e.g., codeine), drugs used to aid sleep, antidepressants (e.g., SSRI-types such as fluoxetine or fluvoxamine), MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine), psychiatric medicine (e.g., nefazodone), "triptan"-type drugs, anti-anxiety drugs (e.g., diazepam), sibutramine. Also, report use of certain antihistamines (e.g., diphenhydramine) which are also present in many cough-and-cold products. Do not begin or cease this or any medicine without doctor or pharmacist approval.
OVERDOSE: If Tramadol hcl overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include cold and clammy skin, low body temperature, slowed breathing, reduced heartbeat, drowsiness, dizziness or falling spells, lightheadedness, an excessively deep sleep, loss of consciousness, or seizures.
NOTES: Do not share this medication with others, even if you think it may be safe.
MISSED DOSE: If you miss a dose of Tramadol, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store this medication at room temperature between 59 and 86 degrees F (15 to 30 degrees C) away from heat, light and extreme moisture. Avoid storing this medicine in the bathroom. Keep this and all medications out of the reach of children.
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store Tramadol at a temperature that is no higher than 85 degrees, and away from excessive heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include: confusion
decreased size of the pupil (the black circle in the center of the eye)
First, techdirt and then the Electronic Frontier Foundation examine the draft bill on patent reform introduced by House Judiciary Chair Bob Goodlatte.
Techdirt (http://www.techdirt.com/blog/innovation/articles/20130923/17400624628/posturing-over-patent-reform-shows-how-young-companies-innovate-while-old-companies-litigate.shtml) looks at the sources of support for the proposal, mostly from startups that are innovators and are frequent critics of existing patents. Older firms which have an established position and may fear innovation are opposed. EFF's piece (https://www.eff.org/deeplinks/2013/09/troll-killing-patent-reform-one-step-closer) looks at the details and specifies what it likes in the draft, most of the bill's proposals. Given the balance of forces in the Congress, passage seems questionable but one can always hope.
Bartees Cox Jr. contrasts the company image and the public image of the patent troll, Intellectual Ventures (http://www.publicknowledge.org/blog/two-sides-intellectual-ventures). He sums it up, "Intellectual Ventures is giving you the good side of the story. They say that they are champions of invention and they're quick to point out their health and medical research. Everyone else in the battle for patent reform sees the other side. The side that preys on businesses without penalty, that buys up patents to sue innovators building companies, and that ultimately keeps innovation at a standstill while raking in massive profits.
Later, he writes, "Because when a company like Intellectual Ventures sits on technologies and patents, waiting for someone to independently make a product to become unintentional fodder for a lawsuit trap, there is no benefit to knowledge, consumers, or to society."
Worth a read and thought about the purpose of patents and current experience and whether we wouldn't be better off without them.
The other day, the New York Times published instructions for aspiring inventors on how to take their inventions through the patent granting process and on to the retailers' shelves link here
. The examples are a couple of aspiring inventors and describes the pitfalls, the costs, and a rough estimate of the likelihood of success.
In the first example, the invention is a sun shade for a baby's stroller. The problem in this case was the number of thieves waiting to take the aspiring inventor's money without providing any service or charging an arm and a leg for minimal services. First lesson: know your help's history. Second lesson: you have to do a lot of the work yourself; it is hard to write a contract that specifies what is needed and to find a contractor who can provide it.
The second case is an inventor of a screw device to replace the broken one on the ear pieces of eyeglasses. The experience with companies who are selling consulting and other assistance is much the same as in the first case. The upfront costs of patenting and marketing are stiff and the need for added funding, often high.
The article seems to suggest that there is a growing number of successful inventor-developers and leaves the thought that with a bit of effort, you too can succeed. This does not account for the number who failed. Nor does the data cite the proportion that were brought to market by big companies who seem to dominate the marketplace when you shop and who turn out to end up with the patents that make market dominance possible.
The blog, Public Knowledge, argues that the International Trade Commission should consider the public interest in reaching regulatory decisions on patents. The Obama has so decreed when it overruled an ITC case and permitted imports of Apple phones that it had found to violate duly recognized patents of other companies, in this case foreign firms link here
When I look at the mess in the whole patent system, I see a world of oligopolies and monopolies built on patents, supposedly designed to encourage innovation, but instead creating a self-perpetuating means to paralyze innovation.
I would do away with the whole system of patents, but that isn't going to happen. Too many huge companies have a vested interest in the existing highly profitable system. Instead, those of my persuasion must examine whether the legal change making importation illegal under a finding of public interest is a good thing, rather than allowing the competing imports and slowing Apple's ability to go on coining money. To put it differently, isn't allowing the imports in the public interest? In this case, the big American company was the winner. Who lost?
Public Knowledge has a couple of pieces up on the fight between CBS and Time Warner Cable over TWC's payment for the right to rebroadcast broadcasts and then charge the public link here
and link here
. CBS has already been amply rewarded through advertising on its over the air broadcasts free use of the public airwaves. But in the current fight, it wants still more money. Congress set this up in 1992 legislation which allowed the networks to charge for retransmission permission of its broadcasts.
CBS has the right to charge for its retransmission consent but the law stipulates that the fees must be reasonable. However, left to themselves the parties have self-interest to decide what is reasonable. The 1992 law gives the FCC the power to intervene on what is reasonable link here but it has so far avoided taking a position.
CBS has now upped its pressure and limited its over-the-air broadcasts in some areas served by TWC. The public pays in lost services and will pay again with higher charges.
Competition for cable-television providers looks safe at least for a time, as the result of two copyright suits link here
. In one, Aereo TV captures from antennas and delivers regular programming via the internet for a monthly fee; this allows the subscriber to record the programs playing them back when he wants. In the other, the satellite Dish provider offered a service, Hopper, which allowed the customer to eliminate ads on home recorded programs. Neither service allows the broadcaster to charge for its programs since the courts ruled that they could not use copyright to enforce payment.
The crucial court decisions found that it was the customer who made the recording so copyright was not violated.
As the Times article points out, unless the two interlopers pay, the broadcasters can and now are likely to retaliate by ceasing to broadcast over the air and providing cable service only.
In judging the result of these cases, once again copyright appears to reduce competition and raise prices to consumers. But its ostensible purpose, to reward the creator of the program to induce new creativity, is largely avoided--if that ever happened, it was long in the past.
Here is one for the books; you may record copyrighted material and play it back without the ads, because dumping the ads is covered by fair use link here
. Fox TV, the plaintiff, saw it was losing revenue when others downloaded and redistributed its on-line material without the ads. Dish, the TV redistributor, made a good business out of doing so and charging subscriptions from its customers. Its successful defense will no doubt attract others into the redistribution business.
I'm late with this but Public Knowledge announced two weeks ago that it was starting a Patent Reform Project link here
. Given that we are surrounded with an incredibly expensive and inefficient and now corrupt (with the presence of the patent trolls' extortion) system, it is important for the informed and interested to weigh in.
One cannot be terribly optimistic about the outcome, but to leave the system to the big money and personally interested is to give up. We can do better. Given our democratic system, compromise is essential so one almost never gets all his wishes. But the critics have been making a dent in the unthinking belief that intellectual property was property like physical goods or land and that it always encouraged innovation and thus human progress. It is a right with characteristics like real property, created by law and law can be changed. Now is the time to change it.
Weigh in, please.