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traMADol HCl (ER Biphasic)
Tramadol HCl ER Biphasic is an extended-release (ER) formulation of tramadol, a synthetic opioid used to manage moderate to moderately severe chronic pain in adults. The biphasic release mechanism provides both an initial immediate release of tramadol for quick pain relief and a sustained release to maintain pain control over a longer period. This formulation is typically prescribed for patients requiring continuous pain management throughout the day.
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Frequently Asked Questions
How long does it take for Tramadol ER Biphasic to start working?
The immediate-release component starts providing pain relief within 1 to 2 hours, while the extended-release mechanism maintains pain control throughout the day.
Can I crush or split the Tramadol ER Biphasic tablet?
No, the tablet must be swallowed whole. Crushing or splitting it may cause a rapid release of the medication, increasing the risk of overdose and severe side effects.
What should I do if I miss a dose?
Take the missed dose as soon as you remember, unless it is close to your next scheduled dose. Do not double the dose to make up for the missed one.
Is Tramadol ER Biphasic safe for long-term use?
Tramadol can be used long-term for chronic pain management under the supervision of a healthcare provider. However, regular monitoring for side effects such as dependence and respiratory depression is essential.
Can Tramadol ER Biphasic cause serotonin syndrome?
Yes, especially if combined with other drugs that affect serotonin levels, such as antidepressants. Symptoms of serotonin syndrome include confusion, rapid heart rate, fever, and muscle stiffness. Contact your healthcare provider immediately if you experience these symptoms.
Comprehensive Drug Guide
How Does traMADol HCl (ER Biphasic) Work?
The biphasic release system of Tramadol HCl ER provides an initial burst of the drug for quick pain relief, followed by a sustained release to maintain therapeutic levels over 24 hours. Tramadol works by binding to mu-opioid receptors in the brain and spinal cord, blocking pain signals. It also inhibits the reuptake of serotonin and norepinephrine, which helps modulate pain perception.
Common Dosages
- 100 mg
- 200 mg
- 300 mg
Typical Dosing
- The usual starting dose for adults is 100 mg once daily, which may be increased by 100 mg every 5 days depending on response, up to a maximum of 300 mg once daily.
Typical Dosing
FDA Approved Indications
- Management of chronic pain in adults who require continuous, around-the-clock treatment.
Who Shouldn't Take traMADol HCl (ER Biphasic)?
- Severe respiratory depression
- Acute or severe asthma
- GI obstruction
- Concurrent use of MAO inhibitors within the last 14 days
- Known hypersensitivity to tramadol or other opioids
Advice From The Pharmacist
- Swallow the ER Biphasic tablet whole; do not crush, chew, or break it, as this can release the drug all at once, increasing the risk of overdose.
- Avoid alcohol while taking Tramadol, as it may enhance the risk of serious side effects like respiratory depression.
- Do not abruptly stop taking Tramadol, as this may cause withdrawal symptoms. Your healthcare provider will guide you on how to taper the medication if necessary.
- Monitor for signs of serotonin syndrome, especially if you are taking other medications that affect serotonin levels.
Side Effects of traMADol HCl (ER Biphasic)
Common Side Effects
- Drowsiness
- Dizziness
- Nausea
- Constipation
- Headache
Uncommon/Severe Side Effects
- Respiratory depression
- Seizures
- Serotonin syndrome
- Dependence or addiction
- Severe allergic reactions (anaphylaxis)
Risks and Warnings of traMADol HCl (ER Biphasic)
- Addiction and Dependence: Tramadol HCl ER Biphasic carries a risk of addiction and dependence, especially with prolonged use or in patients with a history of substance abuse.
- Seizure Risk: Tramadol may lower the seizure threshold, particularly in individuals with a history of seizures or those taking other medications that increase seizure risk.
- Serotonin Syndrome: Combining Tramadol with serotonergic drugs (e.g., SSRIs, SNRIs, or MAO inhibitors) increases the risk of serotonin syndrome, a potentially life-threatening condition.
Interactions with traMADol HCl (ER Biphasic)
Common Drug Interactions
- MAO inhibitors: Tramadol should not be used with MAO inhibitors due to the risk of severe reactions, including serotonin syndrome.
- SSRIs, SNRIs, TCAs, and antipsychotics: These drugs can increase the risk of serotonin syndrome when taken with Tramadol.
- CNS depressants: Combining Tramadol with benzodiazepines, alcohol, or other CNS depressants increases the risk of sedation, respiratory depression, and overdose.
Alternatives to traMADol HCl (ER Biphasic)
- Hydrocodone/Acetaminophen (Norco): A stronger opioid used for moderate to severe pain management.
- Oxycodone ER (OxyContin): A more potent opioid analgesic for managing severe, chronic pain.
- Gabapentin: A non-opioid alternative for managing nerve pain.
- Ibuprofen (Motrin): A non-opioid option for mild to moderate pain.
