Tramadol ER is specifically designed to be used for continuous, around-the-clock relief of moderate to moderately severe chronic pain. This prescription medication is only approved for use in adults. Tramadol ER works in a similar way as morphine, which may cause abuse or dependence on the medication. At this time, there are no off-label uses.
Tramadol ER Uses
Tramadol ER (ConZip™, Ultram® ER, Ryzolt®) is a long-acting prescription medication approved to treat moderate to moderately severe chronic pain in adults. It is appropriate only for individuals who require continuous, around-the-clock pain medication.
As of July 2014, tramadol ER is a Schedule IV controlled substance. This means there are certain rules that regulate the prescribing and use of this medication, put in place to help prevent abuse.
Originally, tramadol medications were marketed as medications with very weak narcotic effects and very little potential for abuse. As a result, many healthcare providers came to view tramadol as a relatively safe medication for use in people at risk for drug abuse (such as people with previous problems with drug or alcohol abuse). However, research has since demonstrated that tramadol works primarily through morphine-like activity, and numerous cases of abuse and dependence have been reported (see Tramadol Abuse).
How Does Tramadol ER Work?
Tramadol ER tablets and capsules are specially designed to release the medication continuously over a 24-hour period. Tramadol ER contains tramadol, a drug that is classified as a "centrally acting opioid analgesic." This means that it works in the central nervous system (the brain and spinal cord), acts much like morphine in the body, and relieves pain. Much like morphine, tramadol ER binds to certain opioid receptors in the body known as μ ("mu") receptors.
Tramadol ER also works a little like some antidepressant medications by inhibiting the reuptake of certain brain chemicals (serotonin and norepinephrine). Serotonin and norepinephrine are two of several chemicals used to send messages from one nerve cell to another. As a message travels down a nerve, it causes the end of the cell to release serotonin or norepinephrine. The serotonin or norepinephrine enters the gap between the first nerve cell and the one next to it.
When enough serotonin or norepinephrine reaches the second nerve cell, it activates receptors on the cell and the message continues on its way. The first cell then quickly absorbs any serotonin or norepinephrine that remains in the gap between the cells. This is called "reuptake."
Ultram ER [package insert]. Raritan, NJ: PriCara;2007 December.
U.S. Drug Enforcement Administration. Schedules of controlled substances: placement of tramadol into Schedule IV (July 2, 2014). DEA Web site. Available at: http://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0702.htm. Accessed September 28, 2014.
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