DRUG ABUSE AND DEPENDENCE
Although tramadol can produce drug dependence of the µ-opioid type (like codeine or dextropropoxyphene) and potentially may be abused, there has been little evidence of abuse in foreign clinical experience. In clinical trials, tramadol produced effects similar to an opioid, and at supratherapeutic doses was recognized as an opioid in subjective/behavioral studies. Tolerance development has been reported to be relatively mild and withdrawal when present, is not considered to be as severe as that produced by other opioids. Part of tramadol's activity and some extension of the duration of µ-opioid activity. Delayed µ-opioid activity is believed to reduce a drug's abuse liability.
An assay for tramadol is not included in routine urine screens for drugs of abuse.
OVERDOSAGE:
Few cases of overdoses with tramadol have been reported. Estimates of ingested dose in foreign fatalities have been in the range of 3 to 5 g. A 3 g intentional overdose in a patient in the clinical studies produced emesis and no sequelae. The lowest dose reported to be associated with a fatality was possibly between 500 and 1000 mg in a 40 kg woman, but details of the case are not completely known.
Serious potential consequences of overdosage are respiratory depression and seizure. Naloxone will reverse some, but not all symptoms caused by overdosage with Tramadol so that general supportive treatment is recommended. Primary attention should be given to the assurance of adequate respiratory exchange. Hemodialysis is not expected to be helpful because it removes only a small percentage of the administered dose. Convulsions occurring in mice following the administration of toxic doses of tramadol could be suppressed with barbiturates or benzodiazepines, but were increased with naloxone. Naloxone did not change the lethality of an overdose in mice.
Although tramadol can produce drug dependence of the µ-opioid type (like codeine or dextropropoxyphene) and potentially may be abused, there has been little evidence of abuse in foreign clinical experience. In clinical trials, tramadol produced effects similar to an opioid, and at supratherapeutic doses was recognized as an opioid in subjective/behavioral studies. Tolerance development has been reported to be relatively mild and withdrawal when present, is not considered to be as severe as that produced by other opioids. Part of tramadol's activity and some extension of the duration of µ-opioid activity. Delayed µ-opioid activity is believed to reduce a drug's abuse liability.
An assay for tramadol is not included in routine urine screens for drugs of abuse.
OVERDOSAGE:
Few cases of overdoses with tramadol have been reported. Estimates of ingested dose in foreign fatalities have been in the range of 3 to 5 g. A 3 g intentional overdose in a patient in the clinical studies produced emesis and no sequelae. The lowest dose reported to be associated with a fatality was possibly between 500 and 1000 mg in a 40 kg woman, but details of the case are not completely known.
Serious potential consequences of overdosage are respiratory depression and seizure. Naloxone will reverse some, but not all symptoms caused by overdosage with Tramadol so that general supportive treatment is recommended. Primary attention should be given to the assurance of adequate respiratory exchange. Hemodialysis is not expected to be helpful because it removes only a small percentage of the administered dose. Convulsions occurring in mice following the administration of toxic doses of tramadol could be suppressed with barbiturates or benzodiazepines, but were increased with naloxone. Naloxone did not change the lethality of an overdose in mice.
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