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Tramadol is a prescription pain medication used to treat moderate to moderately severe pain. It works through a dual mechanism: binding to opioid receptors in the brain and affecting serotonin and norepinephrine levels, which helps reduce the perception of pain. Because of this mixed action, tramadol is considered less potent than some opioids, but it still carries risks of dependence and misuse.

The recommended dosage of tramadol depends on the formulation and patient needs. Immediate-release tablets are commonly prescribed at 50 mg to 100 mg every 4–6 hours as needed, with a maximum of 400 mg per day for adults. Extended-release forms are usually taken once daily and should be swallowed whole, not crushed or chewed. Dose adjustments are required for individuals with kidney or liver impairment, and elderly patients may need lower doses.

Common side effects of tramadol include dizziness, drowsiness, nausea, vomiting, constipation, headache, and dry mouth. Some patients may experience sweating, itching, or fatigue. More serious side effects include seizures, serotonin syndrome, slow breathing, and confusion, especially when taken at high doses or combined with certain other medications.

There are important warnings associated with tramadol use. It carries a boxed warning for addiction, abuse, and misuse, as well as life-threatening respiratory depression. Tramadol should not be combined with alcohol, benzodiazepines, antidepressants, or other central nervous system depressants without medical guidance. It is not recommended for children and should be used cautiously in patients with a history of seizures, mental health disorders, or substance abuse. Pregnant or breastfeeding individuals should only use tramadol under strict medical supervision to ensure safe and appropriate treatment.