Tramadol

(for veterinary information only)

BRAND NAME: ULTRAM

AVAILABLE IN
50 mg        
TABLETS     

BACKGROUND:

The search for the relief of pain has existed for centuries if not millennia. It has long been known that the opiates are able to produce excellent analgesia as well as feelings of euphoria. Unfortunately, they are also habit forming, cause respiratory depression, sedation, and hallucinations. As science has examined the brain, several types of opiate receptors have been found such that stimulation of different receptors is responsible for the different effects of the opiates. For example, the “mu” and “delta” receptors account for analgesia (pain relief), euphoria, addiction, reduction in heart rate, and respiratory depression. The “kappa” receptors cause dysphoria (unpleasant feelings), constricted pupils, and sedation. The “sigma” receptors account for hallucinations. In the laboratory, it is possible to create opiates that stimulate only some (ideally only the mu) receptors and not others. With delicacy it is possible to create a drug that creates analgesia and euphoria without being addictive or sedating. Such opiates (more correctly called “opioids”) are generally strictly controlled by governmental paperwork because of their abuse potential though they are excellent pain relievers.

Tramadol is a weaker opiate, weak enough not to require governmental paperwork (at least in most of the U.S.). Its binding affinity to the opioid mu receptor might even be so weak as to preclude its usefulness but there is a part two to tramadol. Tramadol is split in the body not only to an opiate but also to non-opioid psychoactive pain reliever. The opioid and non-opioid metabolites produce very effective pain relief in human beings as well as in pets.

Strangely, in the dog, tramadol is not metabolized into an opioid and how tramadol is able to effect pain relief in pets remains somewhat of a mystery.

In veterinary medicine there has been a recent explosion in the development of non-steroidal anti-inflammatory medications for the control of animal pain, particularly pain associated with canine arthritis. These medications act by inhibiting cyclo-oxygenase (abbreviated "COX"), an enzyme that leads to production of assorted inflammatory biochemicals. Suppressing this enzyme, suppresses the pain as well as the inflammation. Unfortunately, cyclo-oxygenase also helps produce some much needed biochemicals and it becomes tricky to suppress production of inflammatory products while keeping the helpful ones. Occasionally, a dog will develop a reaction to one of these anti-inflammatory medications or will develop a liver or kidney problem which is incompatible with their use. These dogs still require pain management and for these patients, a “mu” agonist like tramadol may be just the ticket.

Tramadol can be used separately or in combination with non-steroidal anti-inflammatory drugs and can also be used in cats (whereas non-steroidal anti-inflammatory drugs have limited use).

HOW THIS MEDICATION IS USED:

  • Tramadol can be used for pain relief in both dogs and cats. (Most non-steroidal anti-inflammatory drugs are not safe for feline use so tramadol provides a nice choice for cats with chronic pain issues).
     
  • Tramadol is given two to three times daily.

SIDE EFFECTS:

Side effects are considered rare but we list the following for completeness:

  • Upset stomach is occasionally observed with tramadol.
     
  • Pupil constriction and panting may occur with this medication.
     
  • Tramadol has some ability to suppress coughing.
     
  • Decreased heart rate may result but should not be problematic.
     
  • Constipation may be a side effect.
     
  • Overdose may manifest as seizures, pinpoint pupils, and mental alterations. Seek veterinary assistance at once should any of these occur.

If a pet develops apparent sedation or bizarre behavior, the tramadol dose should be reduced.

INTERACTIONS WITH OTHER DRUGS:

The beauty of this pain reliever is that it is compatible with all the COX -inhibiting non-steroidal anti-inflammatory drugs, possibly even synergizing with them. It is also compatible with joint pain nutriceuticals such as glucosamine, MSM, chondroitin sulfate etc.

Tramadol is NOT compatible with Deprenyl. Animals taking deprenyl either to control Cushing’s Syndrome or to control senility may not take any sort of narcotic medication including tramadol. Similarly, tramadol is not compatible with other psychoactive drugs such as serotonin reuptake inhibitors, tricyclic antidepressants, or monoamine oxidase inhibitors. If you are not sure if your pet is on one of these medications, check with your veterinarian.

Tramadol may not be compatible with SAMe, a liver and joint support nutriceutical. Until further studies are performed, these two treatments should not be used together.

Tramadol can induce sedation when combined with amitraz, the active ingredient in the Preventic® tick control collar and also in Promeris Canine®, a flea and tick control product recently removed from the market. Amitraz is also sometimes used in the treatment of demodectic mange.

CONCERNS AND CAUTIONS:

Tramadol is not passed to nursing young and should be an acceptable pain reliever for a lactating mother.

  • Tramadol is removed from the body by the liver (70%) as well as via kidney excretion (30%). Should disease be present in either of these systems, a dose reduction may be necessary.
     
  • A human product called “Ultracet®” is available. It contains acetaminophen in addition to tramadol. This product is NOT safe for cats at any dose and requires specific veterinary instruction if it is to be used in dogs. Never use your own medication on your pet.

Tramadol can cause seizures in humans and thus should be used cautiously in animals with a history of seizures.

If discontinuing tramadol after long term use, it is recommended that it be tapered off rather than abruptly discontinued.

Page last updated: 630/2011