Potentially Fatal: Respiratory depression. Possible increase in anticoagulation with warfarin. Reduced analgesic efficacy of tramadol with carbamazepine, 5-HT3-receptor antagonist e. Suicidal patients, acute alcoholism; head injuries; raised intracranial pressure; severe renal impairment; lactation. Tramadol inhibits reuptake of norepinephrine, serotonin and enhances serotonin release. It alters perception and response to pain by binding to mu-opiate receptors in the CNS.

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If a person is not breathing, or if they are unresponsive, seek help straight away. Tramadol is used for the short-term relief of severe pain. Tramadol is not usually recommended for the treatment of chronic long-term pain. Tramadol works directly on opioid receptors in the central nervous system and reduces feelings of pain by interrupting the way nerves signal pain between the brain and the body. Tramadol is also available in a combination tablet together with paracetamol. This can increase your risk of paracetamol overdose. All opioids, including tramadol, can have side effects that include life-threatening breathing problems.

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