Tìm theo
Tramadol
Các tên gọi khác (2) :
  • (+)-Tramadol
  • (+)-trans-2-(Dimethylaminomethyl)-1-(m-methoxyphenyl)cyclohexanol
Thuốc giảm đau, hạ sốt, chống viêm không steroid, điều trị Gút và các bệnh xương khớp
Thuốc Gốc
Small Molecule
CAS: 27203-92-5
ATC: N02AX02
ĐG : 4uOrtho LLC , http://www.4udr.com
CTHH: C16H25NO2
PTK: 263.3752
A narcotic analgesic proposed for moderate to severe pain. It may be habituating. [PubChem] Tramadol is also prepared as a variable release capsules, marketed under the brand name ConZip. For example, a 150 mg capsule will contain 37.5 mg of the immediate release form and 112.5 mg of the extended release form.
Nhận Dạng Quốc Tế & Đặc Tính Hóa Học
Công thức hóa học
Phân tử khối
263.3752
Monoisotopic mass
263.188529049
InChI
InChI=1S/C16H25NO2/c1-17(2)12-14-7-4-5-10-16(14,18)13-8-6-9-15(11-13)19-3/h6,8-9,11,14,18H,4-5,7,10,12H2,1-3H3/t14-,16+/m1/s1
InChI Key
InChIKey=TVYLLZQTGLZFBW-ZBFHGGJFSA-N
IUPAC Name
(1R,2R)-2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexan-1-ol
Traditional IUPAC Name
tramadol
SMILES
COC1=CC=CC(=C1)[[email protected]@]1(O)CCCC[[email protected]@H]1CN(C)C
Độ tan chảy
180-181 °C
Độ hòa tan
Soluble
logP
2.4
logS
-2.5
pKa (strongest acidic)
13.8
pKa (Strongest Basic)
9.23
PSA
32.7 Å2
Refractivity
78.27 m3·mol-1
Polarizability
30.45 Å3
Rotatable Bond Count
4
H Bond Acceptor Count
3
H Bond Donor Count
1
Physiological Charge
1
Number of Rings
2
Bioavailability
1
Rule of Five
true
Ghose Filter
true
pKa
9.41
Dược Lực Học : Tramadol, a centrally-acting analgesic, exists as a racemic mixture of the trans isomer, with important differences in binding, activity, and metabolism associated with the two enantiomers. Although its mode of action is not completely understood, from animal tests, at least two complementary mechanisms appear applicable: binding of parent and M1 metabolite to μ-opioid receptors and weak inhibition of reuptake of norepinephrine and serotonin. Opioid activity is due to both low affinity binding of the parent compound and higher affinity binding of the O-demethylated metabolite M1 to μ-opioid receptors. In animal models, M1 is up to 6 times more potent than tramadol in producing analgesia and 200 times more potent in μ-opioid binding. Opiate antagonist naloxone only partially antagonized tramadol-induced analgesia.
Cơ Chế Tác Dụng : A narcotic analgesic proposed for moderate to severe pain. It may be habituating. [PubChem] Tramadol is also prepared as a variable release capsules, marketed under the brand name ConZip. For example, a 150 mg capsule will contain 37.5 mg of the immediate release form and 112.5 mg of the extended release form. Tramadol and its O-desmethyl metabolite (M1) are selective, weak OP3-receptor agonists. Opiate receptors are coupled with G-protein receptors and function as both positive and negative regulators of synaptic transmission via G-proteins that activate effector proteins. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine and noradrenaline is inhibited. The analgesic properties of Tramadol can be attributed to norepinephrine and serotonin reuptake blockade in the CNS, which inhibits pain transmission in the spinal cord. The (+) enantiomer has higher affinity for the OP3 receptor and preferentially inhibits serotonin uptake and enhances serotonin release. The (-) enantiomer preferentially inhibits norepinephrine reuptake by stimulating alpha(2)-adrenergic receptors.
Dược Động Học :
▧ Absorption :
Racemic tramadol is rapidly and almost completely absorbed after oral administration. The mean absolute bioavailability of a 100 mg oral dose is approximately 75%. The mean peak plasma concentration of racemic tramadol and M1 occurs at two and three hours, respectively, after administration in healthy adults.
▧ Volume of Distribution :
* 2.6 L/kg [male, 100 mg intravenous dose] * 2.9 L/kg [female, 100 mg intravenous dose]
▧ Protein binding :
20% bound to plasma proteins.
▧ Metabolism :
Hepatic. The major metabolic pathways appear to be N- and O- demethylation and glucuronidation or sulfation in the liver. One metabolite (O-desmethyltramadol, denoted M1) is pharmacologically active in animal models. CYP3A4 and CYP2B6 facilitates the biotransformation of tramadol to N-desmethyl-tramadol. CYP2D6 facilitates the biotransformation of tramadol to O-desmethyl-tramadol.
▧ Route of Elimination :
Tramadol is eliminated primarily through metabolism by the liver and the metabolites are excreted primarily by the kidneys. Approximately 30% of the dose is excreted in the urine as unchanged drug, whereas 60% of the dose is excreted as metabolites.
▧ Half Life :
Tramadol and its metabolites are excreted primarily in the urine with observed plasma half-lives of 6.3 and 7.4 hours for tramadol and M1, respectively.
▧ Clearance :
* 5.9 mL/min/Kg [Healthy Adults, 100 mg qid, MD p.o] * 8.5 mL/min/Kg [Healthy Adults, 100 mg SD p.o] * 6.89 mL/min/Kg [Geriatric, (<75 yr), 50 mg SD p.o.] * 4.23 mL/min/Kg [Hepatic Impaired, 50 mg SD p.o.] * 4.23 mL/min/Kg [Renal Impaired, Clcr10-3mL/min, 100 mg SD i.v.] * 3.73 mL/min/Kg [Renal Impaired, CLcr<5 mL/min, 100 mg SD i.v.] * 6.4 mL/min/Kg [Male following a 100 mg IV dose] * 5.7 mL/min/Kg [Female following a 100 mg IV dose]
Độc Tính : LD50=350mg/kg (orally in mice)
Chỉ Định : Indicated in the treatment of moderate to severe pain. Consider for those prone to constipation or respiratory depression. Tramadol is used to treat postoperative, dental, cancer, and acute musculosketetal pain and as an adjuvant to NSAID therapy in patients with osteoarthritis.
Tương Tác Thuốc :
  • Almotriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Alvimopan Increases levels by receptor binding competition. Discontinue opioid administration at least 7 days prior to administrating Alvimopan.
  • Aminoglutethimide Aminoglutethimide may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Amiodarone Amiodarone may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Amiodarone may decrease the effect of Tramadol by decreasing active metabolite production.
  • Amitriptyline Tramadol increases the risk of serotonin syndrome and seizures.
  • Amoxapine Tramadol increases the risk of serotonin syndrome and seizures.
  • Amprenavir Amprenavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Aprepitant Aprepitant may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Atazanavir Atazanavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Benzphetamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Bosentan Bosentan may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Bromocriptine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Cabergoline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Carbamazepine Carbamazepine may decrease the effect of tramadol by increasing Tramadol metabolism and clearance.
  • Chloroquine Chloroquine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Chlorpromazine Chlorpromazine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Cimetidine Cimetidine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Cimetidine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Cinacalcet Cinacalcet may decrease the effect of Tramadol by decreasing active metabolite production.
  • Citalopram The use of two serotonin modulators, such as citalopram and tramadol, may increase the risk of serotonin syndrome. Consider alternate therapy or monitor for serotonin syndrome during concomitant therapy.
  • Clarithromycin Clarithromycin may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Clomipramine Tramadol increases the risk of serotonin syndrome and seizures. Clomipramine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Clotrimazole Clotrimazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Clozapine Clozapine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Cocaine Cocaine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Conivaptan Conivaptan may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Cyclobenzaprine Increases risk of seizure.
  • Cyclosporine Cyclosporine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Darifenacin Darifenacin may decrease the effect of Tramadol by decreasing active metabolite production.
  • Darunavir Darunavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Delavirdine Delavirdine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Delavirdine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Desipramine Tramadol increases the risk of serotonin syndrome and seizures. Desipramine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Desipramine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Desvenlafaxine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Dexamethasone Dexamethasone may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Dextroamphetamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Dextromethorphan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Dihydroergotamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Diltiazem Diltiazem may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Diphenhydramine Diphenhydramine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Doxepin Tramadol increases the risk of serotonin syndrome and seizures.
  • Duloxetine Duloxetine may decrease the effect of Tramadol by decreasing active metabolite production. Increased risk of serotonin syndrome. Monitor for Tramadol efficacy and symptoms of serotonin syndrome.
  • Efavirenz Efavirenz may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Eletriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Ergoloid mesylate Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Ergonovine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Ergotamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Erythromycin Erythromycin may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Escitalopram Tramadol may increase the risk of serotonin syndrome and seizures.
  • Etravirine Tramadol,when used concomitantly with etravirine (a strong CYP3A4 inducer), may experience a decrease in serum concentration and efficacy due to increased tramadol metabolism and clearance.
  • Fluconazole Fluconazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Fluoxetine The use of two serotonin modulators, such as fluoxetine and tramadol, may increase the risk of serotonin syndrome. Fluoxetine may decrease the effect of tramadol by decreasing active metabolite production.
  • Fluvoxamine Tramadol may increase the risk of serotonin syndrome and seizures.
  • Fosamprenavir Fosamprenavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Fosphenytoin Fosphenytoin may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Frovatriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Furazolidone Tramadol increases the risk of serotonin syndrome and seizure induction by the MAO inhibitor, Furazolidone.
  • Haloperidol Haloperidol may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Haloperidol may decrease the effect of Tramadol by decreasing active metabolite production.
  • Imatinib Imatinib may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Imatinib may decrease the effect of Tramadol by decreasing active metabolite production.
  • Imipramine Tramadol increases the risk of serotonin syndrome and seizures. Imipramine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Indinavir Indinavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Isocarboxazid Tramadol may increase the risk of serotonin syndrome and seizure induction by the MAO inhibitor, isocarboxazid.
  • Isoniazid Isoniazid may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Isoniazid may decrease the effect of Tramadol by decreasing active metabolite production.
  • Itraconazole Itraconazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Ketoconazole Ketoconazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Ketoconazole may decrease the effect of Tramadol by decreasing active metabolite production.
  • Lapatinib Lapatinib may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Lidocaine Lidocaine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Lidocaine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Linezolid Tramadol increases the risk of serotonin syndrome and seizure induction by the MAO inhibitor, Linezolid.
  • Lisdexamfetamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Lopinavir Lopinavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Lopinavir may decrease the effect of Tramadol by decreasing active metabolite production.
  • Maprotiline Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Methadone Methadone may decrease the effect of Tramadol by decreasing active metabolite production.
  • Methamphetamine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Methotrimeprazine Additive CNS depressant effects. Decrease dose of tramadol by 50% if initiating methotrimeprazine therapy. Monitor for increased CNS depression and apply further dosage adjustments as required.
  • Methylergometrine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Metronidazole Metronidazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Miconazole Miconazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Miconazole may decrease the effect of Tramadol by decreasing active metabolite production.
  • Mirtazapine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Moclobemide Tramadol may increase the risk of serotonin syndrome and seizure induction by the MAO inhibitor, moclobemide.
  • Nafcillin Nafcillin may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Naratriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Nefazodone Nefazodone may increase tramadol toxicity by decreasing tramadol metabolism and clearance. Increased risk of serotonin syndrome. Monitor for tramadol toxicity and symptoms of serotonin syndrome.
  • Nelfinavir Nelfinavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Nevirapine Nevirapine may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Nicardipine Nicardipine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Nicardipine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Nilotinib Nilotinib may decrease the effect of Tramadol by decreasing active metabolite production.
  • Norfloxacin Norfloxacin may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Nortriptyline Tramadol increases the risk of serotonin syndrome and seizures.
  • Oxcarbazepine Oxcarbazepine may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Paroxetine Tramadol may increase the risk of serotonin syndrome and seizures. Paroxetine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Pentobarbital Pentobarbital may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Pergolide Pergolide may decrease the effect of Tramadol by decreasing active metabolite production. Increased risk of serotonin syndrome. Monitor for Tramadol efficacy and symptoms of serotonin syndrome.
  • Pethidine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Phendimetrazine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Phenelzine Tramadol may increase the risk of serotonin syndrome and seizure induction by the MAO inhibitor, phenelzine.
  • Phenobarbital Phenobarbital may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Phentermine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Phenytoin Phenytoin may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Pioglitazone Pioglitazone may decrease the effect of Tramadol by decreasing active metabolite production.
  • Posaconazole Posaconazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Primidone Primidone may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Procarbazine Tramadol increases the risk of serotonin syndrome and seizure induction by the MAO inhibitor, Procarbazine.
  • Promethazine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Protriptyline Tramadol increases the risk of serotonin syndrome and seizures.
  • Pyrimethamine Pyrimethamine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Quinidine Quinidine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Quinidine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Quinine Quinine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Ranolazine Ranolazine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Rasagiline Tramadol may increase the risk of serotonin syndrome and seizure induction by the MAO inhibitor, rasagiline.
  • Rifabutin Rifabutin may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Rifampicin Rifampin may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Rifapentine Rifapentine may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance.
  • Ritonavir Ritonavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Ritonavir may decrease the effect of Tramadol by decreasing active metabolite production.
  • Rizatriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • S-Adenosylmethionine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Saquinavir Saquinavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Selegiline Tramadol increases the risk of serotonin syndrome and seizure induction by the MAO inhibitor, Selegiline.
  • Sertraline Tramadol increases the risk of serotonin syndrome and seizures. Sertraline may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Sertraline may decrease the effect of Tramadol by decreasing active metabolite production.
  • Sibutramine Sibutramine may incrase the serotonergic effect of the Tramadol. Concomitant therapy should be avoided.
  • Sitaxentan Sitaxsentan may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • St. John's Wort Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Sumatriptan Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Telithromycin Telithromycin may decrease the metabolism and clearance of tramadol. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of tramadol if telithromycin is initiated, discontinued or dose changed.
  • Terbinafine Terbinafine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Tetracycline Tetracycline may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Thioridazine Thioridazine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Ticlopidine Ticlopidine may decrease the effect of Tramadol by decreasing active metabolite production.
  • Tranylcypromine Tramadol may increase the risk of serotonin syndrome and seizure induction by the MAO inhibitor, tranylcypromine. Tranylcypromine may decrease the effect of tramadol by decreasing active metabolite production.
  • Trazodone The use of two serotonin modulators, such as trazodone and tramadol, may increase the risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Trimipramine Tramadol may increase the risk of serotonin syndrome and seizures.
  • Triprolidine The CNS depressants, Triprolidine and Tramadol, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy.
  • Venlafaxine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
  • Verapamil Verapamil may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Voriconazole Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of tramadol by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of tramadol if voriconazole is initiated, discontinued or dose changed.
  • Zolmitriptan The use of two serotonin modulators, such as zolmitriptan and tramadol, may increase the risk of serotonin syndrome. Consider alternate therapy or monitor for serotonin syndrome during concomitant therapy.
Liều Lượng & Cách Dùng : Capsule - Oral - 100 mg, 150 mg, 200 mg, 300 mg
Tablet - Oral - 50 mg
Tablet, extended release - Oral - 100 mg, 200 mg, 300 mg
Tablet, orally disintegrating - Oral - 50 mg
Dữ Kiện Thương Mại
Giá thị trường
Nhà Sản Xuất
  • Công ty :
    Sản phẩm biệt dược : ConZip
  • Công ty :
    Sản phẩm biệt dược : Durela
  • Công ty : Biovail
    Sản phẩm biệt dược : Ralivia
  • Công ty :
    Sản phẩm biệt dược : Rybix
  • Công ty :
    Sản phẩm biệt dược : Ryzolt
  • Công ty : Grünenthal GmbH
    Sản phẩm biệt dược : Tramal
  • Công ty :
    Sản phẩm biệt dược : Tridural
  • Sản phẩm biệt dược : Ultram
  • Công ty :
    Sản phẩm biệt dược : Zytram XL
Đóng gói
... loading
... loading