Poltram – indications, contraindications, dosage, interactions, side effects

Poltram is an opioid analgesic drug containing tramadol. The drug is used in the form of oral drops or tablets and is issued on prescription. The active substance tramadol has a narcotic analgesic effect, comparable to that of morphine. Contrary to morphine, Poltram in the recommended doses does not disturb the functioning of the respiratory and digestive systems. This preparation is intended for the relief of moderate to high intensity pain.

Poltram, Producer: Polpharma

Poltram – indications for use

Poltram is a preparation indicated in the treatment of moderate and high intensity pain. Its active substance tramadol has a narcotic effect and is compared to morphine.

Also check the action of other drugs that belong to the group of opioid drugs

Poltram – contraindications to use

Contraindications to the use of Poltram are:

1. hypersensitivity to any component of the preparation or other opioid analgesics,
2. acute intoxication with alcohol, hypnotics, centrally acting analgesics, including opioids or psychotropic drugs,
3. epilepsy that is not amenable to treatment
4. simultaneous use of MAO inhibitors (tramadol should not be used during and 14 days after treatment with MAO inhibitors),
5. treatment of opioid dependence.
6. should not be used in children under 14 years of age.

Poltram – dosage

The preparation is in the form of drops or tablets and should be taken orally. The drops can be taken with the sugar method with a little liquid. Can be taken with or without food. An individual dose is always selected by a doctor, based on the intensity of the pain and the patient’s response. You absolutely should not exceed the recommended dose, as it may harm your life or health.

1. Adults and children over 12 years of age: usually 50-100 mg (20-40 drops or 4-8 actuations of the dosing pump) every 4-6 hours (the maximum daily dose is 400 mg per day, unless the doctor decides otherwise).
2. Patients after the age of 75, as well as patients with moderate renal or hepatic insufficiency, the doctor will probably recommend an appropriate extension of the intervals between doses.
3. People with severe renal insufficiency should not use this preparation.

Poltram – warnings

1. Caution should be exercised in opioid-dependent patients with shock, head trauma, impaired consciousness, respiratory distress, increased intracranial pressure or increased sensitivity to opioids.
2. People who have problems with the functioning of the respiratory center and use drugs that suppress it should exercise caution.
3. Seizures (over 400 mg per day) may occur in people taking the drug in high doses.
4. People suffering from epilepsy and at risk of seizures, may only take the drug if the doctor agrees.
5. Patients taking tramadol may become addicted to the drug.
6. People who have problems with drug abuse should be under constant medical supervision while taking Poltram.
7. Tramadol should not be used as a replacement therapy in opioid dependent people.
8. Tramadol should not be used as a replacement therapy in opioid addicts.
9. Patients with hepatic and renal failure should monitor plasma levels.
10. There is a risk of awakening the patient when tramadol is used in parallel with drugs inducing mild anesthesia.
11. Mental / physical impairment may occur, e.g. when driving a motor vehicle.

Poltram with other medications

Poltram should not be used simultaneously with:

1. MAO inhibitors (as central nervous system stimulation or depression may occur with hypertension or hypotension). Treatment with tramadol can be started 14 days after stopping the MAO inhibitor treatment.
2. tramadol may induce seizures, and also increase the potency of drugs such as: serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, antipsychotics, other drugs that lower the seizure threshold,
3. carbamazepine, as it may weaken and shorten the duration of action of tramadol
4. pentazocine, nalbuphine, butorphanol, buprenorphine as they may reduce the effect of tramadol,
5. reuptake inhibitors – may cause serotonin syndrome
6. coumarin derivatives (e.g. warfarin) – the INR may be increased (formation of major bleeding and petechiae)
7. with drugs metabolized in the liver by the cytochrome P-3 isoenzyme CYP4A450, which inhibits this metabolic process (erythromycin, ketoconazole) – may increase the concentration of tramadol in the blood (by inhibiting its degradation),
8. Poltram should not be mixed with alcohol.

Poltram – side effects

1. Mood disturbances (usually excitement, sometimes dysphoria), changes in activity (usually a decrease, sometimes an increase), excessive fatigue, and changes in cognitive and sensory perception (e.g. decision-making behavior, visual disturbances) may appear.
2. May occur: addiction. Symptoms similar to those seen with opioid withdrawal may occur following abrupt withdrawal: agitation, restlessness, nervousness, sleep disturbances, hyperkinesia, tremors, and gastrointestinal disturbances.
3. Very often the following may occur: dizziness, headache, somnolence, nausea.
4. Often the following may occur: vomiting, constipation, diarrhea, dry mouth, sweating.
5. Uncommon: belching, gastrointestinal irritation (e.g. abdominal fullness, pressure in the stomach), skin reactions (itching, rash, hives).
6. Rarely may occur: changes in appetite, paraesthesia, tremor, respiratory depression, cerebral seizures, hallucinations, confusion, sleep disturbances and nightmares, blurred vision, weakness in skeletal muscles, micturition disorders (urination disorders, urinary retention), allergic reactions (e.g. dyspnoea, bronchospasm, wheezing, angioedema) and anaphylactic shock.
7. Other side effects that have occurred in rare cases after stopping tramadol are: panic attacks, severe anxiety, hallucinations, paraesthesia, ringing in the ears and other central nervous system symptoms. Occasionally, an increase in liver enzymes has occurred after administration of tramadol.