Like other opioid painkillers, tramadol may cause side effects that are particularly noticeable among older individuals. These side effects may include nausea, vomiting, urinary retention and constipation – with long-term users even possibly experiencing withdrawal symptoms as they taper off use.
In this study, new and continuing tramadol users had an increased risk of emergency room (ER) visits, injurious falls/hip fractures, cardiovascular disease hospitalizations and safety event hospitalizations compared with nonusers.
Tramadol Side Effects in Elderly People
Nausea and vomiting
As with any medication, tramadol comes with risks. To assess its potential adverse reactions in older individuals and assess potential benefits against potential risks.
Elderly adults must take tramadol only as prescribed. Exceeding dosage or taking longer than intended could cause dangerous side effects such as breathing issues and sedation that may prove life-threatening.
Tramadol works by altering how your brain and nervous system respond to pain. Being an opioid, it acts like morphine in your body – however, its long-term use may become habit forming.
Mixing tramadol with opioids, benzodiazepines or any central nervous system depressants (including alcohol) may result in extreme fatigue, slow breathing, respiratory depression and eventually coma or even death. Furthermore, this combination can increase your risk of seizures.
Diarrhea
Diarrhea can be a significant health threat for seniors, leading to dehydration, malnutrition, electrolyte imbalances and even infections that may be more difficult for weakened immune systems to fight than for younger populations.
Elderly individuals experiencing diarrhea should immediately reach out to their healthcare team. A physician can test a stool sample or take rectum swabs in order to diagnose their symptoms and offer solutions and recommendations.
Anti-motility medications like Imodium (Loperamide) and Bismuth Subsalicylate (Pepto-Bismol) can often help stop diarrhea in its tracks. A doctor may also examine an individual’s breathing rate to see if they are experiencing respiratory distress, order blood tests to evaluate kidney function, or schedule a colonoscopy in order to rule out complications caused by an underlying medical condition that could be contributing to it.
Constipation
Constipation is one of the more frequent side effects of tramadol. To combat constipation, ensure you drink enough water and consume foods rich in fiber; you could also consider an over-the-counter laxative like Senokot.
When measuring liquid tramadol dosages be sure to use either a medication dose cup or oral syringe instead of household spoons which could give an incorrect reading.
Elderly patients taking tramadol may be at increased risk for constipation. This could be because their kidneys or liver aren’t working as effectively, or due to medications combined with health conditions such as dementia or spinal cord injury; symptoms of constipation in this age group typically include frequent bowel movements with hard stools; however, its importance cannot be overemphasized as constipation in this age range may lead to serious health complications.
Sedation
Tramadol (a centrally acting synthetic opioid analgesic and serotonin/norepinephrine reuptake inhibitor) has become more widely prescribed among elderly individuals due to its perceived safety advantages over stronger opioid medications.
Unfortunately, elderly are more prone to complications associated with sedation including hyponatremia and decreases in physiological reserve than other populations, making this medication even more problematic in this group.
Tramadol can interact with numerous medications used to treat depression, including selective serotonin reuptake inhibitors such as fluoxetine, paroxetine and amitriptyline as well as CYP2D6 inhibitors such as erythromycin and ketoconazole.
People taking MAO inhibitors like isocarboxazid (Marplan), linezolid (Zyvox), or phenelzine (Nardil) should not take tramadol. Inform your physician if you experience slow or difficult breathing, asthma symptoms, or lung diseases as they could impact this medication’s effects negatively.
Serotonin syndrome
Serotonin syndrome is a potentially life-threatening side effect caused by taking medications that alter serotonin levels too much in your body, increasing serotonin levels by too much and leaving too much serotonin behind in your system.
Serotonin acts as a neurotransmitter to regulate mood and other bodily processes; medications which increase serotonin include certain antidepressants, pain killers, migraine medications and some dietary supplements; serotonin syndrome can also occur if certain combinations or doses of an increase serotonin drug are combined together or increased;
Family physicians can help prevent serotonin syndrome by informing their patients about its signs and symptoms, such as high body temperature, rapid heart rate, dilated pupils, confusion and muscle rigidity.
The symptoms often develop within hours after taking new or increased doses of medication that increases serotonin such as selective serotonin reuptake inhibitors (SSRIs), triptans for migraine or one containing monoamine oxidase inhibitors.
Respiratory depression
If you suffer from liver disease, have an obstruction in the stomach or intestines, or suffer from paralytic ileus (when digested food fails to move through your digestive tract), taking tramadol could put you at increased risk for breathing difficulties while on treatment.
Your physician will monitor your breathing rate prior to beginning and after any dosage increases of tramadol as well as conducting blood tests to check kidney and liver functions during and post treatment with this drug.
Tramadol may have lower abuse potential than opioids such as pethidine and oxycodone, yet still cause side effects that are detrimental to older adults, including serotonin syndrome and respiratory depression. Tramadol is classified as a Schedule IV controlled substance and should never be combined with benzodiazepines as this may lead to profound sedation, slow breathing and possibly coma or death.
How Much Tramadol Can An Elderly Person Take?
Initial Dose and Gradual Increase
According to UpToDate, prescribing guidelines recommend an initial dose of 25 mg of tramadol orally once daily for older adults.
After 3 to 7 days, the daily dosage may be increased by 25 to 50 mg. To ensure optimal effectiveness, the increased dose should be administered in 3 or 4 divided doses throughout the day.
Maximum Daily Dose and Individual Considerations
The maximum daily dose of tramadol for elderly individuals is 300 mg per day. However, it’s crucial to note that dosages should be adjusted for elderly, cachectic, or debilitated patients.
These individuals may have altered pharmacokinetics or clearance compared to younger and healthier patients.
Importance of Individualized Approach
In practical terms, it is recommended to carefully titrate the tramadol dosage based on an individual’s response. This means that the dose should be tailored to each patient’s specific needs and tolerance.
Consulting a healthcare professional, such as a doctor, is vital before initiating tramadol treatment to determine the appropriate dosage and ensure safe administration.
Prioritize Safety and Expert Guidance
Given the potential complexities of prescribing tramadol for elderly individuals, it is crucial to prioritize their safety and well-being. Elderly patients should work closely with their healthcare providers to establish a personalized treatment plan that considers their unique circumstances and potential interactions with other medications.
