Tramadol is often prescribed "as needed," which means that you do not need to take a dose if you do not feel pain. If you forget to take a dose, however, and notice significant pain, take your missed dose right away. However, make sure to wait the recommended time before the next dose.
How Does Tramadol Work?
Tramadol is classified as a "centrally acting opioid analgesic." This means that it works in the central nervous system (the brain and spinal cord), acts much like morphine in the body, and relieves pain. Much like morphine, tramadol binds to certain opioid receptors in the body known as μ ("mu") receptors.
Tramadol also works in a similar manner as some antidepressant medications by inhibiting the reuptake of certain brain chemicals (serotonin and norepinephrine). These are two of several chemicals used to send messages from one nerve cell to another. As a message travels down a nerve, it causes the end of the cell to release serotonin or norepinephrine. The serotonin or norepinephrine enters the gap between the first nerve cell and the one next to it. When enough serotonin or norepinephrine reaches the second nerve cell, it activates receptors on the cell and the message continues on its way. The first cell then quickly absorbs any serotonin or norepinephrine that remains in the gap between cells. This is called "reuptake."
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U.S. Department of Justice, Drug Enforcement Administration, Office of Diversion Control. Drugs and chemicals of concern: tramadol (9/2008). DEA Web site. Available at: http://www.deadiversion.usdoj.gov/drugs_concern/tramadol.htm. Accessed December 16, 2008.
U.S. Drug Enforcement Administration. Schedules of controlled substances: placement of tramadol into Schedule IV (July 2, 2014). DEA Web site. Available at: http://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0702.htm. Accessed September 21, 2014.
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