The round and white pill which is imprinted with AN 627 is tramadol 50mg. Tramadol is a centrally acting analgesic with potency ranging from weak opioids and morphine.
The drug belongs to the family of opioid analgesics. It was introduced in the United States in the mid-’90s. Chemically speaking, the opioid can be classified as a cyclohexanol.
This man-made opioid painkiller is similar to other opioid drugs like oxycodone, fentanyl (a synthetic opioid which is more toxic than most other opioids), or morphine. Tramadol can be found under the following brand names:
- Ultram ER;
- Rybix ODT;
Street Value of AN 627 Pill
The cost ranges between 1 to $5 per pill.
Uses of Tramadol 50 mg
It is used for the treatment of moderate to severe pain.
In addition, this drug may be used alone or combined with non-narcotic pain medications, such as – acetaminophen (a drug that belongs to a family of drugs called analgesics and antipyretics).
The mechanism of action is not exactly known, but specialists do know that it acts on noradrenergic and serotonergic nociception, while its metabolite O-desmethyltramadol ((O-DSMT) acts on the µ-opioid receptor.
The peak plasma concentration of this drug after an oral intake is 1.6 to 1.9 hours. It completely penetrates the blood-brain barrier (acting as a strict control point for what can enter the brain).
This man-made opioid has 10 percent the potency of morphine with regards to its pain-relieving attribute and is as potent as codeine.
The most common adverse events associated with this synthetic opioid treatment include:
- dry mouth;
- joint pain;
- skin itching;
- lower abdominal pain;
- loss of body strength;
- sore throat;
- loss of concentration;
- mood swings;
- stuffy nose;
- feeling unusually cold;
- excessive sweating;
- muscle pain and aches;
- skin rashes;
- loss of appetite;
- fever (high temperature).
Serious side effects may include:
- seizure (convulsions);
- shallow breathing;
- missed menstrual periods;
- loss of interest in sex;
- noisy breathing;
- weak pulse;
- a slow heart rate;
- worsening tiredness;
- a light-headed feeling like you might pass out.
Important note – according to a report in MedPage Today, in 2011, this synthetic opioid was linked to over 20,000 emergency department visits in the United States.
The dose should be adjusted according to the severity of pain. However, the usual recommended initial dose is 50 mg once or twice per day.
The dosage can be 300 mg per day in elderly patients and 400 mg per day in patients without hepatic or renal dysfunction.
The maximum recommended dose is 400 mg per day. Exceeding this limit, either alone or in combination with other central nervous system depressants, are a cause of drug-related deaths.
Warnings & Precautions
Tell your healthcare provider right away if you have thoughts about hurting yourself or start to feel more depressed since it can increase thoughts of suicide.
It is contraindicated in people treated with monoamine oxidase inhibitors. Also, the risk of convulsions may increase in people with a history of seizures, those with epilepsy (the 4th most common neurological disorder), or in people with a recognized risk for seizure, like:
- metabolic disorders;
- head trauma;
- drug and alcohol withdrawal;
- central nervous system infections.
Addiction & Abuse
Similar to other narcotics, tramadol can be highly addictive. Some people become mentally addicted to this opioid the first time they use it, however, it usually takes several months before an addiction to the medication develops.
Signs of abuse include:
- excessive drowsiness;
- pinpoint pupils (due to stimulation of the parasympathetic side of the autonomic nervous system);
- changes in appetite;
- an incapacity to limit use on one’s own;
- slurred speech;
- seizures (without a history of epilepsy);
- difficulty functioning without the opioid;
- compulsive drug-seeking behavior.
Important note – to lower the risk of addiction, your healthcare provider should have you take the smallest dose of this synthetic opioid which works, for the shortest possible time.
Withdrawal from this medication does not occur only in patients who abuse the opioid but also in people who use the drug as prescribed for long periods of time.
Common withdrawal symptoms upon suddenly stopping the drug use may include:
- fast heart rate;
- a runny nose;
- muscle cramps;
- loss of appetite;
- increased anxiety;
- stomach cramps;
- feeling irritable or restless;
- trouble sleeping;
- body aches;
- increased blood pressure;
- fast breathing rate;
- high anxiety;
- teary eyes;
- joint pain;
- back pain;
- muscle aches;
- excessive sweating.
This man-made opioid can interact with other vitamins, medications, or herbs you may be taking, but more especially with:
- Neurontin (gabapentin);
- Ambien (zolpidem);
- Percocet (acetaminophen/oxycodone);
- Benadryl (diphenhydramine);
- Suboxone (buprenorphine/naloxone);
- Celebrex (celecoxib);
- Zyrtec (cetirizine);
- Cymbalta (duloxetine);
- Zoloft (sertraline);
- Flexeril (cyclobenzaprine);
- Xanax (alprazolam);
- Norco (acetaminophen/hydrocodone);
- Lyrica (pregabalin).
Is It Safe During Pregnancy or Breastfeeding?
According to the US Food and Drug Administration classification of drugs, this opioid falls under the category C.
Data from studies conducted on animal models established that this medication can cause moderate to severe side effects in the developing babies.
In addition, this drug has been shown to cross the placental barrier (an important tissue barrier which separates the developing fetus from the mother).
There are case reports of withdrawal symptoms in newborn babies following exposure to the medication in the womb.
Moreover, the US FDA recommends against the use of the medication during breastfeeding since it passes to the infant through breast milk. However, the amount of drug excreted into breastmilk is much less than the dosage which has been given to newborn babies for analgesia.
People taking this man-made opioid should not combine it with alcoholic beverages since both substances are CNS depressants, that actually means they can slow down brain function when mixed.
In addition, mixing this opioid with alcohol can significantly increase the chances of overdosing on either substance.
Sources https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755854/ http://journals.sagepub.com/doi/pdf/10.1177/201010581102000311 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610115/ https://www.hindawi.com/journals/jad/2017/6716929/