TRAMADOL VS GABAPENTIN ARE THE TWO MOST TRENDING PAIN KILLER

tramadol vs gabapentin

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Tramadol who is sold under the brand name of Ultram, typically doctors prescribe Tramadol for severe pain when over-the-counter drugs (OTC) do not help, such as pain after an accident or medical procedures such as surgery. In contrast, Gabapentin is known by the brand name Neurontin, is a prescription analgesic that belongs to its own class of drugs, the gabapentinoids. 

Gabapentin is also considered antispasmodic and is used to treat epilepsy, restless leg syndrome, hot flushes, and neuropathic pain. Last December, the Ohio Board of Pharmacy began notifying the FDA to sell gabapentin prescriptions for regular monitoring as a controlled substance. The FDA determined that Gabapentin was the most commonly prescribed drug on its list last December, surpassing oxycodone by more than 9 million doses to become the most trending pain killer in the USA.

If you are prescribed Rimadyl (r), generic carprofen, or another type of non-steroidal anti-inflammatory medication (NSAIDs), you should not think twice about your pain control plan. People with young children may want to avoid these drugs, as one single accidental dose can be fatal for them. After the initial positive effects, the pain worsens over time and becomes inadequate, so supplement it with other, more specific, stronger painkillers.

What is Tramadol and Gabapentin? How do they work?

Tramadol is a pain medication consumed to treat moderate to moderately severe pain. After the consumption, an individual will start feeling relief from pain, usually within an hour. For people who have trouble or are not fond of taking a pill, the medication is also available in injection.

On the other hand, Gabapentin is a medication to treat partial seizures and neuropathic pain. It is also the first choice for treating neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain. 

What are the uses of Tramadol vs. Gabapentin?

Doctors prescribe Tramadol and Vicodin (Vicodin) for moderate to severe pain. When choosing between Tramadol and Vicodin, the differences in benefits, side effects, and risks should be considered. In dogs, sedation and gastrointestinal side effects are more likely. The use of Tramadol and Gabapentin, especially for dog pain, increases the risk of side effects, says veterinarian Dr. Tom Crippen. 
Like a glass of wine, Tramadol boosts mood and acts as an emotion-altering drug; studies on Gabapentin don’t look quite so rosy. 

Gabapentin treats nerve pain, alcohol and cocaine withdrawal, restless legs syndrome, diabetic neuropathy, fibromyalgia, and seizures. Gabapentin creates feelings of relaxation and serenity to help with nerve pain and anxiety, and sleep disturbances. 

What's the difference between Tramadol and Gabapentin? 

Our purpose in the current study is to test the hypothesis that the analgesic effects of Tramadol in combination with Gabapentin in rats models for the pain incisions are similar or better than buprenorphine. Its practical suitability in the laboratory reinforces additional advantages of Tramadol vs. Gabapentin as a controlled substance category. 

  • Gabapentin was the first approved medication in 1993, whereas Tramadol was approved almost after two years, in 1995. 
  • The side effects of Gabapentin include ataxia, dizziness, drowsiness, fatigue, fever, nystagmus disorder, sedated state, and viral infection. In comparison, the side effects of Tramadol include pruritus, agitation, anxiety, constipation, diarrhea, hallucination, nausea, tremor, vomiting, and diaphoresis.
  • The cost is $22.42; Gabapentin raises the bar as Tramadol stands at $11.72. 
    With the different brand names of Gabapentin- Fanatrex, Gabarone, Gralise, Neurontin. For tramadol- ConZip, Qdolo, Tramadol Hydrochloride ER, Ultram. 
    If you see for pregnancy purposes, then with both the medications, risk cannot be ruled out. 
  • Total of 223 drugs interact with Gabapentin; on the contract total of 542 drugs are there that interact with Tramadol. 
  • Mentioning more about the interaction but with alcohol, food, and lifestyle, both the medication carry the same luggage. For alcohol, it can increase the nervous system side effects of both pain killers, such as dizziness, drowsiness, and difficulty concentrating. Also, alcohol should be avoided when treating both pills. Take care that you don’t consume more than the recommended dose and avoid activities that want you to be mentally alert, such as driving or working with any machinery. Always rings the bell of the doctor if you have any questions or concerns.
  • Dosage form available for Gabapentin is- Oral capsule, Oral solution, and Oral tablet, whereas for Tramadol it is- Oral capsule, extended-release, Oral tablet.
  • Both the drugs’ disease interacts with – Drug dependence, Renal dysfunction, and Suicidal tendency.
  • Additionally, Gabapentin interacts with diseases like- Hemodialysis.
  • Tramadol interacts with diseases like- Gastrointestinal obstruction, Acute alcohol intoxication, Liver disease, Seizure disorders, Acute abdominal conditions, Intracranial pressure, Respiratory depression.

What are the side effects, dosages, and precautions of Tramadol and Gabapentin?

Side effects of Tramadol: –

Some of the common side effects- 

  • Stomach pain
  • Constipation.
  • Headache.
  • Itching.
  • Drowsiness. 
  • Tiredness.

Visit your doctor once if you experience any of these- 

  • Weak pulse or slowdown of heart rate.
  • Shortness of breath while sleeping may occur death too. 
  • Loss of appetite, worsening tiredness, or weakness.
  • Vomiting. 
     Swelling of face or throat.  

Rush to your doctor soon if you develop symptoms like-

  • agitation
  • hallucinations 
  • fever
  • sweating 
  • shivering
  • fast heart rate 
  • muscle stiffness
  • twitching
  • loss of
  • coordination 
  • nausea

Dosage of Tramadol: –

  • For Adults aged 17 or more than that, it is recommended to take 50 to 100 mg orally every 4 to 6 hours as needed for pain.
  • For patients not requiring immediate onset result, the initial dose will be 25 mg orally once a day; titrate in 25 mg increases every three days to hit a dose of 25 mg 4 times a day; after that, increase by 50 mg tolerated every three days.
  • Maximum dose for can day can go up to 400 mg.

Precautions: – 

  • Do not consume alcohol while medicating with Tramadol.
  • Tramadol can impair your thinking. So, make sure you don’t do activities that demand alertness of mind.
  • Do not change the dose. Take as per the prescription of a doctor.
  • Swallow the whole Tramadol at once.
  • Do not try to break, chew, crush or dissolve other than swallowing.
  • Take the dose simultaneously every day; if you miss your dose, take it on the next day at the usual time.
  • If you don’t feel any change in your plan, talk to your doctor. Don’t skip or stop taking the pills on your own. 

Side effects of Gabapentin: –

Visit your doctor immediately if you have any of these side effects –

  • Unsteadiness
  • continuous, back-and-forth, or rolling
  • eye movements
  • More common in children-
  • Aggression or behavior problems. 
  • Anxiety
  • Problem in concentrating.
  • Crying/ depression.
  • Hyperactivity
  • Development of Suspiciousness or
  • distrust.
  • Constant mood changes. 
  • Less common side effects-
  • Black, tarry stools.
  • Pin in chest
  • Cough
  • Fever
  • Sore throat
  • Weakness
  • Difficulty or pain while urinating. 
  • Incidences that are not known-
  • Dark urine.
  • Decrease urine output
  • Irregularity in heartbeat
  • Coma
  • Stomach pain, joint pain
  • Headache
  • Skin rash
  • loss of appetite.
  • Irritation in eyes.
  • Vomiting of blood
  • Yellow eyes or skin
  • Pale or blue lips, skin or fingernails.  

Side effects that do not require immediate medical attention-

  • Blurred in vision.
  • Lack or loss of strength. 
  • Hoarseness.
  • Delusions.
  • Cold or flu-like symptoms. 
  • Swelling of hands, feet, or lower legs. 
  • Less common or rare side-effects-
  • Increased hunger.
  • Noises in the ear.
  • Constipation.
  • Sneezing and running nose.
  • Weight gain
  • Eye discharge
  • Sweating

Dosage of Gabapentin: -

In contrast to conventional efficacy studies, the pain data resulting from these studies were used in conjunction with the modeling and simulation concepts to validate the dosage logic for children between 3 months and 3 years. During the development of the oral and liquid formulations of Gabapentin, the application and dosage of the drug were optimized using pharmacokinetic and pharmacodynamic modeling to combine data from adults with data from children. The advantage was the possibility that children who had Tramadol, Gabapentin, and PRN (ibuprofen) during the recovery period reportedly had better pain control and fewer side effects than children who received these other medications. 

Precautions: - 

  • Avoid consumption of alcohol. 
  • Do not consume Gabapentin if you are allergic to it. 
  • Avoid driving or any hazardous activity which involves machinery.
  • Avoid taking an antacid within 2 hours before you take Gabapentin. 

Are Gabapentin and Tramadol addictive?

Tramadol can be addictive even if at the prescribed dosage, especially if one takes for a longer period or when consumed in larger doses than prescribed

Drug interaction of Tramadol and Gabapentin-

For Tramadol-

  • There are 293 major drug interactions.
  • 246 average drug interactions
  • Three slight drug interactions.

For Gabapentin-

  • There are 26 major drug interactions.
  • 187 average drug interactions
  • Ten slight drug interactions

Tramadol vs Gabapentin for back pain- 

  • Gabapentin is an anti-seizure treatment used to disallow seizures and to medicate postherpetic neuralgia, the pain that follows multiple shingles.
  • Tramadol is an opioid pain aid used to manage common to moderately severe pain. 

Tramadol vs. Gabapentin for anxiety-

  • Tramadol can help reduce anxiety and depressions.
  • Whereas, Gabapentin is not used to reduce anxiety. It is more often given to ease the anxiety symptoms for those whose who are undergoing depression and bipolar disorder. It may not help only for anxiety. 

Is it safe to take Tramadol or Gabapentin while being pregnant or breastfeeding? 

  • Researchers have not yet established the safety of Tramadol for pregnant women. 
  • Healthcare professionals should precisely take care that breastfeeding should not be done during the medication of Tramadol as it will have a serious adverse effect on the infant with the developing symptoms of excess sleepiness, serious breathing problems, which may also result in death.  
  • As far as Gabapentin is concerned, it is not recommended to the pregnant lady, but for the safety of women, it is usually advised only if the benefit of the medicines outweigh the harm. 
  • For breastfeeding, no adverse effects have been seen in the infants who are exposed to Gabapentin. if the mother is taking the medications, it has been recommended to monitor the infant.

Conclusion

Tramadol and Gabapentin are both the most consumed pain killers. They both have their respective side effects, dosages, and precautions. Some of the things are common in both the medication. It is always recommended that starting or discontinuing both drugs should be prescribed by health care professionals only.

References

 
ESI–LC–MS/MS for Therapeutic Drug Monitoring of Binary Mixture of Pregabalin and Tramadol: Human Plasma and Urine Applications, Separations, 10.3390/separations8020021, 82, (21), (2021)
 
. (2019) Development of a novel LC–MS/MS method for detection and quantification of tramadol hydrochloride in presence of some mislabeled drugs: Application to counterfeit study. Biomedical Chromatography 33:6, pages e4486.
 Accessed date July 8th 2021
 
 
Ko SH, Kwon HS, Yu JM, Baik SH, Park IB, Lee JH, Ko KS, Noh JH, Kim DS, Kim CH, Mok JO, Park TS, Son HS, Cha BY. Comparison of the efficacy and safety of tramadol/acetaminophen combination therapy and gabapentin in the treatment of painful diabetic neuropathy. Diabet Med. 2010 Sep;27(9):1033-40. doi: 10.1111/j.1464-5491.2010.03054.x. PMID: 20722677.
https://pubmed.ncbi.nlm.nih.gov/20722677/ Accessed date July 8th 2021
 
McKeon GP, Pacharinsak C, Long CT, et al. Analgesic effects of tramadol, tramadol-gabapentin, and buprenorphine in an incisional model of pain in rats (Rattus norvegicus)J Am Assoc Lab Anim Sci. 2011;50(2):192-197. Accessed date July 8th 2021