{"id":8019,"date":"2026-04-22T22:24:51","date_gmt":"2026-04-22T22:24:51","guid":{"rendered":"https:\/\/bristishpharmacy.co.uk\/?post_type=product&#038;p=8019"},"modified":"2026-09-16T11:00:00","modified_gmt":"2026-09-16T11:00:00","slug":"tamol-x-225mg","status":"publish","type":"product","link":"https:\/\/bristishpharmacy.co.uk\/it\/shop\/tamol-x-225mg\/","title":{"rendered":"Tamol-X 225 mg"},"content":{"rendered":"<div class=\"container\">\n<div id=\"model-response-message-contentr_2bec3de20a52155e\" class=\"markdown markdown-main-panel md-content enable-luminous-fast-follows enable-updated-hr-color stronger tutor-markdown-rendering\" dir=\"ltr\" aria-live=\"polite\">\n<h3 data-path-to-node=\"3\">Clinical Monograph: Tamol-X 225 mg (Tramadol HCl)<\/h3>\n<h2 data-path-to-node=\"4\">1. Classification and Chemical Overview<\/h2>\n<p data-path-to-node=\"5\">Tramadol hydrochloride is a centrally acting synthetic analog of codeine belonging to the aminocyclohexanol chemical group. Chemically designated as <span class=\"math-inline\" data-math=\"(\\pm)\" data-index-in-node=\"149\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mopen\">(<\/span><span class=\"mord\">\u00b1<\/span><span class=\"mclose\">)<\/span><\/span><\/span><\/span><\/span>-cis-2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexanol hydrochloride, it functions as a racemic mixture of two enantiomers. Under the Anatomical Therapeutic Chemical (ATC) system, tramadol is indexed under N02AX02.<\/p>\n<p data-path-to-node=\"6\">Tamol-X 225 mg represents a <b data-path-to-node=\"6\" data-index-in-node=\"28\">high-strength supratherapeutic formulation<\/b> (substantially exceeding standard immediate-release 50 mg or 100 mg clinical doses). In most regulated markets, high-dose tramadol preparations of this magnitude carry severe regulatory restrictions, are classified as Controlled Substances due to dependence and misuse liability, and are strictly available as Prescription Only Medicines (POM). Unregulated online sourcing of high-dose variants carries extreme risks of counterfeit manufacture and toxic contamination.<\/p>\n<h2 data-path-to-node=\"7\">2. Mechanism of Action and Pharmacodynamics<\/h2>\n<p data-path-to-node=\"8\">Tramadol utilizes a dual-action mechanism to interrupt nociceptive signaling:<\/p>\n<ul data-path-to-node=\"9\">\n<li>\n<p data-path-to-node=\"9,0,0\"><b data-path-to-node=\"9,0,0\" data-index-in-node=\"0\"><span class=\"math-inline\" data-math=\"\\mu\" data-index-in-node=\"0\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">\u03bc<\/span><\/span><\/span><\/span><\/span>-Opioid Receptor Activation:<\/b> The (+)-enantiomer and its primary active metabolite (<span class=\"math-inline\" data-math=\"O\" data-index-in-node=\"86\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">O<\/span><\/span><\/span><\/span><\/span>-desmethyltramadol or M1) bind to central <span class=\"math-inline\" data-math=\"\\mu\" data-index-in-node=\"129\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">\u03bc<\/span><\/span><\/span><\/span><\/span>-opioid receptors, inhibiting ascending pain pathways and suppressing neurotransmitter release in the dorsal horn.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"9,1,0\"><b data-path-to-node=\"9,1,0\" data-index-in-node=\"0\">Monoaminergic Reuptake Inhibition:<\/b> Both enantiomers inhibit the neuronal reuptake of serotonin (5-HT) and norepinephrine (NE) in descending spinal inhibitory pathways, enhancing spinal gating of pain signals.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"10\">3. Approved Clinical Indications and Dosing Scope<\/h2>\n<ul data-path-to-node=\"11\">\n<li>\n<p data-path-to-node=\"11,0,0\"><b data-path-to-node=\"11,0,0\" data-index-in-node=\"0\">Moderate to Severe Pain:<\/b> Management of acute and chronic moderate to severe pain where non-opioid analgesics are insufficient.<\/p>\n<\/li>\n<\/ul>\n<p data-path-to-node=\"12\"><i data-path-to-node=\"12\" data-index-in-node=\"0\">Dosing &amp; Safety Warnings:<\/i><\/p>\n<ul data-path-to-node=\"13\">\n<li>\n<p data-path-to-node=\"13,0,0\"><b data-path-to-node=\"13,0,0\" data-index-in-node=\"0\">Excessive Potency Risk:<\/b> Standard clinical starting doses for tramadol range from 50 mg to 100 mg, with a standard maximum daily ceiling of 400 mg\/day for adult patients. A single 225 mg unit strength represents more than double standard single-dose recommendations, drastically elevating the risk of acute toxicity, profound respiratory depression, and seizures.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"13,1,0\"><b data-path-to-node=\"13,1,0\" data-index-in-node=\"0\">Administration Rules:<\/b> Must be swallowed whole. Crushing, chewing, or breaking high-strength tramadol formulations can cause rapid drug dumping, leading to immediate-release toxicity or lethal overdose.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"14\">4. Pharmacokinetic Profile and Metabolic Fate<\/h2>\n<ul data-path-to-node=\"15\">\n<li>\n<p data-path-to-node=\"15,0,0\"><b data-path-to-node=\"15,0,0\" data-index-in-node=\"0\">Absorption:<\/b> Rapidly and almost completely absorbed following oral ingestion. Peak plasma concentrations (<span class=\"math-inline\" data-math=\"C_{max}\" data-index-in-node=\"105\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord\"><span class=\"mord mathnormal\">C<\/span><span class=\"msupsub\"><span class=\"vlist-t vlist-t2\"><span class=\"vlist-r\"><span class=\"vlist\"><span class=\"\"><span class=\"sizing reset-size6 size3 mtight\"><span class=\"mord mtight\"><span class=\"mord mathnormal mtight\">ma<\/span><span class=\"mord mathnormal mtight\">x<\/span><\/span><\/span><\/span><\/span><span class=\"vlist-s\">\u200b<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span>) typically occur within 2 hours (<span class=\"math-inline\" data-math=\"T_{max}\" data-index-in-node=\"146\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord\"><span class=\"mord mathnormal\">T<\/span><span class=\"msupsub\"><span class=\"vlist-t vlist-t2\"><span class=\"vlist-r\"><span class=\"vlist\"><span class=\"\"><span class=\"sizing reset-size6 size3 mtight\"><span class=\"mord mtight\"><span class=\"mord mathnormal mtight\">ma<\/span><span class=\"mord mathnormal mtight\">x<\/span><\/span><\/span><\/span><\/span><span class=\"vlist-s\">\u200b<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span>) for standard formulations, though high-dose variations may alter absorption kinetics.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"15,1,0\"><b data-path-to-node=\"15,1,0\" data-index-in-node=\"0\">Distribution:<\/b> Plasma protein binding is low (~20%). Readily crosses the blood-brain barrier and placenta.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"15,2,0\"><b data-path-to-node=\"15,2,0\" data-index-in-node=\"0\">Biotransformation:<\/b> Extensively metabolized in the liver via Cytochrome P450 enzymes:<\/p>\n<ul data-path-to-node=\"15,2,1\">\n<li>\n<p data-path-to-node=\"15,2,1,0,0\"><b data-path-to-node=\"15,2,1,0,0\" data-index-in-node=\"0\">CYP2D6 Pathway:<\/b> O-demethylation converts tramadol into <b data-path-to-node=\"15,2,1,0,0\" data-index-in-node=\"55\">M1 (O-desmethyltramadol)<\/b>, an active metabolite with significantly higher <span class=\"math-inline\" data-math=\"\\mu\" data-index-in-node=\"128\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">\u03bc<\/span><\/span><\/span><\/span><\/span>-opioid affinity.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"15,2,1,1,0\"><b data-path-to-node=\"15,2,1,1,0\" data-index-in-node=\"0\">CYP3A4 Pathway:<\/b> N-demethylation converts tramadol into inactive metabolites.<\/p>\n<\/li>\n<\/ul>\n<\/li>\n<li>\n<p data-path-to-node=\"15,3,0\"><b data-path-to-node=\"15,3,0\" data-index-in-node=\"0\">Elimination:<\/b> Excreted primarily via the kidneys in urine as unchanged drug and polar metabolites. The elimination half-life (<span class=\"math-inline\" data-math=\"t_{1\/2}\" data-index-in-node=\"125\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord\"><span class=\"mord mathnormal\">t<\/span><span class=\"msupsub\"><span class=\"vlist-t vlist-t2\"><span class=\"vlist-r\"><span class=\"vlist\"><span class=\"\"><span class=\"sizing reset-size6 size3 mtight\"><span class=\"mord mtight\">1\/2<\/span><\/span><\/span><\/span><span class=\"vlist-s\">\u200b<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span>) of tramadol is roughly 6 hours, while M1 has a half-life of approximately 7 hours.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"16\">5. Physiological Effects and Adverse Event Spectrum<\/h2>\n<p data-path-to-node=\"17\">High-dose tramadol profoundly alters central nervous system neurotransmission, lowers seizure thresholds, and depresses respiratory drive.<\/p>\n<h3 data-path-to-node=\"18\">Adverse Drug Reaction Spectrum<\/h3>\n<ul data-path-to-node=\"19\">\n<li>\n<p data-path-to-node=\"19,0,0\"><b data-path-to-node=\"19,0,0\" data-index-in-node=\"0\">Very Common (<span class=\"math-inline\" data-math=\"\\ge 1\/10\" data-index-in-node=\"13\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">\u2265<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/10<\/span><\/span><\/span><\/span><\/span>):<\/b> Nausea, dizziness, somnolence, headache, severe dry mouth.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"19,1,0\"><b data-path-to-node=\"19,1,0\" data-index-in-node=\"0\">Common (<span class=\"math-inline\" data-math=\"\\ge 1\/100\" data-index-in-node=\"8\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">\u2265<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/100<\/span><\/span><\/span><\/span><\/span> to <span class=\"math-inline\" data-math=\"&lt;1\/10\" data-index-in-node=\"21\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">&lt;<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/10<\/span><\/span><\/span><\/span><\/span>):<\/b> Vomiting, constipation, sweating, fatigue, vertigo, dyspepsia, tachycardia, palpitations.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"19,2,0\"><b data-path-to-node=\"19,2,0\" data-index-in-node=\"0\">Uncommon (<span class=\"math-inline\" data-math=\"\\ge 1\/1,000\" data-index-in-node=\"10\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">\u2265<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/1<\/span><span class=\"mpunct\">,<\/span><span class=\"mord\">000<\/span><\/span><\/span><\/span><\/span> to <span class=\"math-inline\" data-math=\"&lt;1\/100\" data-index-in-node=\"25\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">&lt;<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/100<\/span><\/span><\/span><\/span><\/span>):<\/b> Orthostatic hypotension, flushing, abdominal pain, flatulence, pruritus, rash, urticaria, visual disturbances.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"19,3,0\"><b data-path-to-node=\"19,3,0\" data-index-in-node=\"0\">Rare \/ Severe (&lt;1\/1,000):<\/b> <b data-path-to-node=\"19,3,0\" data-index-in-node=\"26\">Generalized tonic-clonic seizures<\/b> (particularly at supratherapeutic doses like 225 mg), <b data-path-to-node=\"19,3,0\" data-index-in-node=\"114\">serotonin syndrome<\/b>, life-threatening respiratory depression, anaphylaxis, severe hypoglycemia, hallucinations, and physical dependence.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"20\">6. Contraindications, Drug Interactions, and Clinical Precautions<\/h2>\n<h3 data-path-to-node=\"21\">Contraindications<\/h3>\n<ul data-path-to-node=\"22\">\n<li>\n<p data-path-to-node=\"22,0,0\">Known hypersensitivity to tramadol or other opioids.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"22,1,0\">Acute intoxication with alcohol, hypnotics, centrally acting analgesics, opioids, or psychotropic medications.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"22,2,0\">Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of their discontinuation.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"22,3,0\">Patients with severe epilepsy, a history of seizures, or uncontrolled seizure disorders (heightened risk due to high unit strength).<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"22,4,0\">Severe respiratory depression or acute bronchial asthma.<\/p>\n<\/li>\n<\/ul>\n<h3 data-path-to-node=\"23\">Key Drug Interactions<\/h3>\n<ul data-path-to-node=\"24\">\n<li>\n<p data-path-to-node=\"24,0,0\"><b data-path-to-node=\"24,0,0\" data-index-in-node=\"0\">Monoamine Oxidase Inhibitors (MAOIs) &amp; Serotonergic Agents (SSRIs, SNRIs, Triptans):<\/b> Co-administration triggers severe, potentially fatal <b data-path-to-node=\"24,0,0\" data-index-in-node=\"138\">serotonin syndrome<\/b> (hyperthermia, clonus, autonomic instability, and mental status shifts).<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,1,0\"><b data-path-to-node=\"24,1,0\" data-index-in-node=\"0\">CYP2D6 Inhibitors (e.g., Fluoxetine, Paroxetine, Quinidine):<\/b> Inhibit the formation of the active M1 metabolite, altering analgesic response.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,2,0\"><b data-path-to-node=\"24,2,0\" data-index-in-node=\"0\">CYP3A4 Inhibitors\/Inducers (e.g., Ketoconazole, Erythromycin, Carbamazepine):<\/b> Alter parent drug clearance and systemic exposure.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,3,0\"><b data-path-to-node=\"24,3,0\" data-index-in-node=\"0\">CNS Depressants &amp; Alcohol:<\/b> Additive central nervous system depression leading to profound sedation, respiratory arrest, coma, and death.<\/p>\n<\/li>\n<\/ul>\n<h3 data-path-to-node=\"25\">Clinical Precautions and Monitoring<\/h3>\n<ul data-path-to-node=\"26\">\n<li>\n<p data-path-to-node=\"26,0,0\"><b data-path-to-node=\"26,0,0\" data-index-in-node=\"0\">Dose Toxicity Hazard:<\/b> 225 mg taken as a single unit significantly increases the risk of dose-dependent seizures, even in patients without a prior seizure history.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"26,1,0\"><b data-path-to-node=\"26,1,0\" data-index-in-node=\"0\">Dependence &amp; Withdrawal:<\/b> Prolonged use establishes physical and psychological dependence. Abrupt cessation triggers a severe withdrawal syndrome (anxiety, sweating, insomnia, rigors, nausea, and hallucinations). Gradual tapering under medical supervision is mandatory.<\/p>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n    <div class=\"xs_social_share_widget xs_share_url after_content \t\tmain_content  wslu-style-1 wslu-share-box-shaped wslu-fill-colored wslu-none wslu-share-horizontal wslu-theme-font-no wslu-main_content\">\n\n\t\t\n        <ul>\n\t\t\t        <\/ul>\n    <\/div> \n","protected":false},"excerpt":{"rendered":"<p data-path-to-node=\"1\">Tamol-X 225 mg is a high-dose analgesic preparation containing tramadol hydrochloride. As a centrally acting synthetic opioid, it is formulated for the management of moderate to severe pain, utilizing a dual mechanism involving opioid receptor agonism and monoaminergic reuptake inhibition.<\/p>\n<h3 data-path-to-node=\"3\">\u00a0<\/h3>","protected":false},"featured_media":8031,"comment_status":"closed","ping_status":"closed","template":"","meta":{"postBodyCss":"","postBodyMargin":[],"postBodyPadding":[],"postBodyBackground":{"backgroundType":"classic","gradient":""}},"product_brand":[],"product_cat":[15],"product_tag":[237],"class_list":["post-8019","product","type-product","status-publish","has-post-thumbnail","product_cat-uncategorized","product_tag-tamol-x-225mg","instock","shipping-taxable","purchasable","product-type-simple"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.5 (Yoast SEO v28.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Tamol-X 225mg - British Pharmacy<\/title>\n<meta name=\"description\" content=\"Tramadol binds to\u00a0mu-opioid receptors\u00a0in the brain and spinal cord to block pain signals. It also inhibits\u00a0norepinephrine and serotonin reuptake,\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bristishpharmacy.co.uk\/it\/shop\/tamol-x-225mg\/\" \/>\n<meta property=\"og:locale\" content=\"it_IT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tamol-X 225mg\" \/>\n<meta property=\"og:description\" content=\"Tamol-X 225 mg is a high-dose analgesic preparation containing tramadol hydrochloride. 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Inibisce anche la ricaptazione della noradrenalina e della serotonina,","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/bristishpharmacy.co.uk\/it\/shop\/tamol-x-225mg\/","og_locale":"it_IT","og_type":"article","og_title":"Tamol-X 225mg","og_description":"Tamol-X 225 mg is a high-dose analgesic preparation containing tramadol hydrochloride. 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