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Furthermore, although opioids have no ceiling effects, clinicians are often reluctant to prescribe efficacious doses because of concerns of addiction and possible serious adverse events, such as sedation and respiratory and cardiovascular depression, particularly in highrisk patients, such as those with tramadol dosage shingles tramadol hcl dosage tramadol sr overdose tramadol dosage rls tramadol poor cardiopulmonary reserves . [81,131] With its ultram unique dual mechanism of action (weak opioid agonist, and a weak noradrenaline and 5-HT reuptake inhibitor), tramadol offers an alternative to other opioids, as these 2 complementary, synergistic actions enhance its analgesic effects and improve its tolerability profile .
Most importantly, unlike other opioid agents, this weak opioid agonist shows no clinically relevant effects on cardiovascular and respiratory parameters and has a tramadol low blood pressure tramadol dosage bluelight tramadol 50 mg uses tramadol tablets usp low potential for abuse and dependence . [11-14,37,79,129] In addition, tramadol is not tramadol high vs vicodin high tramadol tabletkasi haqida tramadol hcl manufacturers in india ultram a controlled substance, although along with its low potential for abuse, this factor is probably less relevant in the management of postoperative pain than with long term administration .

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