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Acema (Tramadol)

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Acema is used to relieve moderate to moderately severe pain. Acema is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.

Other names for this medication:
Acema, Avdol, Axedol, Bestodol, Bludol, Bolodol, Damol, Dolfre, Dolmeri, Dolocet, Euphodol, Gemodol, Jpdol, Midol, Opigesic, Orchidol, Relidol, Sayodol, Tolydol, Tramacon, Tramaflam, Tramasol, Tramed, Tramoflex, Trampar, Trandol, Trandy, Ultraspas, Ultrazac, Zamadol

Similar Products:
Moduretic, Uroxatral, Xeloda, Inderal, Fasigyn, Avana

Also known as: Tramadol


{name} ER is an pain medicine similar to an opioid. This medicine is used to treat moderate to severe pain.

The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.


Usual Adult Dose for Pain:

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain -For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain:

Extended-Release (ER): 18 years or older (tramadol-naive): 100 mg orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day For patients CURRENTLY receiving Immediate-Release (IR) Acema: Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day Conversion from OTHER Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy -Initial dose: 100 mg ER orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day.

Usual Geriatric Dose for Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Geriatric Dose for Chronic Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Pediatric Dose for Pain:

Acema is not recommended for use in pediatric patients 17 years or older: See Adult Dose.

Detailed Acema dosage information


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Acema are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


You should not take Acema ER if you are allergic to it, or if you have:

severe asthma or breathing problems; a stomach or bowel obstruction (including paralytic ileus); if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications; or if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine).

Acema ER should not be given to a child younger than 12 years old. Acema ER should not be given to anyone younger than 18 years old.

Do not give Acema ER to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.

Seizures have occurred in some people taking Acema ER. Your seizure risk may be higher if you have ever had:

a head injury, epilepsy or other seizure disorder; drug or alcohol addiction; or a metabolic disorder.

Tell your doctor if you have ever had:

breathing problems, sleep apnea; liver or kidney disease; urination problems; problems with your gallbladder, pancreas, or thyroid; a stomach disorder; or mental illness, or suicide attempt.

If you use Acema ER during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Ask a doctor before using Acema ER if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

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We present a case of natural killer cell lymphoma in a 34-year-old woman. Our data emphasize the fact that PTEN acts in two distinct steps of the PI3k/AKT pathway to control the expression of GLUT1 at the plasmamembrane and, further, add AKT to the list of the protein substrates of PTEN. Length of time poliovirus is infectious following contamination of fabrics. But to address these questions, we must first determine whether the pseudogap and superconducting states share a common property: particle-hole symmetry. Glucosamine sulfate (GS) is a commonly used drug for the treatment of osteoarthritis. The role of epidemiological science in revealing the epidemiological regularities of emerging and re-emerging infections is emphasized. Modulation of cell death by alpha-synuclein is stimulus-dependent in mammalian cells. Only patients with a positive EUS-guided FNA were included in the analysis. While there was no difference between the two restorations for quality and longevity, the SSC was considerably cheaper to use and needed only one visit, but more tooth tissue was lost in preparation and fitting. The nuclear lamina protein lamin A/C is required for FSHD region chromatin localization to the nuclear envelope, as the association is lost in lamin A/C null fibroblasts.

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Oxidized low density lipoproteins bind to collagen by negative-charge-dependent mechanisms. We report two cases of leptomeningeal angiomatosis in atypical frontoparietotemporal locations without an associated facial port-wine stain. Adequate breastfeeding protects against childhood adiposity and reduces the increased adiposity levels associated with exposure to diabetes in utero. Western blot results proved the recombinant protein HCA587 had the similar antigenicity with its native counterpart. Because the transgene integrates into the genome prior to fertilization, the resulting transgenic embryos are not chimeric and there is no need to breed to the next generation in order to obtain nonmosaic transgenic animals. Surgical intervention is difficult, furthering coil embolization as a reasonable alternative treatment in some cases. Declining cognitive development from 8 to 18 months in preterm children predicts persisting higher parenting stress.


Advantages over previous approaches include full use of multilocus information and the ability to cope appropriately with missing data and ambiguities about which alleles are maternally vs. The importance of blood flukes and the role of anthropochore movement of fish hosts in dissemination of S. The reported results can be useful in plasmonic and other subwavelength and near-field settings. Reslicing of attenuation data with transformation parameters obtained from realignment of emission data provides an accurate and reliable method to obtain correct quantification in the presence of changes in position due to subject movement during or between PET examinations. Hemolytic activity of mica dust and its relation to polyvinylpyridine N-oxide. mellifera only two regions may be distinguished: a proximal, short germarium and a very long distal, terminal filament. To improve their overall health status, while reducing the number of exacerbations, a multidisciplinary approach including different elements of care is needed. Mostly, the MP inhibitors increased the cytotoxicity of the anticancer drugs in an additive manner. More well designed randomized and quasi-experimental trials with adequate sample size are needed to further examine the effective methods of eye irrigation for ocular chemical burns. A second form, Skn-1a, contains an alternative amino terminus and serves to activate cytokeratin 10 (K10) gene expression.

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Here, we report the observation of 2- and 3-dimensional ordered assemblies of methanol molecules on hydrophobic silicon surfaces, using reflection high-energy electron diffraction. A total of 840 molecular markers, 475 AFLPs, 235 RAPDs, 129 SSRs and 1 SCAR, were used for the two parental maps constructed with JoinMap and spanning 1,140 cM and 1,450 cM, respectively. Expression of c-erbB receptors, MMPs and VEGF in squamous cell carcinoma of the head and neck. Fluctuating asymmetry in relation to indices of quality and fitness in the damselfly, Enallagmaebrium (Hagen). Adoption of these recommendations is anticipated to reduce the potential for ambiguity in describing sequence findings and facilitate the sharing of genomic data among clinical laboratories and other entities. Although this is similar in zebrafish, there are important differences in the distribution of transcripts in the PSM indicating different modes of regulation in both fish species. These studies can provide important references for the development of tilting double prisms. Sequencing of the FLU gene of barley revealed a frame shift mutation in the FLU gene of the tig d mutant that results in the loss of two tetratricopeptide repeats that in the FLU protein of Arabidopsis are essential for its biological activity. Improved lithium-ion battery anode capacity with a network of easily fabricated spindle-like carbon nanofibers. PP1 is involved in the regulation of HIV-1 transcription, and dephosphorylates RNA polymerase II C-terminal domain (RNAPII CTD) or CycT1-dependent kinase 9 (CDK9) to increase Tat-dependent HIV-1 transcription.

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Deliberations and resolutions from the consultative meeting enabled the Vice-Chancellor of the University of Buea to sign a memorandum of understanding with the Goldfarb School of Nursing in the USA on HIV/AIDS international collaboration paving the way forward for more developmental health projects in this domain. Binding of antibodies to HBL14 was demonstrated by solid-phase ELISA and chromatography on immobilized HBL14. The temporal pace of response appears, however, to be much slower than that observed after administering growth factors which act on neutrophils. Haemodynamic properties of PTFE femoropopliteal bypass grafts as determined by a new magnetic resonance technique. Identification of accessory olfactory system and medial amygdala in the zebrafish. Female farm workers were found to have shorter interarticular distances than females in other occupational groups. Past fights, past fight injuries, and seeing someone else shot were markers associated with assault injury. An inoculation method was established which allowed the survival on seed of a Gram-negative bacterium at ambient temperature with little loss in viability.

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These observations re-emphasize the need for hypertension awareness programs targeting the general public and the increased use of opportunistic blood pressure screening, and underscore the importance of measures to increase the knowledge of current guidelines for the detection and treatment of hypertension among healthcare providers. Detoxication pathways involving glutathione and epoxide hydrolase in the in vitro metabolism of chloroprene. We report a patient with solitary extramedullary plasmacytoma of the thyroid gland. Diabetes insipidus in Langerhans cell histiocytosis: results from the DAL-HX 83 study. A laparoscopic pelvic and para-aortic lymphadenectomy was performed and showed no evidence of lymphatic metastasis. Results of 12-month lamivudine therapy of chronic hepatitis B in children.

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High prevalence of prolonged QT interval in obese hypogonadal males. Extraction of crystalline nuclear inclusions induced by type 5 adenovirus in KB cells. Failure to rescue an airway at an appropriate time has led to disastrous consequences. Impact of smoking, diabetes and hypertension on survival time in the elderly: the Dubbo Study. However, we found, from a prodromal stage of DLB, memory (free recall and visual recognition) and social cognition deficits, as well as weakened visuospatial and praxic abilities. Performance and results of a collaborative study to evaluate the test system. It is also the primary substrate for soil microorganisms, which is fundamental to nutrient cycling. The effect of the mechanochemical treatment is loss of layer stacking, which prevents the intercalation of the kaolinite.

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As a part of the Chemicals Management Plan launched in 2006, the Government of Canada is assessing and managing, where appropriate, the potential health and ecological risks associated with approximately 4300 substances under the Canadian Environmental Protection Act (1999). The differential diagnosis for new-onset palpitations in pregnancy ranges from benign conditions to life-threatening arrhythmias. In this article we review two new approaches to the management of gliomas: nutraceutical intervention and heterocyclic drugs. The ability to respond to KCl appears about the time of first cleavage, and is correlated with the appearance of active membrane responses. We describe the case of a patient who presented with narrow QRS tachycardia at a rate of 100 b/min.

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Osteoporosis in rheumatoid arthritis: role of osteoclast differentiation and cytokines. Objective evaluation of lens clarity after the intravitreal injection of sustained-release dexamethasone implant. Alpha-particle emitting atomic generator (Actinium-225)-labeled trastuzumab (herceptin) targeting of breast cancer spheroids: efficacy versus HER2/neu expression. We investigate the synchronization properties between two excitatory coupled neurons in the presence of an inhibitory loop mediated by an interneuron. Faculty members in conflict with president of Japanese university. No effect of enalapril on progression in autosomal dominant polycystic kidney disease.

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Is CD133 mRNA expression a prognostic factor in colorectal cancer?. The growth: weight-ratio approximates better to the value of normally developed animals in case of LTH-treatment than in case of STH-treatment. By detection of binding procyclidine tablets 5mg for three different antivenoms and performing an alanine scan, linear elements of epitopes and the positions important for binding were identified. Available data indicate that ASRs of all cancers collectively have increased over the last 20 years. The cyst resolved spontaneously after the institution of thyroid hormone therapy. The treatment of secondary hip dislocation in cerebral palsy is facilitated by the use of a graduated treatment concept with early preventive soft tissue release, extended reconstruction and optional palliative care. Whereas national tuberculosis eradication programmes continue to be effective in maintaining the disease prevalence in cattle at a low level, strategies to control and eradicate tuberculosis in badgers remain constrained by a lack of reagents and rapid tests to diagnose tuberculosis infection in live badgers. We have studied mice homozygous for a mutation (S112A) that prevents PPARgamma phosphorylation. NO synthase inhibition abolished basal levels of exhaled NO as well as the responses in exhaled NO to all compounds except nitroglycerine.

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Advances in the understanding of acute respiratory distress syndrome: summarizing a decade of progress. rsly1 binding to syntaxin 5 is required for endoplasmic reticulum-to-Golgi transport but does not promote SNARE motif accessibility. All studies that compared the prevalence of depression in subjects with IGM and UDD were included. On November 23, 1992, the first endovascular stent graft (ESG) repair of an aortic aneurysm was performed in North America. The neck was well developed with densely packed epidermal micropores. Blue-pink color transformation of the gold sol has been observed in relation to the change in the interparticle distances without any change in the aspect ratio of the particles. Assessment of genotoxicity of benzidine and its structural analogues to human lymphocytes using comet assay.

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Covalent modification of human homeodomain interacting protein kinase 2 by SUMO-1 at lysine 25 affects its stability. The time interval from neurological symptoms onset to diagnosis of myelopathy ranges from 2 months to several years in almost all cases, mimicking the clinical course of subacute combined degeneration due to vitamin B12 deficiency. Choice of either beta-catenin or Groucho/TLE as a co-factor for Xtcf-3 determines dorsal-ventral cell fate of diencephalon during Xenopus development. Changes in counts of peripheral blood cells including lymphocytes and lymphocyte subpopulations were examined in response to acute insulin-induced tramadol hcl 50mg alcohol hypoglycaemia in fourteen insulin-dependent diabetic patients of differing duration, and in eight normal subjects. information provision, cognitive-behavioral therapy, social support and counseling. Multiple 13C site-selective excitation experiments using 1H decoupling in conjunction with pulsed field gradient-enhanced spectroscopy were used to determine 3J(C,H) values.

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A two-sample t test was used to determine the statistically significant differences between the two ADC measurements. Cad erythrocytes have abnormal glycophorin O-glycans, structurally related to the more common human Sd(a) and murine CT determinants, and accumulate an Sd(a)-like ganglioside. Plant- and marine-derived n-3 polyunsaturated fatty acids have differential effects on fasting and postprandial blood lipid concentrations and on the susceptibility of LDL to oxidative modification in moderately hyperlipidemic subjects. After years of dedicated research, it appears as though ST analysis of the fetal ECG has become an additional source of information allowing detailed analysis of fetal responses and more accurate identification of a non-reassuring fetal status. Interestingly, Ln-5 has been shown to both stimulate and downregulate epithelial cell migration.

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Semantic maintenance elicited greater activity in bilateral inferior frontal gyrus and left middle temporal gyrus regions of interest (ROI). Here we demonstrate that ICAM-1 induction represents a new cellular response to p53 activation and that NF-kappaB inhibition does not prevent the effect of p53 on ICAM-1 expression after DNA damage. Analysis of the frontier molecular orbital coefficient in the eigenvector with eigenvalue 1 gives information on the quality of the frontier molecular orbital picture. In this paper, we discuss the molecular interaction mechanism of diprotin A with hDPPIV based on the X-ray crystal structure. Use of the C3b-RBC binding technic for the determination of immune complexes in patients with various pathologies. daigremontiana, and decreased with reduced water and nitrogen supply. In this review, we summarize the present knowledge about the role of miRNAs in inflammation and in the response to environmental agents and pollutants, such as cigarette smoke, ethanol, carcinogenic chemicals such as benzo(a)pyrene (BaP) and dioxin, and UV radiation. Associations with local and locoregional radiation response, overall survival (OS), disease-free (DFS), and disease-specific survival (DSS) were assessed. Folate for depressive disorders: systematic review and meta-analysis of randomized controlled trials.

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