TRAMADOL

Opioid analgesic. Produces analgesia by opioid effect as well as by enhancement of serotonergic and adrenergic pathways

Dosage Forms

Capsule

50 mg

Injection

50 mg/ml

Uses

  • Management of moderate to severe pain
  • Post-operative pain

Dose and Duration

Management of moderate to severe pain

Adult and child over 12 years: by mouth, 50–100 mg not more often than every 4 hours (max 400 mg daily). By IM injection, slow IV injection over 2–3 minutes, or IV infusion, 50–100 mg every 4–6 hours.

Post-operative pain

Adult: initially, 100 mg then 50 mg every 10–20 minutes if necessary during the first hour to a total of 250 mg (includes initial dose). Then, 50–100 mg every 4–6 hours (max 600 mg daily).

Contra-indications

  • Hypersensitivity to tramadol
  • Acute intoxication with alcohol, hypnotics, analgesics, opioids or psychotropic drugs
  • Patients taking MAOIs currently or in the past 2 weeks
  • Epilepsy uncontrolled by treatment

Side Effects

  • Vertigo, headache, drowsiness, fatigue
  • Nausea, vomiting, constipation, dry mouth
  • Sweating

Interactions

  • Fluoxetine, imipramine, amitriptyline (increased risk of CNS toxicity)
  • MAOIs (increased risk of convulsions)
  • Warfarin (enhanced anticoagulant effect)

Patient Instructions

  • Do not drive till you know how this medicine affects you.

Pregnancy

  • Do not use.

Breast-feeding

  • Can be used.

⚠️ Caution

  • Do not use in opioid-dependent patients.
  • Use with caution in impaired consciousness and excessive bronchial secretions.
  • Do not use for longer than is absolutely necessary.
  • Give bisacodyl to prevent and treat constipation.