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Its analgesic effects take about one hour to come into effect and 2 h to 4 h to peak after oral administration with an immediate-release formulation.
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DOSAGE AND ADMINISTRATION
Tramadol is an opioid agonist indicated for the management of pain
severe enough to require daily around-the-clock, long-term opioid treatment
and for which alternative treatment options are inadequate.
Limitations of Use
-Because of the risks of addiction, abuse, and misuse with opioids, even
at recommended doses, and because of the greater risks of overdose and
death with extended-release opioid formulations, reserve Tramadol
for use in patients for whom alternative treatment options (e.g., nonopioid
analgesics or immediate-release opioids) are ineffective, not
tolerated, or would be otherwise inadequate to provide sufficient
management of pain.
-Tramadol is not indicated as an as-needed (prn) analgesic.
Indications Dosage regimen Pain (moderate to severe).
Lower Back Pain:
Immediate-release 50 to 100 mg orally,up to 4 times daily as necessary. For pain persisting for more than 5 days sustained-release 100 to 150 mg orally, twice daily.
Post Operative Pain
100 mg initially then 50 mg every 10-20 minutes if necessary during first hour to total maximum 250 mg (including initial dose) in first hour, then 50-100 mg every 4-6 hours; max 600 mg daily.
Rotator Cuff Disease
Immediate-release 50 to 100 mg orally, as necessary up to 4 times daily For pain persisting for more than 5 days Tramadol sustained-release 100 mg to 150 mg orally, twice daily.
Tramadol Side Effects
The most common adverse effects of tramadol include nausea, dizziness, dry mouth, indigestion, abdominal pain, vertigo, vomiting, constipation, drowsiness and headache.
Before taking Tramadol, tell your doctor or pharmacist if you are allergic to it.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders, breathing problems, kidney disease, liver disease, mental/mood disorders, stomach/intestinal problems, difficulty urinating, gallbladder disease, pancreatitis and obesity.
It is contraindicated in patients hypersensitive to Tramadol, intoxication with alcohol, hypnotics, centrally acting analgesics, opioids orpsychotropic drugs.
Pregnancy and Lactation
Tramadol’s use in pregnancy is generally avoided as it may cause some reversible withdrawal effects in the newborn.
Labour and Delivery
Its use as an analgesic during labour is generally advised against due to its long-onset of action (one hour).
Its use in children is generally advised against, although it may be done under the supervision of a specialist.
There is an increased risk of opioid-related adverse effects such as respiratory depression, falls, cognitive impairment and sedation.
TRAMADOL WARNINGS AND PRECAUTIONS
-Risk of Seizure: Present within recommended dosage range. Risk is
increased with higher than recommended doses.
-Risk of Suicide: Do not use Tramadol in suicidal or addiction-prone
patients. Use with caution in those taking tranquilizers, anti depressants
or abuse alcohol.