Tramadol

Listed in Dosage.

Adult: PO Moderate to severe pain 50-100 mg 4-6 hrly. Extended-release tab: 50-100 mg 1-2 times/day. Max: 400 mg/day. IV/IM Moderate to severe pain 50-100 mg 4-6 hrly. Post-op pain Initial: 100 mg, then 50 mg every 10-20 mins if needed, up to 250 mg for the 1st hr. Maintenance: 50-100 mg 4-6 hrly. Max: 600 mg/day.

May be taken with or without food.

Suicidal patients; acute intoxication w/ hypnotics, centrally acting analgesics, opioids, psychotropic drugs or alcohol; uncontrolled epilepsy, acute or severe bronchial asthma, hypercapnia or significant resp depression in unmonitored settings or absence of resuscitative equipment. Not intended for narcotic withdrawal treatment. Severe renal and hepatic impairment. CYP2D6 ultra-rapid metabolisers. Concomitant use w/ MAOIs or w/in 2 wk after withdrawal of MAOIs.

Patients who suffer from emotional disturbance or depression, history of epilepsy or risk of seizure, head injury, increased intracranial pressure. CYP2D6 intermediate and poor metabolisers. Renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor pain relief, resp rate, BP, pulse rate; signs of tolerance, abuse, or suicidal ideation.

Resp depression, seizure, dizziness, headache, somnolence, weakness, CNS stimulation (e.g. anxiety, euphoria, hallucinations), asthenia, sweating, confusion, coordination disturbance, paraesthesia, hypoaesthesia, amnesia, cognitive dysfunction, depression, dysphoria, constipation, nausea, vomiting, dyspepsia, diarrhoea, abdominal pain, anorexia, flatulence, wt loss, gastroenteritis, pruritus, rash, dermatitis, urticaria, bronchospasm, angioedema, anaphylaxis, allergic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, vasodilation, orthostatic hypotension, syncope, tachycardia, flushing, chest pain, palpitations, MI, HTN, peripheral ischaemia, menopausal symptoms, dysuria, menstrual disorder, micturition difficulty, haematuria.

Increased risk of convulsions or serotonin syndrome w/ SSRI, serotonin-norepinephrine reuptake inhibitors (SNRI), TCA and other seizure threshold lowering drugs (e.g. bupropion, mirtazapine, tetrahydrocannabinol). Decreased serum concentrations w/ carbamazepine. May potentiate the anti-depressant effect of norepinephrine, 5-HT agonists or lithium. Increased INR and ecchymoses w/ coumarin derivatives (e.g. warfarin).

Analgesics (Opioid)

N02AX02 - tramadol ; Belongs to the class of other opioids. Used to relieve pain.