Tramadol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
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.
Administration
May be taken with or without food.
Contraindications
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.
Special Precautions
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.
Adverse Reactions
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.
Drug Interactions
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).
CIMS Class
ATC Classification
N02AX02 - tramadol ; Belongs to the class of other opioids. Used to relieve pain.
Disclaimer: This information is independently developed by CIMS based on tramadol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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