TRAMADOL injectable

Therapeutic action

• Opioid analgesic

Indications

• Moderate pain

Forms and strengths, route of administration

• 100 mg ampoule (50 mg/ml, 2 ml) for IM, slow IV injection or infusion

Dosage

• Child over 12 years and adult: 50 to 100 mg every 4 to 6 hours (max. 600 mg daily)

Duration

Change to oral route as soon as possible.

Contra-indications, adverse effects, precautions

• Do not administer in the event of severe respiratory depression and to patients that risk seizures (e.g. epilepsy, head injury, meningitis).
• May cause:
  • dizziness, nausea, vomiting, drowsiness, dry mouth, sweating;
  • rarely: allergic reactions, seizures, confusion; withdrawal symptoms; respiratory depression in the event of overdosage.
• Do not combine with opioid analgesics, including codeine.
• Avoid combination with carbamazepine, fluoxetine, chlorpromazine, promethazine, clomipramine, haloperidol, digoxin.
• Reduce doses by half and administer every 12 hours in elderly patients and in patients with severe renal or hepatic impairment (risk of accumulation).
• Use tramadol by infusion over 20-30 minutes rather than by IV injection.
• Pregnancy: no contra-indication. The neonate may develop withdrawal symptoms, respiratory depression and drowsiness in the event of prolonged administration of large doses at the end of the 3^rd trimester. In this event, closely monitor the neonate.
• Breast-feeding: use with caution, for a short period (2-3 days), at the lowest effective dose. Monitor the mother and the child: in the event of excessive drowsiness, stop treatment.

Remarks

• Tramadol is approximately 10 times less potent than morphine.
• In some countries, tramadol is on the list of narcotics: follow national regulations.
• Tramadol is not included in the WHO list of essential medicines.

Storage