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    Prescription under medical supervision


    Therapeutic action

    • Opioid analgesic


    • Moderate pain, alone or in combination with a non-opioid analgesic

    Forms and strengths

    • 50 mg capsule
    • 100 mg/ml oral solution (1 drop = 2.5 mg)


    • Child over 12 years and adult: 50 to 100 mg every 4 to 6 hours (max. 400 mg daily)


    • According to clinical evolution; as short as possible.
    • In the event of prolonged treatment, do not stop abruptly, reduce doses progressively.

    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).
    • 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 3rd 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.


    • 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.


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