– Opioid analgesic
– Moderate pain
Forms and strengths, route of administration
– 100 mg ampoule (50 mg/ml, 2 ml) for IM, slow IV injection or infusion
– Child over 12 years and adult: 50 to 100 mg every 4 to 6 hours (max. 600 mg daily)
– 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 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.
– Storage: below 25 °C -