Tramadol

General

  • Type: opioid
  • Dosage Forms: PO
  • Common Trade Names: Ultram, Ryzolt

Adult Dosing

General

  • Pain:
    • 50-100mg PO q4-6h PRN
  • Chronic severe pain:
    • 100-300mg ER PO QDAY

Pediatric Dosing

  • Not Currently recommended

Special Populations

  • Pregnancy Rating: C
  • Lactation Risk Categories: Probably safe
  • Renal Dosing
    • Adult: CrCL < 30: given q12h, max 200mg/day
    • Pediatric: none
  • Hepatic Dosing
    • Adult: cirrhosis: 50mg q12h, max 100mg/day
    • Pediatric: not defined

Contraindications

  • Allergy to class/drug
  • asthma, acute
  • respiratory depression
  • severe hepatic impairment
  • severe renal impairment
  • acute alcohol intoxication

Adverse Reactions

Serious

  • Respiratory Depression
  • suicidal ideation
  • Seizures
  • anaphylaxis
  • serotonin syndrome
  • steven johnson syndrome

Common

  • Nausea
  • Rash
  • Headache
  • Fatigue
  • xerostomia
  • constipation
  • Tremor
  • insomnia

Pharmacology

  • Half-life: 6.3 - 7.9 hour
  • Metabolism: Liver
  • Excretion: urine
  • Mechanism of Action:exact mechanism unknown, binds to mu opioid receptors and weakly inhibits NE/Serotonin reuptake