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

Authors

Babak Missaghi, Colin Hoff, Neil Young, Daniel Ostermayer, Daniel Eggeman