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Tramadol is used primarily to treat mild to severe pain, both acute and chronic.
It was the most prescribed medication in the United States, with more than 22 million prescriptions.
Dosages and administrations of Tramadol
The doctor administers Tramadol consumption and suggests the dosage depending on your body condition. This medicine has got the power to slow down or stop the breath as the intake starts and when there are changes in dosage. So, a strong recommendation of consumption in large amounts or in longer time frames is dangerous. Consult the doctor when there’s a note on improper working with the medication.
To achieve maximum effectiveness, consume Tramadol as directed and not exceeding the prescribed doses. The dosage cannot more than 400mg per day max as followed with the titration regimen (gradual increase in dosage as the body gets habituated to the medication). Never break, crush, or open Tramadol tablet. Swallow entirely at a time.
Two proven procedures that lead to death as per research as mishandling Tramadol
Breakage and inhaling of the medicine
Crushing and injecting through the liquid
Dosage Allocation With Severity
Chronic pain:
Extended-Release capsules (oral dosage form):
Initially, adults might be consuming 100 milligrams (mg) once a day as per the doctor’s prescription. The dosage cannot exceed 300 mg per day, however.
Doctor’s suggestion of whether to use or not is a must for children with 12 years and above. The consumption of Tramadol is strictly prohibited for children less than 12 years.
Extended-Release tablets (oral dosage form):
Initially, adults might be consuming 100 milligrams (mg) once a day as per the doctor’s prescription. The dosage cannot exceed 300 mg per day, however.
Doctor’s suggestion with the usage and dosage is a must for children with 12 years and below.
For Moderate To Severe Pain
Disintegrating tablets (oral dosage form):
Initially, adults might have a doctor’s recommendation of 50 to 100 milligrams (mg) a day (with a gap of 4 to 6 hours as per requirement). The dosage cannot exceed 400 mg per day, however. The same dosage might apply to children of 16 years and older.
Doctor’s suggestion with the usage and dosage is a must for children with 16 years and below.
Tablets (oral dosage form):
Initially, adults might be consuming 25 milligrams (mg) every morning as per the doctor’s prescription. The dosage cannot exceed 400 mg per day, however.
Doctor’s suggestion of whether to use or not is a must for children with 12 years and above. The consumption of Tramadol is strictly prohibited for children less than 12 years.
Indications for Tramadol Extended-Release Tabs:
Management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatments are inadequate.
Limitations of Use:
Not for use as an as-needed (prn) analgesic. Use only if alternative treatment options (eg, non-opioid analgesics) are ineffective, not tolerated, or otherwise inadequate to provide sufficient management of pain.
Adult:
Use lowest effective dose for shortest duration. Swallow whole. Individualize. ≥18yrs: initially 100mg once daily; may increase by 100mg every 5 days; max 300mg/day. Severe renal (CrCl <30mL/min) or hepatic (Child-Pugh Class C) impairment: not recommended. Concomitant use or discontinuation of CYP2D6 inhibitors, CYP3A4 inhibitors or inducers: monitor closely and consider dose adjustments (see full labeling). Withdraw gradually (esp. if opioid-dependent), taper by ≤10–25% every 2–4 weeks.
Children:
<18yrs: not recommended.
Contraindications:
Children <12yrs. Post-op management in children <18yrs following tonsillectomy and/or adenoidectomy. Significant respiratory depression. Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment. Known or suspected GI obstruction, including paralytic ileus. During or within 14 days of MAOIs.
Boxed Warning:
Addiction, abuse, and misuse. Risk evaluation and mitigation strategy (REMS). Life-threatening respiratory depression. Accidental ingestion. Ultra-rapid metabolism of tramadol and other risk factors for life-threatening respiratory depression in children. Neonatal opioid withdrawal syndrome. Interactions with drugs affecting CYP450 isoenzymes. Risks from concomitant use with benzodiazepines or other CNS depressants.
Warnings/Precautions:
Abuse potential (monitor). Life-threatening respiratory depression; monitor within first 24–72hrs of initiating therapy and following dose increases. Accidental exposure may cause fatal overdose (esp. in children). Sleep-related breathing disorders (including central sleep apnea (CSA), sleep-related hypoxemia); consider dose reduction if CSA develops. Risk of life-threatening respiratory depression and death related to ultra-rapid metabolizers of tramadol (esp. in children for post-tonsillectomy and/or adenoidectomy pain). Avoid in adolescents 12–18yrs with conditions associated with hypoventilation (eg, post-op status, obstructive sleep apnea, obesity, severe pulmonary disease, neuromuscular disease, concomitant drugs that cause respiratory depression). COPD, cor pulmonale, decreased respiratory reserve, hypoxia, hypercapnia, or pre-existing respiratory depression; monitor and consider non-opioid analgesics. Adrenal insufficiency. Head injury. Increased intracranial pressure, brain tumors; monitor. Seizure disorders. Avoid in depressed, suicidal, or addiction-prone patients; consider non-narcotic analgesics. Emotional disturbance. CNS depression. Impaired consciousness, coma, shock; avoid. Biliary tract disease. Acute pancreatitis. Drug abusers. Severe hepatic (Child-Pugh Class C) or renal impairment (CrCl<30mL/min): not recommended. Ultra-rapid metabolizers (due to CYP2D6 polymorphism): avoid. Reevaluate periodically. Avoid abrupt cessation. Elderly (esp. >75yrs). Cachectic. Debilitated. Pregnancy; potential neonatal opioid withdrawal syndrome during prolonged use. Labor & delivery, nursing mothers: not recommended.
See Also:
ULTRAM
Pharmacologic Class:
Opioid agonist.
Interactions:
Concomitant other forms of tramadol or carbamazepine: not recommended. Increased risk of hypotension, respiratory depression, sedation with benzodiazepines or other CNS depressants (eg, non-benzodiazepine sedatives/hypnotics, anxiolytics, general anesthetics, phenothiazines, tranquilizers, muscle relaxants, antipsychotics, alcohol, other opioids); reserve concomitant use in those for whom alternative options are inadequate; limit dosages/durations to minimum required; monitor. Risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, 5-HT3 antagonists, mirtazapine, trazodone, tramadol, cyclobenzaprine, metaxalone, MAOIs, linezolid, IV methylene blue); monitor and discontinue if suspected. Increased risk of seizures with SSRIs, SNRIs, anorectics, TCAs, cyclobenzaprine, promethazine, other opioids, MAOIs, naloxone, neuroleptics, and others that lower seizure threshold. Avoid concomitant mixed agonist/antagonist opioids (eg, butorphanol, nalbuphine, pentazocine) or partial agonist (eg, buprenorphine); may reduce effects and/or precipitate withdrawal symptoms. May be affected by CYP2D6 inhibitors (eg, amiodarone, quinidine, fluoxetine, paroxetine, bupropion). Potentiated by CYP3A4 inhibitors (eg, macrolides, azole antifungals, protease inhibitors). Antagonized by CYP3A4 inducers (eg, rifampin, carbamazepine, phenytoin). May antagonize diuretics; monitor. Paralytic ileus may occur with anticholinergics. Monitor digoxin, warfarin.
Adverse Reactions:
Dizziness, nausea, constipation, headache, somnolence, flushing, pruritus, vomiting, insomnia, dry mouth; respiratory depression, severe hypotension, syncope; rare: serious skin reactions or another hypersensitivity; discontinue if occur.
Note:
Formerly known under the brand name Ultram ER.
REMS:
YES
How Supplied:
ER tabs—contact supplier; Tabs—100
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Tramadol is used primarily to treat mild to severe pain, both acute and chronic.
It was the most prescribed medication in the United States, with more than 22 million prescriptions.
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The doctor administers Tramadol consumption and suggests the dosage depending on your body condition. This medicine has got the power to slow down or stop the breath as the intake starts and when there are changes in dosage. So, a strong recommendation of consumption in large amounts or in longer time frames is dangerous. Consult the doctor when there’s a note on improper working with the medication.
To achieve maximum effectiveness, consume Tramadol as directed and not exceeding the prescribed doses. The dosage cannot more than 400mg per day max as followed with the titration regimen (gradual increase in dosage as the body gets habituated to the medication). Never break, crush, or open Tramadol tablet. Swallow entirely at a time.
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Chronic pain:
Extended-Release capsules (oral dosage form):
Initially, adults might be consuming 100 milligrams (mg) once a day as per the doctor’s prescription. The dosage cannot exceed 300 mg per day, however.
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