Tramadol is a strong pain medication used to treat moderate to severe pain that is not being relieved by other types of pain medicines. Tramadol is a synthetic opioid and acts in the brain and spine (central nervous system) to reduce the amount of pain you feel.
The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.
Dosing information
Usual Adult Dose for Pain:
Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain
-For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days
Maximum dose: 400 mg per day.
Usual Adult Dose for Chronic Pain:
Extended-Release (ER):
18 years or older (tramadol-naive): 100 mg orally once a day
-Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions
-Maximum Dose: 300 mg/day
For patients CURRENTLY receiving Immediate-Release (IR) Tramadol:
Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day
Conversion from other Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy
-Initial dose: 100 mg ER orally once a day
-Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions
-Maximum Dose: 300 mg/day.
Usual Geriatric Dose for Pain:
Dose selection should be cautious generally starting at the low end of the dose range
Over 75 years:
Maximum dose of Immediate-release: 300 mg per day.
Usual Geriatric Dose for Chronic Pain:
Dose selection should be cautious generally starting at the low end of the dose range
Over 75 years:
Maximum dose of Immediate-release: 300 mg per day.
Usual Pediatric Dose for Pain:
Tramadol is not recommended for use in pediatric patients
17 years or older: See Adult Dose.
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