Tramadol 💊
Related Subjects:
|Analgesia and Pain management
|Sedation and Analgesia on ITU
|Neuropathic Pain Management
|Codeine
|Dihydrocodeine
|Diamorphine
|Morphine
|Paracetamol (Acetaminophen)
|Tramadol
⚠️ Toxicity is only partially reversed with Naloxone.
Tramadol is a Schedule 3 controlled drug and therefore subject to the legal prescription requirements of controlled drugs.
📖 About
⚙️ Mode of Action
- Centrally acting synthetic opioid analgesic.
- Weak μ-opioid receptor agonist + inhibits serotonin/noradrenaline reuptake (SNRI activity).
💊 Indications & Dose
- Analgesia: 50–100 mg every 4 hours. Maximum 400 mg per 24 hours.
- Postoperative pain: 100 mg initially, then 50 mg every 20 minutes.
Max 250 mg in the first hour, then 50–100 mg every 4–6 hours.
Absolute max: 600 mg per 24 hours.
🔗 Interactions
- MAO inhibitors: Contraindicated - risk of severe reactions.
- SSRIs/SNRIs: Risk of serotonin syndrome (agitation, hyperreflexia, fever).
- Other CNS depressants (hypnotics, opioids, alcohol) → additive sedation/respiratory depression.
⚠️ Cautions
- May lower seizure threshold (risk higher with epilepsy).
- Hepatic/renal impairment.
- Use with caution in respiratory disease (COPD, asthma, sleep apnoea).
🚫 Contraindications
- Acute respiratory depression.
- Paralytic ileus.
- Raised intracranial pressure or head trauma.
- Poorly controlled epilepsy.
- Alcohol or drug intoxication.
- Not for use in narcotic withdrawal treatment.
❗ Side Effects
- Nausea, vomiting, constipation, dry mouth.
- Dizziness, headache, somnolence - caution with driving/operating machinery.
- Seizures (dose-dependent, especially with interacting drugs).
📚 References
