Dangerous Drug: Tramadol Hydrochloride(tram’ ah doll)
ConZipDNC, Rybix ODT, RyzoltDNC, Ultram, Ultram ERDNC
PREGNANCY CATEGORY C
Drug Classes
Analgesic (centrally acting)
Opioid analgesic
Therapeutic Actions
Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin; causes many effects similar to the opioids—dizziness, somnolence, nausea, constipation—but does not have the respiratory depressant effects.
Indications
Relief of moderate to moderately severe pain
Relief of moderate to severe chronic pain in adults who need around-the-clock treatment for extended periods (ER tablets)
Unlabeled uses: Premature ejaculation; restless legs syndrome
Contraindications and Cautions
Contraindicated with allergy to tramadol or opioids or acute intoxication with alcohol, opioids, or psychoactive drugs.
Use cautiously with pregnancy, lactation; seizures; concomitant use of CNS depressants, MAOIs, SSRIs, TCAs; renal impairment; history of seizures; hepatic impairment.
Available Forms
Tablets—50 mg; ER tabletsDNC—100, 200, 300 mg; ER capsules—100, 150, 200, 300 mg; orally disintegrating tablets—50 mg
Dosages
Adults
Patients who require rapid analgesic effect: 50–100 mg PO every 4–6 hr; do not exceed 400 mg/day.
Patients with moderate to moderately severe chronic pain: Initiate at 25 mg/day PO in the
morning, and titrate in 25-mg increments every 3 days to reach 100 mg/day PO. Then, increase in 50-mg increments every 3 days to reach 200 mg/day. After titration, 50–100 mg PO every 4–6 hr; do not exceed 400 mg/day. Alternatively, 100-mg ER tablet or capsule once daily PO, titrated by 100-mg increments every 2–3 days (Ryzolx) or every 5 days (Ultram ER, ConZip); do not exceed 300 mg/day. For orally disintegrating tablets, do not exceed 200 mg/day.
morning, and titrate in 25-mg increments every 3 days to reach 100 mg/day PO. Then, increase in 50-mg increments every 3 days to reach 200 mg/day. After titration, 50–100 mg PO every 4–6 hr; do not exceed 400 mg/day. Alternatively, 100-mg ER tablet or capsule once daily PO, titrated by 100-mg increments every 2–3 days (Ryzolx) or every 5 days (Ultram ER, ConZip); do not exceed 300 mg/day. For orally disintegrating tablets, do not exceed 200 mg/day.
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