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
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Relief of moderate to moderately severe pain
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Relief of moderate to severe chronic pain in adults who need around-the-clock treatment for extended periods (ER tablets)
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Unlabeled uses: Premature ejaculation; restless legs syndrome
Contraindications and Cautions
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Contraindicated with allergy to tramadol or opioids or acute intoxication with alcohol, opioids, or psychoactive drugs.
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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.
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