Pregnancy Risk Category C
How supplied
Tablets: 50 mg
Action
Unknown. A centrally acting synthetic analgesic compound not chemically related to opiates. Drug is thought to bind to opioid receptors and inhibit reuptake of norepinephrine and serotonin.
Indications & dosage
Moderate to moderately severe pain--
Adults: 50 to 100 mg P.O. q 4 to 6 hours, p.r.n. Maximum dose is 400 mg daily.
Elderly: for patients over age 75, maximum dose is 300 mg/day in divided
doses.
Adjust-a-dose: For renally impaired patients with creatinine clearance below 30 ml/minute, increase dose interval to q 12 hours; maximum daily dose is 200 mg. In patients with cirrhosis, give 50 mg q 12 hours.
Adverse reactions
CNS: dizziness, vertigo, headache, somnolence, CNS stimulation, asthenia, anxiety, confusion, coordination disturbance, euphoria, nervousness, sleep disorder, seizures, malaise.
CV: vasodilation.
EENT: visual disturbances.
GI: nausea, constipation, vomiting, dyspepsia, dry mouth, diarrhea, abdominal pain, anorexia, flatulence.
GU: urine retention, urinary frequency, menopausal symptoms, proteinuria, increased creatinine clearance.
Hematologic: decreased hemoglobin levels.
Hepatic: increased liver enzyme levels.
Musculoskeletal: hypertonia.
Respiratory: respiratory depression.
Skin: pruritus, diaphoresis, rash.
Interactions
Drug-drug. Carbamazepine: increased tramadol metabolism. Patients receiving chronic carbamazepine therapy at a dose of up to 800 mg daily may need up to twice the recommended dose of tramadol.
CNS depressants: additive effects. Use together with caution. Dosage of tramadol may need to be reduced.
Cyclobenzaprine, MAO inhibitors, neuroleptics, selective serotonin reuptake inhibitors, tricyclic antidepressants: increased risk of seizures. Monitor patient closely.
Quinidine: increased levels of tramadol. Monitor patient closely.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with acute intoxication from alcohol, hypnotics, centrally acting analgesics, opioids, or psychotropic drugs.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING