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Tramadol (Ultram)

Medical and Pharmacy Editor:

Brand Name: Ultram, Ultram ER, Ryzolt, ConZip

Generic Name: tramadol

Drug Class: Opioid analgesic

What Is Tramadol (Ultram) and How Does It Work?

Tramadol is an oral medication that is used to help relieve ongoing moderate to moderately severe pain. Tramadol is similar to opioid (narcotic) analgesics. It works in the brain to change how your body feels and responds to pain.

Tramadol is a narcotic-like pain relieving oral medicine that is used as a treatment for moderate to severe pain in adults.

The extended-release-tablet formulation of this drug is used to treat moderate to severe chronic pain when treatment is needed around the clock.

This medication must be prescribed by a doctor and is available by prescription only.

Patients taking this drug should alert their doctors about any problems from the use of this medication and any unusual side effects or symptoms or troublesome side effects.

Care should be taken to ensure this medication is taken exactly as prescribed.

The risk of addiciton to most opioid medications is usually, high. However the risk of addicton to Tramadol is not high.

Read the patient health information leaflet that accompanies the prescription of this medication as well as every time the prescription is refilled. There may be new health care information.

Tramadol is available under the following different brand names: Ultram, Ultram ER, Ryzolt and ConZip.

Dosages of Tramadol Should Be Given As Follows:

Oral Dose

  • Tincture: 5-15 drops or 1-3 drops of fluid extract.

Adult Dosage Forms & Strengths

Tablet: Schedule IV

  • 50mg

Suspension, Reconstituted

  • 10 mg/mL

Capsule, Extended Release: Schedule IV

  • 100 mg (ConZip, Ultram ER)
  • 150 mg (ConZip)
  • 200 mg (ConZip, Ultram ER)
  • 300 mg (ConZip, Ultram ER)

Pediatric Dosing Forms & Strengths:

Tablet: Schedule IV

  • Oral dose 50 mg

Suspension, Reconstituted

  • 10 mg/mL

Dosage Considerations

Extended-release capsule or oral tablet must not be chewed, crushed, split, or dissolved. Also combined with acetaminophen.

Moderate-to-Severe Pain

Immediate Release

  • Chronic: 25 mg oral dose every morning initially; increase by 25-50 mg/day every 3 days up to 50-100 mg orally every 4-6hr as needed; not to exceed 400 mg/day
  • Acute: 50-100 mg oral dose every 4-6hr as needed; not to exceed 400 mg/day

Extended Release Dose

  • 100 mg orally once daily initially; increase by 100 mg/day every 5 days; not to exceed 300 mg/day
  • Conversion from immediate release to extended release: Round total daily dose down to nearest 100 mg
  • Do not chew, crush, split, or dissolve

Dosing Modifications

Severe renal impairment (CrCl less than 30 mL/min): Immediate release, 50-100 mg orally every 12hr; extended release not recommended

Severe hepatic impairment: Immediate release, 50 mg oral tablets every 12hr; extended release not recommended

Pediatric Dosage Considerations

Immediate Release

  • Treatment for patient under 17 years: Safety and efficacy not established
  • Treatment for patients 17 years and older (acute): 50-100 mg oral tablets every 4-6hr as needed; not to exceed 400 mg/day
  • Treatment for patients 17 years and older (chronic): 25 mg oral tablets every morning initially; increase by 25-50 mg/day every 3 days as separate doses up to 50-100 mg orally every 4-6hr as needed; not to exceed 400 mg/day

Extended Release Tablets

  • Treatment for under 18 years: Safety and efficacy not established. May cause risks to health.

Geriatric Dosage Forms and Strengths:

  • Treatment for under 65 years: Initiate at lower end of dosing range; not to exceed 300 mg/day if over 75 years.
  • Treatment for under 75 years: Not to exceed 300 mg of medicine per day; immediate release; use great caution with extended release formulation of this medicine
Medically Reviewed by a Doctor on 2/22/2017



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