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Tramadol

Chinese name:

曲馬多

Reviewed by

Joseph Blais, Pharmacist

Expert Advisory Board Member

Last Updated: 2022-05-10

What is Tramadol for?

Tramadol is an opioid that is used for moderate to severe acute or chronic pain and postoperative pain (like Morphine). It works by modifying the processing of pain signals between the nerves and the brain. Some products contain a combination of Tramadol and a non-opioid pain reliever such as Paracetamol / Acetaminophen or dexketoprofen (a non-steroidal anti-inflammatory drug [NSAID]).

How to use it?

Tramadol is available as oral immediate release tablets/capsules, long-acting modified release tablets, and as an injection. The dosages for different uses, routes, and age groups are listed below:

For moderate to severe pain

Intramuscular injection / intravenous injection / intravenous infusion
Adult
50-100 mg every 4-6 hours. For intravenous injection, it should be given over 2-3 minutes.

Orally using modified-release 12-hourly preparations
Adult / Child 12-17 years
50-100 mg twice daily, increase the dose if necessary to 150-200 mg twice daily, up to a maximum of 400 mg daily.

Orally using modified-release 24-hourly preparations
Adult / Child 12-17 years
100-150 mg once daily, increase the dose if necessary to 400 mg once daily, up to a maximum of 400 mg daily.

For moderate to severe acute pain

Orally using immediate-release medicines
Adult
Start with 100 mg, followed by 50-100 mg every 4-6 hours, up to a maximum of 400 mg daily.

For moderate to severe chronic pain

Orally using immediate-release medicines
Adult
Start with 50 mg and the dose may be adjusted according to your response; The maximum daily dose is 400 mg.

For postoperative pain

Intravenous injection
Adult
Started with 100 mg, followed by 50 mg every 10-20 minutes if necessary, up to a maximum of 250 mg including initial dose in the first hour, then 50-100 mg every 4-6 hours. For intravenous injection, it should be given over 2-3 minutes. The maximum daily dose is 600 mg.

What are the side effects of Tramadol?

Common side effects of Tramadol include constipation, dizziness and drowsiness, dry mouth, euphoric mood, flushing, hallucinations, nausea and vomiting (more common on initiation), and respiration depression (with high dose). Like all opioid medications, people can become tolerant or addicted to Tramadol, which can result in withdrawal symptoms when you try to stop the medicine.

Who should not take Tramadol?

People who are allergic to Tramadol, opioids or any formulation component
Children younger than 12 years old
People at risk of respiratory depression
Patients who are on monoamine oxidase (MAO) inhibitors or have taken them within the past 14 days

Pharmacist Tips:

Opioids have the potential to be addictive and you can become tolerant over time.
Do not discontinue abruptly or use over long periods of time.
Tramadol can cause serotonin syndrome if taken together with selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI) or triptans. Symptoms include agitation, increased heartbeat, quick involuntary muscle twitching, and sweating. Stop taking the medicine and seek immediate medical attention if you suspect serotonin syndrome.

Common dosing schedule:

You may take Tramadol with or without food.

This schedule is for reference only, adjustments may be made according to individual needs.

Some common medications Tramadol may interact with:

Benzodiazepines, e.g. Alprazolam, Diazepam, Flunitrazepam
Carbamazepine
Dextromethorphan
Duloxetine

Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Tramadol in Hong Kong?

In Hong Kong, Tramadol is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk

Need more information?

For detailed information about the use of Tramadol in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.

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