Medication Guide App

Acetaminophen / Tramadol Dosage

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Geriatric Dose for:

Additional dosage information:

Usual Adult Dose for Pain

Short term management of acute pain (5 days or less): 2 tablets every 4 to 6 hours as needed for pain.
Maximum dose: 8 tablets per day.

Usual Geriatric Dose for Pain

Short term management of acute pain (5 days or less): 2 tablets every 4 to 6 hours as needed for pain.
Maximum dose: 8 tablets per day.

Renal Dose Adjustments

CrCl less than 30 mL/min: Dosing interval increased to every 12 hours.
Maximum dose: 4 tablets per day.

Liver Dose Adjustments

The use of acetaminophen-tramadol in patients with liver disease is not recommended.

Precautions

Patients who consume three or more alcoholic containing drinks per day should be informed to consult with their physician for advice on when and how to take acetaminophen.

Tramadol, like narcotic analgesics, may make clinical observation and assessment difficult and, therefore, should be administered with caution to patients with head injuries, increased intracranial pressure, acute undiagnosed abdominal pain, severe renal disease, severe liver disease, or respiratory depression (or risk factors for respiratory depression). Tramadol should not be for the treatment of patients with acute intoxication from alcohol, hypnotics, centrally acting analgesics, opioids, or psychotropic drugs since it could potentiate the effects of these agents. Tramadol should not be used in patients with a past or present history of narcotic dependence.

Tramadol may increase the risk of seizures in patients with a reduced seizure threshold due to certain medications, including: MAO inhibitors, tricyclic antidepressants, other tricyclic compounds (i.e. cyclobenzaprine, promethazine), neuroleptic drugs, selective serotonin reuptake inhibitors (SSRIs), and others.

Tramadol may increase the risk of seizures in patients with epilepsy, with a history of seizures, or with seizure risk (i.e. head trauma, metabolic disorders, alcohol and/or drug withdrawal, CNS infections, and so forth). Naloxone may increase the risk of seizures when it is used to reverse the effects of a tramadol overdose.

Dialysis

Patients may receive their regular dose of acetaminophen-tramadol on the day of dialysis since less than 7% of tramadol is removed by hemodialysis.

Other Comments

The FDA has asked manufacturers to limit the maximum amount of acetaminophen in prescription products to 325 mg per dosage unit. There are no data that indicate that taking more than 325 mg of acetaminophen per dosage unit provides more pain relief. The goal of the FDA is to reduce the risk of severe liver injury from acetaminophen overdose, which can lead to liver failure, liver transplant, and even death. The total number of units that may be prescribed and the time intervals for dosing will not change. Drug companies will have until January 14, 2014 to comply with FDA requirements.

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