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Tramadol Dosage

Medically reviewed by Drugs.com. Last updated on Feb 5, 2024.

Applies to the following strengths: 50 mg; 100 mg/24 hours; 200 mg/24 hours; 300 mg/24 hours; 100 mg; 5 mg/mL; 150 mg/24 hours; 25 mg

Usual Adult Dose for:

Usual Geriatric Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Pain

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain

Maximum dose: 400 mg per day

Comments:

Use: For the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Usual Adult Dose for Chronic Pain

Extended-Release (ER):
18 years or older (tramadol-naive): 100 mg orally once a day


For patients CURRENTLY receiving Immediate-Release (IR) Tramadol:
Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day

Conversion from OTHER Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy

Comments:

Use: For the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Usual Geriatric Dose for Pain

Dose selection should be cautious generally starting at the low end of the dose range

Over 75 years:
Maximum dose of Immediate-release: 300 mg per day

Comments:

Usual Geriatric Dose for Chronic Pain

Dose selection should be cautious generally starting at the low end of the dose range

Over 75 years:
Maximum dose of Immediate-release: 300 mg per day

Comments:

Usual Pediatric Dose for Pain

Tramadol is not recommended for use in pediatric patients

17 years or older: See Adult Dose

Renal Dose Adjustments

Immediate-release:


Extended-release:

Liver Dose Adjustments

Immediate-release:


Extended-release:

Dose Adjustments

Concomitant use of Drugs affecting CYP450 Isoenzymes:


Safe Reduction or Discontinuation of Therapy in Patients who may be Physically Dependent:

Precautions

US BOXED WARNINGS: ADDICTION, ABUSE AND MISUSE; RISK EVALUATION AND MITIGATION STRATEGY (REMS); LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; ULTRA-RAPID METABOLISM OF TRAMADOL AND OTHER RISK FACTORS FOR LIFE-THREATENING RESPIRATORY DEPRESSION IN CHILDREN; NEONATAL OPIOID WITHDRAWAL SYNDROME; INTERACTIONS WITH DRUGS AFFECTING CYP450 ISOENZYMES; and RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS:


CONTRAINDICATIONS:

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule IV

Dialysis

Hemodialysis patients can receive their regular dose on dialysis days since only 7% of dose is removed
Peritoneal dialysis: No data available

Other Comments

OTHER COMMENTS:
Administration advice:


Extended release (ER) capsules and tablets:

General:

Monitoring:

Patient advice:

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.