Adult:
≥12 yr: As combination tablet containing tramadol hydrochloride 37.5 mg and paracetamol 325 mg: 2 tablets at least every 6 hrly.
Max Dosage: 8 tablets daily.
Oral
MODERATE TO SEVERE PAIN
Child:
≥12 yr: As combination tablet containing tramadol hydrochloride 37.5 mg and paracetamol 325 mg: 2 tablets at least every 6 hrly.
Max Dosage: 8 tablets daily.
Precautions
Not recommended in severe renal impairment (CrCl <10 ml/min), severe respiratory insufficiency, liver disease or opioid dependent patients. Increased intracranial pressure or head injury, patients at risk of seizures or on drugs that may lower the seizure threshold (e.g. SSRI, TCA, antipsychotics, centrally acting analgesics or local anaesthesia), biliary tract disorders, in a state of shock or unconsciousness. May impair ability to drive or operate machinery. Avoid abrupt withdrawal. May cause withdrawal symptoms, dependence and abuse. Elderly. Pregnancy, lactation.
Potentially Life-threatening
Adverse Drug Reactions
Increased risk serotonin syndrome with SSRI and triptans. Increased risk of seizures of SSRI, TCA, antipsychotics, centrally acting analgesics or local anaesthesia. Decreased tramadol levels with carbamazepine. Decreased analgesic efficacy of tramadol with ondansetron. Increased INR with warfarin.
