Tramadol
A weaker opioid. 50–100 mg every 4–6 hours, maximum 400 mg a day. Causes nausea, dizziness, seizures and dependence.
Common brands in Pakistan: Tramal. Brand availability changes; check with your pharmacy.
On this page
Uses
- Moderate pain when NSAIDs and paracetamol aren't enough.
Adult dose
| Route | Dose |
|---|---|
| Oral or IV | 50–100 mg every 4–6 hours, max 400 mg/day (300 mg/day over 75 years) |
Kidney and liver
Creatinine clearance below 30: every 12 hours, max 200 mg/day. Reduce in liver disease.
Pregnancy and breastfeeding
Avoid if possible.
Side effects and cautions
- Nausea, dizziness, constipation, drowsiness.
- Lowers seizure threshold: avoid in epilepsy.
- Serotonin syndrome with SSRIs and other serotonergic drugs.
- Dependence and misuse are common.
Frequently asked questions
What is the maximum dose of tramadol?
400 mg in 24 hours (300 mg in people over 75).
Sources
Doses on this page are typical doses from the sources above. Always confirm with a current drug reference, the product leaflet and your hospital protocol, especially in children, pregnancy and kidney or liver disease.
For FCPS Part 1
Revising for FCPS Part 1? Tramadol is covered in our textbook chapter Antiepileptics and sedatives, with practice MCQs.