Ultram is an FDA-approved medication for pain relief. It has specific indications for moderate to severe pain. It is considered a class IV drug by the FDA and has been since July of 2014. Due to possible misuse disorder potential, limitations to its use should be for pain that is refractory to other pain medication, such as non-opioid pain medication. There are two forms of tramadol: extended-release and immediate release. This activity outlines the indications, mechanism of action, methods of administration, important adverse effects, contraindications, toxicity, and monitoring, of tramadol so providers can direct patient therapy where it is indicated as part of the interprofessional team.
Dosage and Administration of Ultram
Ultram is typically started at a low dose and gradually increased until pain is under control. Dosage should be individualized based on pain severity, therapy response, prior treatment experience and risk factors of addiction, abuse and misuse.
Usual Adult Dose for Pain:
Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain
-For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days
Maximum dose: 400 mg per day.
Usual Adult Dose for Chronic Pain:
18 years or older (tramadol-naive): 100 mg orally once a day
-Individually titrate in 100 mg ining Immediate-Release (IR) Ultram:
Initial Dose: Calculatcrements every 5 days to an effective dose that minimizes adverse reactions
-Maximum Dose: 300 mg/day
For patients CURRENTLY receive 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
-Initial dose: 100 mg ER orally once a day
-Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions
-Maximum Dose: 300 mg/day.
What should I know!
Do not drink alcohol. Dangerous side effects or death could occur. Avoid driving or hazardous activity until you know how tramadol will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. For more side effects