Therapeutic Classification: analgesics (centrally acting), opioid analgesics
Pharmacologic Classification: opioid agonists
High Alert
Absorption: Immediate-release: 75% absorbed after oral administration; Extended-release: 8590% (compared with immediate-release).
Distribution: Crosses the placenta; enters breast milk.
Half-Life: Tramadol (immediate release): 68 hr, Extended release: 7.9 hr; Active metabolite: 79 hr; both are ↑ in renal or hepatic impairment.
(analgesia)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
PO-immediate release | 1 hr | 23 hr | 46 hr |
PO-extended release | unknown | 12 hr | 24 hr |
Contraindicated in:
Use Cautiously in:
Derm: pruritus, sweating
EENT: visual disturbances
Endo: hypoglycemia
F and E: hyponatremia
GI: constipation, nausea, abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, vomiting
GU: ↓fertility, menopausal symptoms, urinary retention/frequency
Neuro: dizziness, headache, somnolence, anxiety, confusion, coordination disturbance, euphoria, hypertonia, malaise, nervousness, SEIZURES, sleep disorder, stimulation, weakness
Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)
Misc: physical dependence, psychological dependence, tolerance
Drug-drug:
Drug-Natural Products:
Immediate Release
Renal Impairment
Hepatic Impairment
Extended Release
Lab Test Considerations:
Toxicity and Overdose:
NDC Code