What Is Tramadol?

Commonly Prescribed Alternatives

For patients who cannot take tramadol, doctors may prescribe other opioids. Commonly prescribed alternatives to tramadol include hydrocodone, hydrocodone-acetaminophen, meperidine, and codeine. Tramadol is a relatively weak opioid, and doctors may need to prescribe something stronger for patients in moderate to severe pain. Medicines such as morphine, oxycodone, and oxymorphone may be considered.

For patients in very severe pain, hydromorphone or fentanyl could be prescribed. All of these drugs are controlled substances that may cause dependence. Patients are often very sedated on these medicines, and they could experience confusion. Due to the side effects of opioids, some doctors often recommend that patients try other methods of pain relief before starting opioids.

Dosage Factors

Healthcare providers consider a patient's age, general health, and pain level when deciding on an appropriate dose of tramadol. For acute pain, the recommended dose for adults is fifty to one hundred milligrams every four to six hours as needed to control pain. Adults who take tramadol for chronic pain may use an extended-release tablet of one hundred milligrams. This is usually taken once per day. Patients who are seventy-five years old and older should not take more than three hundred milligrams of the immediate-release tablet in one day.

This drug is not intended for use in patients under seventeen years old, and individuals who have certain pre-existing health conditions may need to have their dose adjusted. For example, patients who have liver cirrhosis are advised to take fifty milligrams of the immediate-release tablet every twelve hours, and individuals with severe liver impairment should not use tramadol at all. Patients with kidney issues and CrCl values of less than thirty milliliters per minute should take no more than two hundred milligrams of tramadol per day. The extended-release tablet is not recommended for patients with renal issues.