Tramadin Dosage/Direction for Use

The dosage should be adjusted to the intensity of pain and the individual's response to the analgesic action of tramadol.
Tramadol should not be used to treat minor pain.
Unless otherwise prescribed, tramadol 100 mg ampoules should be administered as follows: Single dose for adults and children over 14 years of age: IV: 100 mg-injected slowly and diluted in solution for infusion and infused; IM: 100 mg.
In general, a total daily dose should not exceed 400 mg of tramadol (equivalent to 4 ampoules).
Intravenous injection must be given slowly over 2-3 minutes.
For post-operative pain, administer an initial bolus further doses of 50 mg may be given every 30 minutes, up to a total dose of 250 mg including the initial bolus.
Subsequent doses should be 50 mg or 100 mg 4-6 hourly up to a total daily dose of 600 mg.
For less severe pain, administer 50 mg or 100 mg 4-6 hourly.
Elderly: The usual dosages may be used except in patients 75 years of age and over where a downward adjustment of the dose and/or prolongation of the interval between doses are recommended.
Renal impairment/renal dialysis: The elimination of tramadol may be prolonged. It is recommended that the usual initial dosage be used. For patients with a creatinine clearance <30 mL/min, the dosage interval should be increased to 12 hours. As tramadol is removed very slowly by hemodialysis or hemofiltration, postdialysis administration to maintain analgesia is not usually necessary.
Hepatic impairment: The elimination of tramadol may be prolonged. The usual initial dosage should be used but in severe hepatic impairment, the dosage interval should be increased to 12 hours.