Indications:

Moderate to severe pain syndrome of different genesis (including malignant tumors, acute myocardial infarction, neuralgia, trauma). Painful diagnostic or therapeutic procedures.

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Contraindications
Hypersensitivity, intoxication by alcohol, hypnotics, narcotic analgesics and other psychoactive drugs, pregnancy, lactation (in case of long-term use), children (under 1 year old – for parenteral administration; under 14 years old – for oral administration), taking MAO inhibitors.

Caution:
Opioid addiction, impaired consciousness of various genesis, intracranial hypertension, head injuries, epileptic syndrome (cerebral genesis), conditions accompanied by respiratory depression or pronounced CNS depression.

Pregnancy and lactation:
Adequate and well-controlled studies in humans have not been performed. In animals it caused embryo- and fetotoxic, but not teratogenic effects. Do not use! Penetrates into breast milk at low doses. Do not use!

FDA recommendations – Category C.

Directions for use and dosage:
Adults and children over 14 years of age, single dose when administered orally is 50 mg, rectally 100 mg, intravenously slowly or intramuscularly 50-100 mg. If parenteral administration is not effective enough, an oral dose of 50 mg is possible after 20-30 minutes.

The dosage for children aged 1 to 14 years is established at the rate of 1 to 2 mg/kg.

The duration of treatment is determined individually.

Maximum dose: for adults and children over 14 years old regardless of the method of administration – 400 mg per day.

Specific Notes:

Synthetic opioid analgesic, lower affinity for opioid receptors-10 times compared to codeine and 6,000 times compared to morphine. However, the active metabolite is 2-4 times more active than tramadol. Severity of analgesic effect: 5-10 times weaker than morphine.

Tramadol is effective for back pain; however, the appropriateness of its use for this condition requires further research.