Tramal
Tramal is an opioid painkiller used to relieve moderate to severe pain by acting on nerve cells in the brain and spinal cord.
How to Use
Dosage
For adults and teenagers over 12, the starting dose is 1-2 ml (50-100 mg tramadol hydrochloride). For children 1 year and older, the typical single dose is 1-2 mg per kg of body weight. Always use the lowest effective dose.
Method
Tramal is given as a slow injection into a vein (usually in the arm), into a muscle (usually the buttocks), or under the skin. It can also be diluted and given as an infusion into a vein.
The usual maximum daily dose is 8 ml (400 mg tramadol hydrochloride). For children, the maximum daily dose is 8 mg per kg of body weight or 400 mg, whichever is less.
Possible Side Effects
- •Dizziness
- •Nausea
- •Headache
- •Drowsiness
- •Fatigue
- •Constipation
- •Dry mouth
- •Vomiting
- •Increased sweating
- •Heart palpitations
- •Fast heartbeat
- •Weakness or fainting
- •Retching
- •Stomach discomfort or bloating
- •Diarrhea
- •Skin reactions (e.g., itching, rash)
- •Allergic reactions (e.g., breathing difficulties, wheezing, skin swelling)
- •Shock
- •Slow heartbeat
- •Increased blood pressure
- •Unusual sensations (e.g., itching, tingling, numbness)
- •Tremors
- •Convulsions/Seizures
- •Muscle twitching
- •Coordination disorders
- •Speech disorders
- •Changes in appetite
- •Hallucinations
- •Confusion
- •Sleep disorders
- •Sudden confusion (delirium)
- •Anxiety
- •Nightmares
- •Mood changes
- •Activity changes
- •Changes in thinking or perception
- •Blurred vision
- •Dilated pupils
- •Constricted pupils
- •Shortness of breath
- •Slow breathing
- •Muscle weakness
- •Difficulty or pain when urinating, reduced urine output
- •Increased liver enzyme values
- •Low blood sugar
- •Hiccups
Important Warnings
- Do not use if you are allergic to tramadol or any other ingredient in this medicine.
- Avoid if you are acutely poisoned by alcohol, sleeping pills, or other medicines that affect the brain.
- Do not use if you have taken MAO inhibitors (medicines for depression) in the last 14 days.
- Tell your doctor if you have epilepsy that is not well controlled by medication, or a history of seizures.
- Do not use if you are receiving treatment for opioid dependence or withdrawal.
Show 9 more warnings
- Inform your doctor if you have severe liver or kidney problems.
- This medicine contains tramadol, which is an opioid. Repeated use can lead to tolerance, dependence, abuse, and addiction, which can be life-threatening.
- Not recommended for children with breathing difficulties, as tramadol poisoning symptoms can be worse in such children.
- Tramal can cause sleep-related breathing problems like sleep apnea (breathing pauses during sleep) and low blood oxygen levels. Seek medical advice if you or someone else notices these symptoms.
- Do not drink alcohol while using Tramal, as it can make the medicine's effects stronger.
- This medicine may cause drowsiness, dizziness, or blurred vision, which can affect your ability to drive or operate machinery. Do not drive or use heavy machinery if you feel your reactions are impaired.
- Seek medical attention if you experience extreme tiredness, loss of appetite, severe stomach pain, nausea, vomiting, or low blood pressure, as these could be signs of adrenal insufficiency.
- Tell your doctor if you have symptoms like feeling faint, cold sweats (shock), high pressure in your head (due to injury or illness), or breathing difficulties.
- Be aware of interactions with other medicines, including certain antidepressants, which can cause a serious condition called serotonin syndrome.
Use in Elderly Patients
Avoid use in older adults. Serotonergic. Prodrug. Genotype affects the response. Reduce the dose in moderately severe and severe renal impairment. Increases the risk of confusion and falling. Need for laxative is often necessary. Consider potential interactions. (updated 18.8.2025)