Tramadol ER
Class
Narcotic analgesics
Subclass
Synthetic opioids
Substance name
traMADol hydrochloride ER
Brand names
Conzip®
Common formulations
Capsule
See also
Tramadol (Ultram®, Qdolo®)
Dosage and administration
Adults patients
Symptomatic relief
Pain • Severe, requiring opioids
Treatment
Postherpetic neuralgia • Off-label
Restless legs syndrome • Refractory • Off-label
Other off-label uses
Indications for use
Labeled indications
Adults
Off-label indications
Adults
Safety risks
Boxed warnings
Drug misuse, drug abuse, opioid use disorder
Increased serum tramadol levels, decreased serum tramadol levels
Neonatal abstinence syndrome
Profound sedation, respiratory depression, coma
Respiratory depression
Respiratory depression, apnea
Respiratory depression, death
Contraindications
Hypersensitivity to tramadol or its components or other opioids
Acute or severe asthma
Circulatory shock
Gastrointestinal obstruction
Impaired consciousness or coma
Significant respiratory depression
Suicidal ideation or prone to addiction
Concomitant use of MAOIs
Warnings and precautions
Adrenal insufficiency, opioid-induced hyperalgesia
Decreased blood glucose
Decreased serum sodium, decreased blood glucose
Exacerbation of increased ICP
Hypotension, syncope
Mask symptoms of head injury
Opioid withdrawal syndrome
Respiratory depression
Seizure
Serotonin syndrome
Somnolence
Sphincter of Oddi dysfunction
Suicidal ideation
Specific populations
Renal impairment
CrCl ≥ 30 mL/min
CrCl < 30 mL/min
Renal replacement therapy
Continuous renal replacement
Intermittent hemodialysis
Peritoneal dialysis
Hepatic impairment
Child-Pugh A (mild)
Child-Pugh B (moderate)
Child-Pugh C (severe)
Substantial chronic alcohol consumption
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: C
Breastfeeding
Do not use during breastfeeding.
Very low levels in breastfed infants (< 5%).
Unlikely to cause adverse effects in breastfed infants.
No overt adverse effects on lactation reported.
Adverse reactions
Very common > 10%
Common 1-10%
Uncommon < 1%
Unknown frequency
Interactions
Drug(s)
Check Interactions
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