Tramadol: an Analgesic Tramadol, also know as Saliva ER, Saliva Flashdose, Ultram, Ultram ER, and Ultram ODT, is an synthetic, centrally acting opioid analgesic. Ultracet is a combination drug of acetaminophen and tramadol. Tramadol can be taken orally four times daily. Extended-release tablet called Tramadol ER may be administered once daily (Hair, Curran, & Keam 2006). The recommended dose of tramadol is 50-100 mg (immediate release tablets) every 4-6 hours as needed for pain. The maximum dose is 400 mg/day. To improve tolerance patients should be started at 25 mg/day, and doses may be increased by 25 mg every 3 days to reach 100 mg/day (25 mg 4 times daily). Thereafter, doses can be increased by 50 mg every 3 days to reach 200 …show more content…

Controversy exists in regards to the effects of tramadol on children. Some sources state tramadol is not meant for children under the age of eighteen (drugs.com). However, other sources indicate that 2 mg/kg is safe for minors (Finkel et al., 2002). Yet other sources indicate 3mg/kg is safe. No studies were identified that prove tramadol has adverse effects on children, but two studies did indicate tramadol is safe and effective in children. It has been determined that 1-2 mg/kg by mouth every 4-6 hours is a safe and effective analgesic in patients seven to sixteen, when using it for no more than 30 days. "Tramadol seems to be both effective and well tolerated in this pediatric population" (Finkel et al., 2002, p. 1473). Another study examined the effects of Tramadol on a day case dental extraction with children ages 4 years to 7 years, each child having at least six teeth extracted. Thirty minutes from prior to the anesthetics, which was administered before the procedure, forty children received 3mg/kg of tramadol drops combined with 0.5 mg/kg oral midazolam (group T) and ten children were given placebo (group P) where no tramadol was administered. It is concluded that tramadol at 3 mg/kg has no clinical respiratory depressant effect and that behavior and recovery times are unaffected (Payne & Roelofse 2000). Tramadol is a pregnancy category C and therefore should not be taken during pregnancy or delivery. Administration of this medicine during this time