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Tramest (Tramadol)

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Tramest is a centrally-acting opioid agonist and SNRI (serotonin/norepinephrine reuptake inhibitor) used for the management of moderate to severe pain in adults. Tramest is a centrally acting synthetic opioid analgesic and SNRI (serotonin/norepinephrine reuptake-inhibitor) that is structurally related to codeine and morphine.

Other names for this medication:
Accupain, Adamon, Anazac, Combitram, Contradoc, Damadol, Dolocet, Dolotram, Domadol, Hyperdol, Kamadol, Madol, Moludol, Movon, Muzox, Opidol, Opigesic, Paintrol, Rybix, Soztram, Tacil, Tandam, Taramol, Traceta, Tradol, Tramagesic, Tramdop, Tramoflex, Tramospas, Tranat, Trandol, Trasic, Trectadol, Typhon, Ultracon, Ultrax, Unidol, Urgendol, Urogendo, Vardol, Xidol

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Tenormin, Terramycin, Aurogra, Aldara, Benicar, Prilosec, Silagra, Abhigra, Levosina, Novozitron, Levoxal, Mendazole, Oncomide, Zopotol, Curretab,

Also known as: Tramadol


Tramest ER is an pain medicine similar to an opioid. This medicine is used to treat moderate to severe pain.

The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.


Usual Adult Dose for Pain:

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain -For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain:

Extended-Release (ER): 18 years or older (tramadol-naive): 100 mg orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day For patients CURRENTLY receiving Immediate-Release (IR) Tramest: Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day Conversion from OTHER Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy -Initial dose: 100 mg ER orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day.

Usual Geriatric Dose for Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Geriatric Dose for Chronic Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Pediatric Dose for Pain:

Tramest is not recommended for use in pediatric patients 17 years or older: See Adult Dose.

Detailed Tramest dosage information


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.


Store at room temperature 15 and 30 degrees C (59 and 86 degrees F) away from away from moisture, light and heat. Do not store in the bathroom. Throw away any unused medicine after the expiration date. Keep out of the reach of children in a container that small children cannot open.

Side effects

The most common side effects associated with Tramest are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


You should not take Tramest if you are allergic to tramadol, or if you have:

severe asthma or breathing problems; a stomach or bowel obstruction (including paralytic ileus); if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications; or if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine).

Tramest should not be given to a child younger than 12 years old. Tramest ER should not be given to anyone younger than 18 years old.

Do not give Tramest to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.

Seizures have occurred in some people taking Tramest. Your seizure risk may be higher if you have ever had:

a head injury, epilepsy or other seizure disorder; drug or alcohol addiction; or a metabolic disorder.

To make sure Tramest is safe for you, tell your doctor if you have ever had:

breathing problems, sleep apnea; liver or kidney disease; urination problems; problems with your gallbladder, pancreas, or thyroid; a stomach disorder; or mental illness, or suicide attempt.

If you use tramadol during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Ask a doctor before using tramadol if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

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