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What Factors Affect Tramadol Dosage?

By Amanda Barnhart
Updated May 17, 2024
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Patients with moderate to severe pain are often prescribed tramadol to help relieve their symptoms. The medication is classified as a narcotic painkiller, making the potential for tolerance, dependency, and abuse high. Due to the possibility of serious side effects and the risk of addiction, doctors monitor patients' tramadol dosage carefully to ensure they are getting enough of the drug to be helpful but not so much that it puts them at a higher risk for problems. The main factors that affect tramadol dosage are the patient's pain level, cause of pain, age, and what other medications the patient takes.

Tramadol is available in immediate-release and extended-release formulas. Patients taking tramadol for short periods of time to control acute pain, such as pain associated with an injury or surgery, are typically prescribed immediate release tablets, which are 50 mg each. Many doctors advise their patients to start taking half a tablet, or 25 mg, as a starter tramadol dosage to delay the patient developing a tolerance to the drug. Health care professionals usually advise their patients to increase the dose gradually, adding 25 to 50 mg every three days until their symptoms improve or they reach the maximum dosage.

Patients who have severe pain may be advised to take up to 100 mg at a time if lower doses fail to adequately control their symptoms. Daily tramadol dosage should not exceed 400 mg. Each dosage should be taken at least four to six hours apart. Patients with liver or kidney problems generally take tramadol dosages at least 12 hours apart, and they may only be prescribed between 50 and 200 mg daily, depending on their conditions.

Tramadol is available in extended-release tablets for patients with chronic pain that requires constant treatment to reduce symptoms. The tablets are available in 100, 200, and 300 mg strengths, and doctors usually start patients with the lowest dose so that they can increase it as necessary to enable the patient to take the lowest effective tramadol dosage. Extended-release medications are usually only taken once per day.

Patients who experience negative side effects from tramadol should consult with their doctors to alter the dosage if necessary. Taking certain medications can make the body more sensitive to some of the side effects of tramadol, such as drowsiness, so dosage of one or both medications may need to be adjusted. Tramadol is typically used by adults, though it is approved for pediatric use in children who are at least 16, with a daily maximum dosage of 300 mg.

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