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Tramadex (Tramadol)

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Tramadex is an oral medication that is used to help relieve ongoing moderate to moderately severe pain. Tramadex is similar to opioid (narcotic) analgesics. It works in the brain to change how your body feels and responds to pain.

Other names for this medication:
Acupain, Acuvin, Adamon, Anazac, Antram, Axedol, Damol, Dolocet, Inodol, Ivydol, Jpdol, Kamadol, Kevtram, Madol, Mobiya, Moludol, Muzox, Neutram, Nomadol, Ondol, Opidol, Ramadol, Ramax, Ramcet, Rybix, Sayodol, Sedate, Spasteez, Tamody, Tragesic, Tramaflam, Tramatas, Tramataur, Tramazac, Tramoflex, Trandy, Transic, Tranzat, Trofel, Ubitdol, Veeradol, Xidol, Xtram, Zytram

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Addyi, Effexor, Terramycin, Eldepryl, Sildigra, Imovane, Neoral, Micardis, Avelox, Nazol, Navalin, Mixogen, Topgraf, Pantin, Grisoral, Elazor,

Also known as: Tramadol


Tramadex (tramadol) is a pain medicine similar to an opioid. It acts in the central nervous system (CNS) to relieve pain.

Tramadex is used to treat moderate to severe pain in adults.

The extended-release form of tramadol (Tramadex ER) is for around-the-clock treatment of pain. Tramadex ER 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) Tramadex: 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:

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

Detailed Tramadex 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 between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Tramadex 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 Tramadex ER if you are allergic to it, 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).

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

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

Seizures have occurred in some people taking Tramadex ER. 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.

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 Tramadex ER 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 Tramadex ER if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

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Refractory thrombotic thrombocytopenic purpura: successful treatment by plasmapheresis with plasma cryosupernatant. In rats, these changes occur in the first 25 days of extrauterine development. Scanning electron microscopy of heterochromatin in chromosome spreads of male germ cells in Schistocerca gregaria (Acrididae, Orthoptera) after trypsinization. Values increased above 0.05 microg l-1 in four patients in the GDT group and two patients in the control group. Growth and regression of arteriovenous malformations in a patient with hereditary hemorrhagic telangiectasia. 2-Deoxy-D-glucose reduces epilepsy progression by NRSF-CtBP-dependent metabolic regulation of chromatin structure. Hearing of the African lungfish (Protopterus annectens) suggests underwater pressure detection and rudimentary aerial hearing in early tetrapods. Significantly reduced radiation dose to operators during percutaneous vertebroplasty using a new cement delivery device. Responses of the photosynthetic machinery of Spirulina maxima to induced reactive oxygen species. The visual analysis revealed that ischemic lesions were best depicted with sampling intervals of 0.5 and 1s.

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Prevalence of hearing impairment and hearing complaints in older adults: a study in general practice. Intact and adrenalectomized (ADX) rats were either injected with 0.1 mL of NAL (0.32 microgram/100 g BW), 2.4 mg/kg DOC or 120 micrograms/kg DEX or had 1.0 mg/mL GCA dissolved in their drinking water or normal saline (for the ADX group) dissolved in their drinking water. Endoscopic sphincterotomy has revolutionized the approach to numerous biliary and pancreatic diseases. The oligosaccharides were cleaved from the protein backbone and the glycans from the HPA-binding glycoform of IgA1 were compared with those from normal human IgA1. The result indicates a unique quenching effect of tetrabutylammonium cation on the pyrene excimer, and which is not observed in the other cations with different chain lengths (the same associated hexafluorophosphate anions). Sub-lethal heat stress causes apoptosis in an Antarctic fish that lacks an inducible heat shock response. Viral protease inhibitors are remarkably effective at blocking the replication of viruses such as human immunodeficiency virus and hepatitis C virus, but they inevitably lead to the selection of inhibitor-resistant mutants, which may contribute to ongoing disease.

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Glycolitho-, sulfolitho-, deoxycholic and 3-beta-hydroxy-5-cholenoic acids induced similar but less pronounced changes of alpha 1-Pi, whereas transferrin remained unaffected. Treatments were carried out using several TNF-alpha concentrations, as well as specific pharmacological inhibitors of MAPKs. MMR vaccination and disease elimination: the Finnish experience. The periodic mesostructure of the SiO2-P2O5 films was retained after calcination. Demonstration of its existence by EPR spectroscopy of 5-DOXYL-stearic acid. Patients were characterized as trial participants if highly active antiretroviral therapy (HAART) was initiated within a clinical trial.

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Various problems in the surgical treatment of acute pancreatitis. Twenty healthy participants were administered a masked emotional Stroop task (comparing color-naming latencies for angry, neutral and happy faces) in conditions of rest and social stress. These longitudinal changes depended upon the degree of initial motor impairment: Patients with mild deficits did not differ from healthy subjects. The scope of this study is to better understand CGA synthesis in this plant. Cases with acute stroke symptoms without alternative diagnoses after embolization were diagnosed as ACI. It was found that skeletal muscle cells formed both in vitro and in vivo and cardiac muscle cells formed in vivo synthesize myofibrillar proteins faster when supplied creatine in vitro. Banding of the main pulmonary artery was undertaken in 11 litter-mate puppies and 8 young adult beagle dogs to study the response of the right ventricle to pressure loading. To explore the submolecular basis of these interactions, we conducted mutational analysis to localize sites in p53/56lyn and p59fyn that bind nonphosphorylated and phosphorylated Ig-alpha. Dynamic electron spin resonance (ESR) imaging of the distribution of spin labeled dextran in a mouse. The purpose was to radiographically analyze and compare the marginal bone loss (MBL) between implants with different mismatching distance and to study the influence of the prosthetic abutment height on the MBL in association with the related mismatching distances.

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Inactivation of lipid-enveloped and non-lipid-enveloped model viruses in normal human plasma by crosslinked starch-iodine. Environmental and economic sustainability of the Mediterranean Diet. A comparison of dosimetric findings in 33 patients treated with the Contura multilumen balloon (SenoRx Inc., Irvine, CA) (C-MLB) breast brachytherapy catheter vs. This paper presents mixed Markov models for ordinal data that take into account both sources of variation. Hamster PL-II message increased to Day 14 and remained elevated on Day 15. In the absence of this regulated nuclear egress, mutants of the alphaherpesvirus pseudorabies virus have been described that escape from the nucleus after virus-induced nuclear envelope breakdown. Postnatal DEX exposure was associated with higher expiratory flow with no adverse effects on pulmonary outcomes at school age. Immobilized BLA was observed to produce a different saccharide profile than free BLA at any value of dextrose equivalent. Periodontal health and diabetes awareness among Saudi diabetes patients. The activation latencies were very similar in both regions ( approximately 135 ms) following the direction change onset.

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Three-hundred and fifty-five individuals of both sexes, between 40 and 70 years with no cardiovascular events or lipid lowering treatment who participated in the Adult Health Program between January 1, 2003 and December 31, 2004, of which 192 were lost. In the presence of nano zero-valent iron, not only the short-chain fatty acids production was significantly improved, but also the fermentation time for maximal short-chain fatty acids was shortened compared with those in the absence of nano zero-valent iron. Two cases occurred in the same family and diagnosed prenatally by means of ultrasound, and antenatal and postnatal MR imaging are reported. Here, we use the restoration of male reproductive effort with unfamiliar females to differentiate the role of diminishing returns and lifetime costs of increased reproductive effort of male guppies. Neutralizing antibodies inhibit axonal spread of herpes simplex azithromycin zithromax 250 mg tab virus type 1 to epidermal cells in vitro. The nasal airways response in normal subjects to oxymetazoline spray: randomized double-blind placebo-controlled trial. In the search for relevant tumor markers for improved patient selection an exploration of the proteome (the human proteins) could be fruitful. Arthroscopic meniscal repair in conjunction with anterior cruciate ligament reconstruction: factors affecting the healing rate. All children with CP should have an MRI scan to provide information on the timing and extent of the lesion. Patients with re-obstruction of the culprit lesion after reperfusion were excluded from the study.

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It is not known whether the avipoxvirus vaccine strain used in Croatia is contaminated with REV or if the REV is naturally contaminating Croatian field strains of fowl poxvirus. Given that defects in autophagy lead to increased susceptibility to infection, we investigated the role of autophagy in Helicobacter pylori-related gastric cancer (GC). is a member of the CIHR sponsored Reproduction and Early Development in Health training program. This was a retrospective, observational study from a single center. There are both genetic and environmental influences on WHR and WC, independent of BMI in both males and females, and the differences between the sexes are significantly different. Most registries measure multiple outcomes and capture real-world data that may be unavailable through other study designs. Analysis of 15-day-old efferent-duct-ligated animals at all later ages examined revealed that there was no change in LRP-2 expression along the entire epididymis, suggesting that both the stimulatory and inhibitory factors are not luminally derived testicular substances.

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Comparative antiarrhythmic efficacy of amiodarone and dronedarone during acute myocardial infarction in rats. There was direct lymphatic drainage to paravertebral nodes in the chest on the right side at the level of the sixth and seventh thoracic vertebrae. A fluorescence image cytometry technique was developed to measure the effects of topotecan, a topoisomerase I inhibitor, on the nuclear expression of topoisomerase II alpha in a series of patients with refractory or relapsed acute myeloid leukemia (AML). After bacterial isolation and identification, the administration of ampicillin and gentamicin was followed by the complete recovery of our patient. The health of a Hmong woman had been deteriorating since she underwent caesarean section. On the structure and operation of type I DNA restriction enzymes. We study changes in curvature and elastic properties of lipid membranes induced by anchoring of long hydrophilic polymers at low polymer surface concentrations (corresponding to the mushroom regime).

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Accuracy and reproducibility of brain and how much is nizoral shampoo in mercury drug tissue volumes using a magnetic resonance segmentation method. Preloaded refractive-addition corneal inlay to compensate for presbyopia implanted using a femtosecond laser: one-year visual outcomes and safety. Field populations with a large phenotypic variety were sampled in a range of lakes and streams with different chemical and physical properties. We report a case in which ovarian tumor was revealed by this condition. The G protein-coupled estrogen receptor-1, GPER-1, promotes fibrillogenesis via a Shc-dependent pathway resulting in anchorage-independent growth. We evaluated the mortality pattern of male licensed pesticide users and their wives in central Italy.

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