Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Ultram, conzip, qdolo
Synonyms :
Tramadol, tramadolum
Class :
Opiod analgesics
Brand Name :
Ultram, conzip, qdolo
Synonyms :
Tramadol, tramadolum
Class :
Opiod analgesics
Adult dosing:
Dosage Forms & StrengthsÂ
TabletÂ
Immediate release:Â
50mgÂ
100mgÂ
Extended release:Â
100mgÂ
150mgÂ
200mgÂ
300mgÂ
Oral solutionÂ
5mg/mlÂ
Immediate release Acute:
50 - 100
mg
Tablets
Orally 
every 6 hrs
Do not exceed 400mg/day
Chronic:
Initial dose-25mg orally everyday morning
Maintenance dose-25-50mg/day for every three days
Final dose-50-100mg orally every 4-6 hours.Do not exceed 400mg/day
Extended-release
100mg orally daily once, up to 100mg/day for every five days.Do not exceed 300mg/day
Oral Solution
Initial dose-25mg/day orally ,increase the dosage by 25 mg every three days
Do not exceed 400mg/day
Dose Adjustments
Renal impairment
CrCl<30ml/min: No dosage adjustment is needed
CrCl>30ml/min: 50-100mg orally every 12 hour
Hepatic impairment
No dosage adjustment is necessary
Gediatric dosing:
Refer adult dosingÂ
may increase the central nervous system depressant effect
may increase the central nervous system depressant effect
may increase the central nervous system depressant effect
may enhance the CYP3A4 substrate serum concentration
may increase the central nervous system depressant effect
may increase the central nervous system depressant effect
may decrease the opiod agonists therapeutic effect
may increase the central nervous system depressant effect
may decrease the opiod agonists therapeutic effect
It may enhance serotonin levels when combined with tramadol
It may enhance serotonin levels when combined with tramadol
It may enhance toxicity when combined with tramadol by serotonin levels
It may enhance serotonin levels when combined with tramadol
phenobarbital: they may increase the CNS depressant effect of tramadol
CYP3A strong enhancers of the small intestine may reduce the bioavailability of tramadol 
it increases the effect of CNS depressants
it increases the effect of CNS depressants
CNS depressants increase the CNS depressing effect of paraldehyde
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance serotonin levels when combined with tramadol
It may enhance serotonin levels when combined with tramadol
It may enhance effects when combined with tramadol by pharmacodynamic synergism
It may enhance serotonin levels when combined with tramadol
It may enhance serotonin levels when combined with tramadol
may increase the toxic effect of Monoamine Oxidase Inhibitors
antiemetics increase the serotonergic effect of tramadol
antiemetics increase the serotonergic effect of tramadol
antiemetics increase the serotonergic effect of tramadol
antiemetics increase the serotonergic effect of tramadol
tramadol: they may enhance the serum concentration of digoxin
tramadol: they may diminish the serum concentration of CYP3A4 Inducers
tramadol: they may diminish the serum concentration of CYP3A4 Inducers
tramadol: they may diminish the serum concentration of CYP3A4 Inducers
tramadol: they may diminish the serum concentration of CYP3A4 Inducers
tramadol: they may diminish the serum concentration of CYP3A4 Inducers
tramadol and mephenesin, when used together, the risk or seriousness of CNS depression may rise
tramadol: they may enhance the serum concentration of CYP2D6 Inhibitors
tramadol: they may enhance the serum concentration of CYP2D6 Inhibitors
tramadol: they may enhance the serum concentration of CYP2D6 Inhibitors
tramadol: they may enhance the serum concentration of CYP2D6 Inhibitors
tramadol: they may enhance the serum concentration of CYP2D6 Inhibitors
tramadol : it may increase the toxic effect of Methemoglobinemia Associated Agents
tramadol : it may increase the toxic effect of Methemoglobinemia Associated Agents
tramadol : it may increase the toxic effect of Methemoglobinemia Associated Agents
tramadol : it may increase the toxic effect of Methemoglobinemia Associated Agents
tramadol : it may increase the toxic effect of Methemoglobinemia Associated Agents
an increase in serum level with a decreased excretion rate of almasilate is observed when used in combination with tramadol
tramadol excretion rate is decreased when ceftizoxime is used in combination, which leads to elevated serum level concentrations
when used with dalfopristin, tramadol metabolism may be slowed down
the effect of tramadol is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
ondansetron increases the serotonergic effect of tramadol
antiemetics increases the serotonergic effect of tramadol
antiemetics increases the serotonergic effect of tramadol
perampanel may enhance the CNS depressant effect of CNS Depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
when combined, it may increase sedation
may increase the level of effectiveness through P-glycoprotein MDR1 efflux transporter
when combined, it may increase sedation
may increase the toxic effects
may increase the serum concentrations of CYP2D6 inhibitors
It may enhance serotonin levels when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
It may enhance sedation when combined with tramadol
sedative effects can be increased when tramadol is administered with papaverine
may enhance the serum concentration
may enhance the serum concentration
may enhance the serum concentration
may enhance the serum concentration
may enhance the serum concentration
an increase in severity of adverse effects can be seen when agmatine is administered with tramadol
when used with quinupristin, tramadol metabolism may be slowed down
the rate of metabolism may be altered
the risk of serotonin will be increased when zotepine is taken with tramadol
Tramadol binds to κ, δ and the μ-opioid receptor with 6000-fold less affinity than morphine. The pathways are complementary and synergistic that improves drug ability to modulate the perception of and response to pain.
Frequency defined:Â Â
>10%Â
Immediate releaseÂ
AstheniaÂ
HeadacheÂ
VomitingÂ
CNS stimulationÂ
DizzinessÂ
DyspepsiaÂ
Extended-releaseÂ
Dry mouthÂ
HeadacheÂ
VomitingÂ
NauseaÂ
1-10%Â
Immediate releaseÂ
AnorexiaÂ
ConfusionÂ
HypertoniaÂ
Dry mouthÂ
Abdominal painÂ
RashÂ
SweatingÂ
Urinary frequencyÂ
FlatulenceÂ
Extended-releaseÂ
AnorexiaÂ
SweatingÂ
AstheniaÂ
InsomniaÂ
FeverÂ
Prostatic disorderÂ
MyalgiaÂ
Peripheral edemaÂ
VasodilationÂ
<1%Â
Immediate releaseÂ
DyspneaÂ
SyncopeÂ
Weight lossÂ
Menstrual disorderÂ
UrticariaÂ
TachycardiaÂ
AmnesiaÂ
SeizureÂ
Extended-releaseÂ
AnemiaÂ
ArthritisÂ
PneumoniaÂ
Eye disorderÂ
DysuriaÂ
Leg crampsÂ
Post-marketing reportsÂ
DeliriumÂ
MydriasisÂ
HypoglycemiaÂ
Androgen deficiencyÂ
HyponatremiaÂ
Tramadol can be addictive drug and causes overdose even at recommended doses.
Use only as prescribed. It can cause life-threatening respiratory depression at the start or as dose increases.
Contraindications:Â
HypersensitivityÂ
Acute or Severe AsthmaÂ
Respiratory DepressionÂ
Cautions:Â
History of SeizuresÂ
Concurrent Use of CNS DepressantsÂ
Liver or Kidney ImpairmentÂ
History of Substance AbuseÂ
Pregnancy/Lactation:Â
Pregnancy consideration: Insufficient data availableÂ
Lactation: The drug is excreted in the human breast milkÂ
Pregnancy category:Â
Tramadol inhibits norepinephrine and serotonin reuptake in spinal cord to enhance analgesic properties. It affects inflammatory and immune mediators in pain response, PGE2, and shifting M1 macrophage polarization.
Pharmacodynamics:
Tramadol causes respiratory depression that affects the brain stem respiratory centres to increase CO2 and electrical stimulation. It reduces motility in the antrum and duodenum to delay small intestine digestion.
Pharmacokinetic:
Absorption:
Peak plasma time:
For immediate release: 1.5 hour
For extended release: 10 to 12 hours
Distribution:
Volume of distribution:
2.6L/kg in males
2.9 L/kg in females
Metabolism:
It undergoes hepatic metabolism with CYP2D6 and CYP3A4 pathways.
Excretion and elimination:
Half-life:
For immediate release: 7.61 hour
For extended release: ~10 hour
It is taken orally in tablet, capsule, and solution form.
Generic Name: Tramadol
Why do we use Tramadol?
Tramadol is used in treatment of moderate to severe pain.
The off-label use in the treatment of premature ejaculation and restless leg syndrome.
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