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Opioid Analgesic (Weak) / SNRI

Tramadol 50–100mg

Brand names: Zamadol, Zydol, Mabron (MR)

Tramadol is a centrally acting opioid analgesic used here for moderate-to-severe acute pain following orthopaedic injury or surgery, often as a step beyond simple analgesics.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a weak mu-opioid receptor agonist whose activity is augmented by inhibition of noradrenaline and serotonin reuptake, giving a dual analgesic mechanism.

Prescribing in practice

  • Lowers the seizure threshold and carries a meaningful serotonin syndrome risk, so avoid combining with other serotonergic agents and use cautiously in patients with epilepsy or head injury.
  • Analgesic response varies with CYP2D6 metaboliser status, and the combination of opioid and monoaminergic effects means respiratory depression and dependence remain possible.
  • Use the lowest effective dose for the shortest period, reassess regularly, and consider step-down to non-opioid analgesia as the injury settles.

Monitoring

Monitor pain scores, sedation and respiratory rate, and watch for signs of serotonin toxicity or dependence with continued use.

Counselling the patient

  • May cause drowsiness and dizziness, so avoid driving until you know how it affects you.
  • Do not take with other sedatives or alcohol, and report any agitation, tremor or confusion promptly.
  • Take only as prescribed and do not stop abruptly after prolonged use.

Evidence & guidelines

Tramadol is an established option in stepwise acute pain management, and MHRA advice reflects its seizure, serotonin and dependence risks.

Reference: NICE NG59 (Low Back Pain); WHO Analgesic Ladder; MHRA Drug Safety Update (tramadol in children); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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