— Product
TRAMARITE 2ML INJ
TRAMADOL HCL 50MG 2ML INJ
TRAMARITE 2ML INJ is an injection of tramadol hydrochloride 50 mg per ml in a 2 ml ampoule, a centrally acting opioid analgesic given intramuscularly or by slow intravenous injection. It is used for moderate to severe acute pain — post-operative pain, renal colic, trauma and acute musculoskeletal injury.
01
Benefits
- Combines weak opioid receptor agonism with inhibition of noradrenaline and serotonin reuptake, giving analgesia through two mechanisms.
- Causes less respiratory depression than conventional strong opioids at equianalgesic doses.
- Less constipating than morphine and with a lower risk of dependence, though the risk is real.
- The injectable route gives rapid relief where oral analgesia is impractical or insufficient.
- Useful as a step between simple analgesics and strong opioids in the acute setting.
02
Side effects
Not everyone gets these. Most are mild and settle as the course finishes.
Common
- Nausea and vomiting, which are common and often limiting
- Dizziness or drowsiness
- Sweating
- Dry mouth
Less common
- Constipation
- Headache
- Confusion, particularly in the elderly
- Fall in blood pressure after rapid intravenous injection
Stop and get medical help if any of these occur
- Slow or shallow breathing, or difficulty rousing the patient
- Seizures
- Agitation, confusion, fever, sweating, tremor or muscle rigidity — this may be serotonin syndrome
- Severe drowsiness with pinpoint pupils
- Swelling of the face, lips or tongue, or difficulty breathing
- Confusion with nausea and headache, which may indicate low sodium
03
Precautions
- Tramadol lowers the seizure threshold. Contraindicated in uncontrolled epilepsy, and use with caution in any seizure history, in head injury, and alongside other drugs that lower the threshold.
- Risk of serotonin syndrome with SSRIs, SNRIs, tricyclics, MAOIs, triptans and linezolid. Contraindicated with, or within fourteen days of, a monoamine oxidase inhibitor.
- Combining with benzodiazepines, gabapentinoids or alcohol causes profound sedation and respiratory depression and can be fatal.
- Tramadol is a controlled drug with real dependence potential. Use for the shortest period necessary and avoid in a history of substance misuse.
- Analgesic effect depends on CYP2D6 metabolism — ultra-rapid metabolisers are at risk of opioid toxicity, poor metabolisers of inadequate analgesia.
- Contraindicated in children under twelve, and after tonsillectomy or adenoidectomy in children under eighteen.
- Dose reduction is required in the elderly and in hepatic or renal impairment. Give intravenous doses slowly.
- Causes drowsiness — the patient must not drive. Use in pregnancy and breastfeeding only where clearly indicated.