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- To be prescribed only by healthcare providers knowledgeable in use of potent opioids for management of chronic pain.
- Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
- Individualize dosing based on the severity of pain, patient response, prior analgesic experience, and risk factors for addiction, abuse, and misuse.
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- Children younger than 12 years of age.
- Postoperative management in children younger than 18 years of age following tonsillectomy and/or adenoidectomy.
- Significant respiratory depression
Acute or severe bronchial asthma in an unmonitored setting or in absence of resuscitative equipment
- Known or suspected gastrointestinal obstruction, including paralytic ileus (4) • Hypersensitivity to tramadol
• Concurrent use of monoamine oxidase inhibitors (MAOIs) or use within the last 14 days.