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Usual Pediatric Dose for Pain 17 years or older: Immediate-release: 50 to 100 mg orally every 4 to 6 hours as needed for pain Maximum dose: 400 mg per day For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, tolerability can be improved by initiating slowly:
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…in many cases of tramadol dependence, a history of substance abuse is present….but….the evidence for physical dependence was considered minimal. Consequently, Tramadol is generally considered as a drug with low potential for dependence. In a recent German study (including a literature study, an analysis of two drug safety databases, and questionnaires analyses), the low abuse and low dependence potential of Tramadol were re-confirmed. The German expert group found a low prevalence of abuse or dependence in clinical practice in Germany, and concluded that Tramadol has a low potential for misuse, abuse, and dependence in Germany.[30]
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