1.2. Pediatrics
Tramadol IR, tramadol ER, and tramadol combination formulations are all contraindicated for children younger than 12 years of age. The safety and efficacy of all formulations in pediatric patients has not been established. All formulations are contraindicated for postoperative management in pediatric patients younger than 18 years of age following tonsillectomy and/or adenoidectomy. Avoid the use of all formulations in adolescents 12 to 18 years of age who have other risk factors that may increase their sensitivity to the respiratory depressant effects of tramadol unless the benefits outweigh the risks2-11 . Following a titration phase, recommended IR tramadol regimens for pain management include doses of 50 mg to 100 mg administered every 4 to 6 hours as needed to not exceed 400 mg daily2-6.