2. Duration of Therapy

There is no basis for limiting the duration of tramadol therapy as tramadol is promoted for use in chronic pain (e.g., chronic musculoskeletal pain, cancer pain, osteoarthritis, diabetic neuropathy) as well as acute pain events (e.g., postoperative pain, dental extraction pain). However, cases of tramadol abuse and dependence have been reported, especially in patients with a history of substance abuse. Therefore, tramadol should be administered cautiously, if at all, to patients with a history of drug or alcohol abuse and/or dependence.

The tramadol/acetaminophen combination is indicated for use in the short-term management of acute pain and should be limited to five days or less of use. Patient profiles containing tramadol/acetaminophen prescriptions exceeding this treatment duration will be reviewed^{2-6, 9-23}.