The pain syndrome of moderate to severe intensity of various etiology (postoperative period, trauma, pain in cancer patients). Pain during painful diagnostic femara vs clomid or therapeutic procedures.



  • Hypersensitivity to the drug and other opioids.
  • State, accompanied by respiratory depression or severe depression of the central nervous system (alcohol poisoning, sleeping pills, narcotic analgesics, psychotropic drugs).
  • Severe hepatic and / or renal failure .
  • Concomitant use inhibitors (and two weeks after their cancellation).
  • During pregnancy and lactation use is possible femara vs clomid only for health reasons, the use should be limited to one-off reception.
  • drug withdrawal syndrome.
  • Children’s age (up to 1 year).With caution and under the supervision of a physician should use the drug in patients with impaired renal function and liver, traumatic brain injury, increased intracranial pressure, epilepsy patients, and those with drug addiction to opioids, the patients have abdominal pain of unknown origin ( “acute abdomen”)

    Dosage and administration.
    Tramal is used on doctor’s prescription, the drug dosing regimen is chosen individually, depending on the severity of pain and the patient’s sensitivity. Duration of treatment is determined individually, should not be prescribed the drug beyond the period justified from a therapeutic point of view.

  • In the absence of other regulations femara vs clomid should be given in the following dosages: For adults and adolescents over 14 years for a single administration of 50-100 mg of tramadol hydrochloride (20-40 drops Tramal). 50 mg (20 drops) – if not satisfactory analgesia occurred after 30-60 minutes, repeated single dose can be administered. In severe pain a higher dose (100 mg tramadol hydrochloride) can be designated as the initial dose. Typically, 400 mg of tramadol hydrochloride per day is sufficient for pain relief. For the treatment of pain in cancer and severe pain in the postoperative period may be used higher doses. For children over 1 year old Tramal drops can be administered in a single dose at the rate of 1 -2 mg / kg body weight. The daily dose rate of 8.4 mg / kg body weight is typically sufficient. 1 drop of – 2.5 mg. In elderly patients (aged 75 years and over) in connection with the possibility of a delayed launch, the interval between administration of the drug may be increased in accordance with the individual characteristics. Patients with kidney and liver Tramal can operate longer . For such patients the doctor may recommend an increase in the interval between administration of single doses.


    Tramal drops taken by mouth with a small amount of liquid or on a piece of sugar.
    Tramal should not be administered for longer than is therapeutically necessary.

    Side effects. From the nervous system: sweating, dizziness, headache, weakness, fatigue, lethargy, paradoxical stimulation of the central nervous system (nervousness, agitation, anxiety, tremors, muscle spasms, euphoria, emotional lability, hallucinations), drowsiness, insomnia, confusion, impaired coordination of movement, central genesis seizures (with on / in the introduction in high doses or with concomitant administration of antipsychotic drugs), depression, amnesia, cognitive impairment, paresthesia, instability of gait. From the digestive system: dry mouth, nausea , vomiting, flatulence, abdominal pain, constipation, diarrhea, difficulty in swallowing. Since the cardiovascular system: tachycardia, orthostatic hypotension, syncope, collapse. Allergic reactions: urticaria, pruritus, rash, bullous eruption.From the urinary system: difficulty urination, dysuria, urinary retention. From the senses: blurred vision, taste. The respiratory system: dyspnea. Other: menstrual disorders. With prolonged use – the development of drug addiction. In abrupt cancellation – is not excluded syndrome development “cancel”.

    . Overdose Symptoms: miosis; vomiting; collapse, coma, convulsions, depression of the respiratory center, apnea. Treatment: airway. Maintain respiration and the cardiovascular system, opiate effects can be stopped naloxone, convulsions – benzodiazepine.

    Interaction with other drugs.
    Increases the funds that have a depressing effect on the central nervous system and ethanol.
    Inductors microsomal oxidation (incl carbamazepine, barbiturates) reduce the severity and duration of the analgesic effect of the action. Long-term use of opioids or barbiturates stimulates the development of cross-tolerance.
    Anxiolytics increase the intensity of analgesia, anesthesia duration is increased when combined with barbiturates. Naloxone activates respiration, eliminating analgesia after application of opioid analgesics. Inhibitors, furazolidone, procarbazine, neuroleptics . The risk of seizures (decrease seizure threshold)
    quinidine increases the plasma concentration of tramadol  metabolite reduces the content by competitive inhibition of isoenzyme femara vs clomid.