Tramadol hydrochloride - Pain

A stepped approach to pain management is recommended. Paracetamol is considered a 1st line option for the treatment of pain. A trial of tramadol (patient agreement) may be considered if maximum tolerated doses of codeine /dihydrocodeine are ineffective. Consider whether all measures have been taken to control side effects. Please refer to the guidelines attached: 

Ensure a patient agreement is completed by the patient (see below) prior to a trial of tramadol.

PLEASE NOTE:

• Standard/Immediate release capsules should be prescribed GENERICALLY
• Modified release tablets should be prescribed by BRAND with Marol® being locally preferred (See below)

It is recommended that tramadol modified release preparations are prescribed by BRAND - see UKMI Branded Prescribing Recommendations document below. The locally preferred brand for modified-release, TWICE DAILY dosing is Marol® Marol® is available across all of the twice-daily dose ranges, already represents the most commonly prescribed tramadol brand locally and nationally and remains one of the most cost-effective tramadol MR choices. Patients currently receiving generically written prescriptions should be reviewed with a view to change the prescribing to a cost-effective brand.