Surrey Heartlands

Joint Formulary & PAD

Tramadol hydrochloride - Pain

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I agree that in using this database I understand that this platform only provides guidance on local prescribing policy and that all prescribing decisions are ultimately the responsibility of the clinician.

Status 1

Green (see narrative)
Formulations :
  • Capsules
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
Restrictions / Comments :
Important
Consider use where maximum tolerated doses of codeine / dihydrocodeine are ineffective.

The Faculty of Pain Medicine has produced resources for healthcare professionals around opioid prescribing:http://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware

 

Status 2

Green (see narrative)
Formulations :
  • Modified release capsules
  • Modified release tablets
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
Restrictions / Comments :
Important
Branded prescribing is recommended for modified release tramadol. Do not confuse 12 hourly and 24 hourly preparations. Consider tramadol where maximum tolerated doses of codeine / dihydrocodeine are ineffective.

The Faculty of Pain Medicine has produced resources for healthcare professionals around opioid prescribing:http://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware

 

Status 3

Green (see narrative)
Formulations :
  • Soluble tablets
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
Restrictions / Comments :
Important
Reserved for patients unable to swallow solid dose forms or for administration via an enteral tube. Consider use where maximum tolerated doses of codeine / dihydrocodeine are ineffective.
 

Status 4

Green (see narrative)
Formulations :
  • Oro-dispersible
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
Restrictions / Comments :
Important
Reserved for patients unable to swallow solid dose forms or for administration via an enteral tube. Consider use where maximum tolerated doses of codeine / dihydrocodeine are ineffective.
 

Status 5

Red
Formulations :
  • Injection
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
Restrictions / Comments :
 

Status 6

Non Formulary
Formulations :
  • Oral solution
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
NFD1
Restrictions / Comments :
 

Status 7

Non Formulary
Formulations :
  • Oral drops
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
NFD1
Restrictions / Comments :

Documentation

Webpage
Brand-name Prescribing in Primary Care
Patient resource
Pain management - Prescription agreement (Patient) - June 2018.docx
Patient resource
Pain (Persistent) - Opioids -Patient Information - April 2018.docx
Patient resource
Pain management - Prescription agreement (Patient) - May 24
Information
Pain -Opioids - Assessment Tool- April 2018.docx
Information
CD Legislation changes - Tramadol, Lisdexamfetamine, Zopiclone and Zaleplon - Jun 2014

PAD Profile

ChemicalSubstance :
Tramadol hydrochloride
Indication :
Pain
Group Name :
Keywords :
opioids, opioid analgesics, analgesia, tramadol slow release, tramadol SR, tramadol MR
Brand Names Include :
Marol MR, Maneo MR, Brimisol, Ivodol, Tilodol, Tramulief SR, Zydol SR, Zamadol SR, Maxitram SR, Mabron MR, Zytram SR, Trandorec XL, Zydol XL,
Important Information :
Latest Additions Date From :
Latest Additions Date To :
Guidelines :
Pain
Supporting Documents :
6
Traffic Light Entries :
7

Other Indications

Below are listed other indications that Tramadol hydrochloride is used to treat.

Other Drugs

Below are listed other drugs that are used to treat Pain .

Committee Recommendations (2)

06 Jun 18 - Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

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)
07 Mar 18 - Surrey Medicines Commissioners Group

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.