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Children aged 12 years or more and adults: Adjust the dose according to the level of pain patients feel and their treatment responses. 4 tablets are recommended as the initial dose, and the administration interval should be minimum 6 hours without exceeding 16 tablets a day. The lowest effective dose should be used for the shortest period of time.
It is recommended not to take this drug too long more than necessary, and if a long-term administration is required due to characteristics and severity of diseases, monitoring should be conducted at regular basis to confirm whether this drug is administered continuously or not.
The elderly: Administer usual dose for adults. Since oral administration of tramadol in the elderly aged 75 years or more increased elimination half-life by 17%, this drug should be administered at 6 hours interval or longer.
Patients with renal failure: Extend the administration interval to 12 hours for patients with moderate renal failure (10 - 30 mL/min of creatinine clearance).
Administration to patients with severe renal failure (less than 10 mL/min of creatinine clearance) is not recommended.
Tramadol is removed very slowly during hemodialysis and filtration, thus re-administration of this drug to maintain the antalgic effect after hemodialysis is not required.
Patients with hepatic failure: Carefully consider extending the administration interval for patients with moderate hepatic failure.
Do not administer this drug to patients with severe hepatic failure.
