By Lauren Forsythe, PharmD, DICVP; Rania Gollakner, BS, DVM, MPH

What is tramadol?

Tramadol (brand names: Ultram®, ConZip®, Durela®, Ralivia®, Rybix®, Ryzolt®, Tridural®, Zytram®) is a synthetic opioid used to treat pain in dogs, cats, and other small mammals.

Its use in small animals to treat pain is “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully, as their direction may be significantly different from those on the label.

How is tramadol given?

  • Give tramadol by mouth, in the form of a tablet, capsule, or a compounded liquid. 
  • Give with or without food, but due to its bitter taste, giving it with food may be required. 
  • If your pet vomits after receiving the medication on an empty stomach, give future doses with food or a treat. 
  • Liquid forms of this medication should be measured carefully.

Never give tramadol with acetaminophen (Ultracet®) to cats, as acetaminophen is extremely toxic to cats.

This medication will usually take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow. However, in pets with chronic pain, this medication can take up to a few weeks before full effects are noted.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember. However, if it is close to the time for the next dose, skip the dose you missed, give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects in dogs could include:

  • sedation 
  • tremors
  • dizziness
  • anxiety
  • decreased appetite
  • vomiting
  • diarrhea
  • constipation

Side effects in cats could include:

  • vomiting
  • constipation
  • sedation
  • dilated pupils 
  • feeling uneasy

Adverse effects may occur and may be signs of overdose. Contact your veterinarian if you note these signs:

  • seizures
  • incoordination
  • extreme sleepiness
  • agitation or fast heartbeat

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Tramadol SHOULD NOT be used:

  • in pets that are hypersensitive to opioids
  • in conjunction with medications that decrease brain or lung function

Tramadol should be used with caution in patients:

  • with seizure disorders
  • with liver or kidney disease
  • that are geriatric or debilitated
  • that are pregnant or lactating 

Are there any drug interactions I should be aware of?

Certain medications should be used with caution when given with tramadol, including but not limited to:

  • some antifungals 
  • metoclopramide
  • ondansetron
  • opioids
  • SAMe 
  • some antidepressants

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

  • No specific monitoring needs to be done while your pet is taking this medication. 
  • Your veterinarian may monitor your pet to be sure that the medication is working. 
  • Monitor at home for adverse effects.

How do I store tramadol?

  • Store tramadol tablets or capsules at room temperature, around 25°C (77°F).
  • Store away from moisture and light.
  • Store in a locked cabinet or safe and monitor the amount of medication remaining. 
  • Excursions in temperatures between 15°C and 30°C (59°F to 86°F) are permitted, but extreme heat and cold should be avoided.
  • Tramadol liquid preparations will likely need to be refrigerated, but always follow the storage recommendations on the product label.

Tramadol is a controlled substance, which means that it has been designated by the Drug Enforcement Administration (DEA) as having a potential for diversion to people other than the patient it was prescribed for.

Use of a controlled substance in any person or animal other than that for which it is prescribed is illegal. Therefore, this medication should be stored in a locked cabinet or safe that cannot be easily moved, with access limited to only those that need to administer the medication. Monitor the amount of medication remaining to ensure the expected amount is present.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. Signs of an adverse reaction or overdose of tramadol include:

  • seizures
  • incoordination
  • extreme sleepiness
  • agitation
  • fast heartbeat

If your veterinarian is not available, follow their directions in contacting an emergency facility.

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