Tramadol

By Rania Gollakner, BS, DVM

Medications

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?

Tramadol is given by mouth in the form of a tablet, capsule, or a compounded liquid. It may be given with or without food, but due to its bitter taste, giving it with food may be required. If vomiting occurs when given 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, but if it is close to the time for the next dose, skip the dose you missed and 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 could include sedation, tremors, dizziness, anxiety, decreased appetite, vomiting, diarrhea, or constipation in dogs. In cats, possible side effects include vomiting, constipation, sedation, dilated pupils, or uneasy feeling.

Adverse effects may include seizures, incoordination, extreme sleepiness, agitation, or fast heartbeat, and these may be signs of an overdose. Contact your veterinarian if you note these signs.

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 it pets that are hypersensitive to opioids. It should be used with caution in patients with seizure disorders, liver or kidney disease, or in geriatric, debilitated, pregnant, or lactating pets. Do not use tramadol in conjunction with medications that decrease brain or lung function.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with tramadol: antidepressants, azole antifungals, cimetidine, cyproheptadine, digoxin, ketamine, MAO inhibitors, metoclopramide, ondansetron, opioids, quinidine, SAMe, sevoflurane, SSRI and tricyclic antidepressants, warfarin, and yohimbine.

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?

There is no specific monitoring that 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?

Tramadol tablets or capsules should be stored at room temperature around 25°C (77°F), away from moisture and light. Excursions in temperatures between 15°C to 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.

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 include of an adverse reaction or overdose of tramadol include seizures, incoordination, extreme sleepiness, agitation, or fast heartbeat. If your veterinarian is not available, follow their directions in contacting an emergency facility.

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