PAD - Prescribing Advisory Database
PLEASE NOTE : This is a development system.

For Surrey PAD, please go to https://surreyccg.res-systems.net/PAD.

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PAD Profile : Tramadol hydrochloride - Pain

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,

Traffic Light Status

Status 1 of 7.

Status :
Green (see narrative)
Important
Formulations :
  • Capsules
Important Information :
Consider use where maximum tolerated doses of codeine / dihydrocodeine are ineffective.
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :

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

Documents :

Status 2 of 7.

Status :
Green (see narrative)
Important
Formulations :
  • Modified release capsules
  • Modified release tablets
Important Information :
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.
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
SA
Comments :

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

Documents :

Status 3 of 7.

Status :
Green (see narrative)
Important
Formulations :
  • Soluble tablets
Important Information :
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.
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Status 4 of 7.

Status :
Green (see narrative)
Important
Formulations :
  • Oro-dispersible
Important Information :
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.
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Status 5 of 7.

Status :
Non Formulary
Formulations :
  • Oral solution
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Status 6 of 7.

Status :
Non Formulary
Formulations :
  • Oral drops
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Status 7 of 7.

Status :
Red
Formulations :
  • Injection
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Guidelines

The following guidelines are available for this indication.

Other Drugs

Other Indications

Additional Documents

Committee Recommendations

Date
Committee Name
Narrative
07 March 2018
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.

06 June 2018
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)

Associated BNF Codes

04. Central Nervous System
04.07.02. Opioid analgesics
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