Tramacet Prescription Guidelines for Moderate to Moderately Severe Pain

Dosing Considerations

• For patients with hepatic impairment, such as cirrhosis, the American Association for the Study of Liver Diseases recommends reducing the dose to 50 mg tramadol every 12 hours 1

Clinical Considerations

• The European Society for Medical Oncology suggests that Tramacet is typically used for moderate pain when acetaminophen or NSAIDs alone are inadequate 2
• The Infectious Diseases Society of America recommends that for chronic pain, tramadol/acetaminophen may be used for up to 3 months to decrease pain and improve function, particularly in conditions like osteoarthritis 3

Prescription Writing Format

• The American Geriatrics Society recommends including the patient's full name, address, and date of birth when writing a Tramacet prescription 4
• The American Geriatrics Society suggests including the quantity of medication, such as "Dispense 40 tablets", when writing a Tramacet prescription 5

Important Precautions

• The American Geriatrics Society warns that monitor for signs of serotonin syndrome if patient is taking SSRIs, SNRIs, or tricyclic antidepressants 5
• The American Association for the Study of Liver Diseases warns that exceeding maximum acetaminophen dose (4000 mg/day), especially in patients with liver disease, can be harmful 1
• The American Geriatrics Society warns that drug interactions with serotonergic medications can increase risk of serotonin syndrome 5

Common Pitfalls to Avoid

• The Mayo Clinic warns that not accounting for the ceiling effect of tramadol at doses above 400 mg/day can lead to ineffective treatment 6
• The Infectious Diseases Society of America recommends reassessing efficacy and side effects when prescribing Tramacet for long-term use 3
• The Infectious Diseases Society of America recommends reassessing efficacy and side effects when prescribing Tramacet for long-term use, and also considering the patient's overall health and medical history 4