TRAMADOL JOHN MARTIN

Directions for use: to dose 1 mg/kg administer 0.20 mL every 10 kg live weight, to dose 2 mg/kg administer 0.40 mL every 10 kg live weight, to dose 3 mg/kg administer 0.60 mL every 10 kg live weight.

For all species: it should be administered every 6 to 8 hours.

Do not use in patients with known hypersensitivity to tramadol or to any of the excipients.

Do not use in pregnant or lactating animals.

Simultaneous administration with deprenyl or with psychotropic drugs such as serotonin reuptake inhibitors, tricyclic antidepressants or monoamine oxidase inhibitors may increase seizure threshold. If administered in combination with drugs which are enzymatic inductors, such as carbamazepine, phenobarbital, phenytoin or rifampin, the dose of tramadol should be increased.

Inhibitors of isoenzyme CYP 2D such as amiodarone, cimetidine, clomipramine and haloperidol may decrease the metabolism of tramadol thus reducing the levels of metabolite M1 and, consequently, the analgesic effectiveness, and increasing the appearance of adverse reactions.

TRAMADOL JOHN MARTIN is contraindicated in patients with respiratory depression, acute obstructive pulmonary disease, uncontrolled epilepsy and acute renal and/or hepatic failure. In patients with liver cirrhosis, the dosing interval shall be reduced. In patients with chronic renal and/or hepatic failure the dosing interval shall be increased.

Tramadol can cause miosis which may mask the presence or exacerbation of clinical features of intracranial hypertension.

Do not mix in the same syringe with diazepam, diclofenac sodium, indomethacin, midazolam or piroxicam.

Adverse reactions are rare. The most frequent ones include: gastrointestinal malaise such as nausea, vomiting, constipation or diarrhea. In connection with the nervous system, nervousness, anxiety, agitation, shaking, spasticity, euphoria, deterioration in coordination, somnolence or insomnia may be experienced. In case of apparent sedation or strange behavior, the dose should be reduced. Do not use in the treatment of pain caused by pancreatitis.