Tramadol for Elderly

Tramadol for older adults , effects dosage and direction

Tramadol is very powerful, especially for older Adults. It can be taken only under supervision and should be given with caution. Special care should be taken when this drug is given to the elderly. It is advised to be extra careful when dealing with this medication. Many were developed for purposes other than analgesic use but have effectively managed certain pain syndromes. Anti-convulsants, steroids, topical local anesthetics, and antidepressants are such agents that may be used alone or in combination with non-opioid or opioid analgesics.

Tramadol, also knows as Ultram, has specific quantities given to a person in a single day. Usually, it is recommended not to take more than 400mg per day. 

Elderly people tend to be vulnerable to various things. It’s very Important to test a person before you give them tramadol or any other medication. Proper testing of the individual should be done before giving them any medicine to ensure that they don’t have severe side effects. Adjuvant medications are particularly useful in managing neuropathic pain. Although tricyclic antidepressants such as amitriptyline hydrochloride and nortriptyline hydrochloride have been used to treat patients with this disorder, anticonvulsants such as gabapentin and carbamazepine are thought to be more effective. Also, amitriptyline has significant anticholinergic effects that can be problematic for geriatric patients. When it comes to Tramadol vs Gabapentin, Gabapentin seems to be more effective and better tolerated in older adults. However, the recently available anticonvulsant pregabalin is effective and easier to tolerate than gabapentin.
Selective serotonin reuptake inhibitor (SSRI) drugs are effective and well-tolerated when used for treating patients with depression, but their efficacy in pain management is not documented. More recently, however, serotonin norepinephrine-reuptake inhibitor (SNRI) in duloxetine effectively treats patients with neuropathic pain and seems to be well tolerated in the elderly.


Neonates and elders need extra care when it comes to their health. Age plays an important role when Tramadol is needed to consume even though it is not allowed to consume by people below 18 years of age. It has a high risk of addiction. Doctor and practitioners prefer recommending it only to the people who follows their instructions. Hence, automatically it also becomes their duty to take regular follow-ups. Elders usually have other medicines consumption and keeping the tab this fact; doctors prescribe this drug. 

Doctors always advise dose selection from gentle to strong. If the patient is over 75 years of age, then the maximum dose of immediate-release is 300mg per day.

Side Effects

One major health concern is that this drug affects the respiratory system, and the dosages need to be closely monitored. As the kidney excretes the drug, there is a high risk of affecting renal function as it is important to monitor. 

The Other Side Effects of tramadol in Elderly Include :

  • Constipation
  • Dizziness
  • Shallow Breathing
  • Confusion


Several drugs can help ease the pain as well as chronic pain in elders. With age, it becomes a little difficult to digest such strong medicine, so doctors recommend consuming the dosage as it is written for the patient. Any unnecessary changes in dosage may lead Tramadol side-effects, causing respiratory issues or renal functioning issues.


  • Richard L. Rauck, Gary E. Ruoff, James I. McMillen, Comparison of tramadol and acetaminophen with codeine for long-term pain management in elderly patients, Current Therapeutic Research, Volume 55, Issue 12, 1994, Pages 1417-1431, ISSN 0011-393X,
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  • Ngozi N Imasogie, Sudha Singh, James T Watson, Debbie Hurley, Patricia Morley-Forster, “Ultra Low-Dose Naloxone and Tramadol/Acetaminophen in Elderly Patients Undergoing Joint Replacement Surgery: A Pilot Study”, Pain Research and Management, vol. 14, Article ID 497217, 6 pages, 2009.
  • Skinner-Robertson, S., Fradette, C., Bouchard, S. et al. Pharmacokinetics of Tramadol and O-Desmethyltramadol Enantiomers Following Administration of Extended-Release Tablets to Elderly and Young Subjects. Drugs Aging 32, 1029–1043 (2015).