Tramadol
Tramadol hydrochloride
También conocido como: Ultram ER · Ryzolt · Rybix ODT · Ultracet · Tralieve · Tramadol ER · Zamadol · CG-315E · tramadoli hydrochloridum · U-26225A · Tramadol hydrochloride
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| General/Non-responsive pain | 5 mg/kg PO q6-8h and up to 10 mg/kg PO q6-8h | PO | q6-8h | — | 🌎 NA |
| Analgesic | 2-5 mg/kg four times daily | PO | q6h | — | 🌎 NA |
| Chronic pain | 2-5 mg/kg PO 2-3 times a day | PO | q8-12h | — | 🌎 NA |
| Mild acute and chronic soft tissue and musculoskeletal pain | 2-5 mg/kg | PO | q8h | — | 🌍 EU |
| Perioperative acute pain | 2 mg/kg | IV | single dose or as needed | — | 🌍 EU |
- General/Non-responsive pain: Maximum analgesic effects may not occur immediately and may be delayed up to 14 days for chronic pain conditions.
- Analgesic: Suggested starting dose.
- Chronic pain: Reasonable for mild pain; adjust for severe pain. Best used as multimodal therapy with NSAIDs or other analgesics due to erratic pharmacokinetics.
- Mild acute and chronic soft tissue and musculoskeletal pain: Chewable tablets are authorized for this use. Sustained-release tablets are unsuitable for once-daily dosing.
- Perioperative acute pain: Used instead of traditional opioids to provide analgesia for acute pain.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Starting dose | 2 mg/kg twice daily | PO | q12h | — | 🌎 NA |
| Current dosing recommendations | 1-2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Chronic pain | 1-4 mg/kg PO 2-3 times a day | PO | q8-12h | — | 🌎 NA |
| Analgesia | 2-4 mg/kg | PO | q8h | — | 🌍 EU |
| Analgesia | 1-2 mg/kg | IV | as needed | — | 🌍 EU |
| Analgesia | 1-2 mg/kg | SC | as needed | — | 🌍 EU |
- Starting dose: Based upon the pharmacokinetics of tramadol and ODT in cats.
- Current dosing recommendations: Maximum analgesic effects may be delayed up to 14 days for chronic pain.
- Chronic pain: Reasonable for mild pain; dose and interval may need adjustment for more severe pain.
- Analgesia: Oral preparations are highly unpalatable to cats. Watch for dysphoria.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Chronic laminitis pain | 5 mg/kg PO twice daily for seven days, alone or with ketamine at 0.6 mg/kg/hr IV during six hours each day for the first 3 days of treatment | PO/IV | q12h | 7 days | 🌎 NA |
- Chronic laminitis pain: Pain relief was enhanced.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El tramadol es un analgésico sintético de acción central tipo opiáceo utilizado principalmente para el manejo del dolor leve a moderado y, ocasionalmente, como antitusígeno.
Aspectos clínicos destacados:
- Actúa como un agonista débil de los receptores mu-opioides e inhibe la recaptación de serotonina y norepinefrina.
- Es altamente útil como parte de un protocolo analgésico multimodal (por ejemplo, combinado con AINE, gabapentina o amantadina) para condiciones de dolor crónico como la osteoartritis o el cáncer.
- Puede tardar hasta dos semanas en alcanzar la eficacia analgésica completa en estados de dolor crónico.
- Nota clínica: Aunque el monográfico indica que no es una sustancia controlada, el tramadol fue reclasificado como una sustancia controlada de Lista IV por la DEA en los EE. UU. en 2014 debido a su potencial de abuso en humanos.
- Generalmente bien tolerado en perros, siendo la sedación el efecto secundario más común. Los gatos pueden experimentar disforia y encontrar el medicamento altamente desagradable al paladar.
Mecanismo de acción
Tramadol provides analgesia through a dual mechanism of action:
- Opioid Activity: Tramadol and its active metabolite O-desmethyltramadol (M1) bind to mu-opioid receptors in the central nervous system.
- Monoaminergic Activity: It inhibits the synaptic reuptake of serotonin (5-HT) and norepinephrine (NE) → enhancing descending inhibitory pathways of pain transmission in the spinal cord.
Pharmacologic Pearl: The M1 metabolite is 6 times more potent as an analgesic and has 20 times greater affinity for mu-receptors than the parent drug. Dogs produce very little of the M1 metabolite compared to cats and humans, which explains why tramadol's opioid-mediated efficacy in dogs is often erratic and heavily reliant on its serotonin/norepinephrine reuptake inhibition. Naloxone only partially antagonizes tramadol's analgesic effects.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to tramadol or other opioids
- Combination products containing acetaminophen (e.g., Ultracet) are STRICTLY CONTRAINDICATED in cats
- Concurrent use with MAOIs (e.g., selegiline, amitraz) due to risk of serotonin syndrome
- Patients with a history of epilepsy or seizure disorders
Efectos adversos
- Dogs: Excessive sedation, agitation, anxiety, tremor, dizziness
- Dogs: Inappetence, vomiting, constipation, diarrhea
- Cats: Dysphoria, mydriasis, dose avoidance (unpalatability)
- Humans: Pruritus (approx. 10%)
- Injectable form: Respiratory and cardiac depression
- Sedation (especially at high doses in dogs)
- Dysphoria (more likely in cats)
- Nausea
- Behavioral changes
- Increased risk of seizures
Precauciones
Important Warnings:
- Seizure Risk: Use with caution in animals with preexisting seizure disorders or those receiving drugs that lower the seizure threshold. Tramadol has caused seizures in humans.
- CNS/Respiratory Depression: Use cautiously with other CNS or respiratory depressants.
- Geriatric/Debilitated Patients: Use with caution; dosage adjustments may be needed for patients with impaired renal or hepatic function.
- Dependence & Withdrawal: Physical dependence can occur; withdraw gradually after chronic use.
- Formulation Warning: Extended-release tablets must not be broken, crushed, or chewed, as this can lead to rapid absorption and toxicity. Dogs do not absorb ER tablets well.
Interacciones farmacológicas
Rarely linked to digoxin toxicity in humans.
Potential for fatal serotonin syndrome; concurrent use should be avoided.
May reduce the effectiveness of both drugs.
May increase tramadol concentrations and decrease M1 (active metabolite) concentrations.
Theoretically could cause additive serotonergic effects.
Pretreatment with tramadol reduced MAC values by approximately 30% in dogs and 40% in cats.
Can inhibit the metabolism of tramadol to its active metabolites, decreasing efficacy and increasing the risk of toxicity (serotonin syndrome, seizures).
Increased risk for seizures; amitriptyline may inhibit tramadol metabolism.
Increased PT and INR reported in humans (relatively rare).
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome
Safe and synergistic multimodal analgesia
Safe and synergistic multimodal analgesia
Safe and synergistic multimodal analgesia
Monitorización
- Clinical efficacy (pain scoring, mobility, comfort levels)
- Adverse effects (excessive sedation, GI upset, dysphoria, agitation)
- Pain scores to assess efficacy
- Signs of sedation or dysphoria
- Signs of serotonin syndrome (hyperthermia, hypertension, agitation, tremors)
- Seizure activity in susceptible individuals
Farmacocinética
Vida media
Absorción
Dogs: PO bioavailability ~65% (significant interpatient variability); Rectal ~10%. Cats: PO bioavailability ~60% (high interpatient variability). Horses: PO bioavailability ~14% (adults), 53% (neonatal foals), 20% (weaned foals).
Distribución
Dogs: Vd ~3.8 L/kg. Cats: Vd ~2 L/kg.
Metabolismo
Extensively metabolized via several hepatic pathways. The active metabolite O-desmethyltramadol (M1) has potent agonist activity but is a minor metabolite in dogs. Cats produce more of the M1 metabolite.
Eliminación
Dogs: Total body clearance ~55 mL/kg/min. Cats: Clearance ~12 mL/min/kg.
Sobredosis
Acute oral overdoses may cause either CNS depressive signs or serotonin syndrome.
- Clinical Signs: Lethargy, mydriasis, ataxia, and vomiting are most common. Stimulatory signs such as tachycardia, tremors, vocalization, agitation, and seizures may also occur. Cats frequently show mydriasis, hypersalivation, and tachycardia.
- Treatment: Primarily supportive (maintaining respiration, treating seizures with benzodiazepines or barbiturates).
-
Important: Naloxone may NOT be useful in tramadol overdoses. It only partially reverses effects and may actually increase the risk of seizures. Cyproheptadine and phenothiazines can be used to treat stimulatory signs (serotonin syndrome).
Productos disponibles
Formulaciones
- Oral tablets (immediate release)
- Extended-release tablets
- Oral disintegrating tablets
- Injection (available commercially outside the USA)
- 50 mg tablets
- 100 mg, 200 mg, 300 mg immediate-release tablets
- 20 mg, 80 mg chewable tablets (veterinary)
- 10 mg, 25 mg tablets
- Sustained-release tablets (various sizes)
- 5 mg/ml oral liquid
- 50 mg/ml injectable solution
Veterinario
- None commercially available in the USA.
- Tralieve 20 mg, 80 mg chewable tablets
- Zamadol
Etiquetado para humanos
- Tramadol HCl Oral Tablets (film-coated) 50 mg (Ultram, generic)
- Tramadol HCl Extended-Release Tablets 100 mg, 200 mg, 300 mg (Ultram ER, Ryzolt, generic)
- Tramadol HCl Oral Disintegrating Tablets 50 mg (Rybix ODT)
- Tramadol HCl 37.5 mg / Acetaminophen 325 mg tablets (Ultracet) - WARNING: DO NOT USE IN CATS
- Tramadol ER
- 50 mg immediate-release tablets
Estado regulador
Authorized veterinary chewable tablets available for dogs.
POM-V, POM CD Schedule 3. Subject to safe custody requirements.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store tablets at room temperature 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Dispense in tight, light-resistant containers.
Información para el cliente
Para los propietarios de mascotas:
- Administración: Puede administrarse con o sin comida. Si su mascota vomita después de tomarlo con el estómago vacío, intente administrar las dosis futuras con un pequeño premio o comida.
- Sabor: El medicamento tiene un sabor muy amargo. Los gatos, en particular, pueden salivar excesivamente o resistirse a tomarlo. No triture ni rompa las tabletas de liberación prolongada.
- Cambios de comportamiento: Puede causar cambios en el estado de alerta. Su mascota podría parecer inusualmente somnolienta o, por el contrario, ansiosa, inquieta o vocal (especialmente los gatos). Contacte a su veterinario si estos signos son graves.
- La paciencia es clave: Para condiciones crónicas como la artritis, puede tomar hasta dos semanas de dosificación constante para ver los beneficios completos de alivio del dolor.
- Advertencia de seguridad: Manténgalo fuera del alcance de los niños y otras mascotas. NUNCA le dé a su mascota medicamentos para humanos que contengan tramadol combinado con acetaminofén (como Ultracet), ya que el acetaminofén es altamente tóxico y a menudo fatal para los gatos.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.