What should I Know Regarding Pregnancy, Nursing and Administering TRAMADOL HCL-ACETAMINOPHEN to Children or the Elderly?
If you are pregnant Not Recommended: Not Recommended:
If you are nursing Precaution: LOW LEVELS EXCRETED WITH LOW RISK FOR ADVERSE EFFECTS IN INFANT Precaution: LOW AMOUNTS EXCRETED; MONITOR FOR RESPIRATORY DEPRESSION, MFG DOES NOT REC
If you are an adult over 60 management or monitoring precaution: Hepatic-Start at low initial doses and titrate slowly; reduce dose for cirrhosis. Neuro/Psych-Risk for confusion, hallucinations, delirium and falls. Lowers seizure threshold. Avoid treatment with 3 or more CNS active drugs. Endocrine-Monitor sodium level at start and with dose changes; risk of SIADH, hyponatremia. Pulmonary-Risk of respiratory depression. Renal-Avoid extended release formulation. Reduce dose for CLCr < 30 mL/min. General-Consider naloxone Rx. management or monitoring precaution: Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
Pediatric use Severe Precaution: Use weight based dosing in children less than 12 years. Severe Precaution: Contraindicated post adenoidectomy and/or tonsillectomy, Risk of slowed or difficult breathing and respiratory depression. Avoid in patient with obstructive sleep apnea, lung disease, and CYP2D6 ultra-rapid metabolizers. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose. Severe Precaution: Risk of slowed or difficult breathing and respiratory depression. Contraindicated age< 12 years, With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.