{"ok":true,"entry":{"slug":"tramadol","kind":"medication","name":"tramadol","aliases":["Tramal","Ultram"],"brands_sg":["Acugesic","Mabron","Tramadol Stada","Tradol","Tracidol"],"class":"opioid analgesic","tags":["pain-fever"],"use_for":"moderate to severe pain, per the sg and nhs labels","use_after":"standard forms 3–4 times a day; slow-release 1–2 times","use_duration":null,"take_with":"a glass of water · alcohol adds to the sleepiness (nhs)","pros":["nhs: usually starts to relieve pain in 30 to 60 minutes","nhs: safe with paracetamol, ibuprofen or aspirin","many forms — tablets, capsules, drops, slow-release"],"cons":["nhs: 'it's possible to become addicted to tramadol'","sleepy, dizzy or 'spaced out' in >1 in 100 people (nhs)","prescription-only in sg — all 13 registered products"],"dose_note":"sg label (ACUGESIC CAPSULE 50 MG, SIN08953P): 'in general, the daily dose should not exceed 400 mg Tramadol HCl (equivalent to 8 TRAMADOL capsules/tablets)'; the same label says a single dose is '1 capsule/tablet … if, however, pain relief is unsatisfactory, a further TRAMADOL capsule/tablet can be taken after about 30–60 minutes', and 'in impaired renal or hepatic function it may be necessary to adjust the dose'. nhs does not publish a fixed maximum: 'dosage varies from person to person. Your doctor will decide the right dose for you'. tramadol is prescription-only in singapore, so the dose is the one the prescription sets — as directed on the label or by your doctor. nhs: 'if you have been taking tramadol for more than a few weeks, do not stop taking it without speaking to your doctor first'.","dosage":null,"ul_status":null,"sg_class":"prescription-only","cautions":["a condition that causes seizures or fits, or a head injury — nhs says tell your doctor first; sg label: contraindicated if epilepsy is not adequately controlled","addiction to alcohol, strong painkillers or recreational drugs — nhs says tell your doctor first","breathing difficulties, or kidney or liver problems — nhs says tell your doctor first; sg label says the dose may need adjusting","pregnant, breastfeeding or trying to get pregnant — nhs says tell your doctor first; under 18 after tonsil/adenoid surgery: sg label contraindicates it"],"clashes":[{"src":["nhs_tram_interact","ndf_acugesic"],"note":"nhs: do not take maois with tramadol — the combination can cause serious side effects such as anxiety, confusion and hallucinations; sg label contraindicates use within 14 days of an maoi","with":"maoi antidepressants and parkinson's medicines (moclobemide, phenelzine, rasagiline, selegiline)"},{"src":["nhs_tram_interact"],"note":"nhs: do not take medicines that contain codeine with tramadol because you are more likely to get side effects","with":"codeine-containing painkillers (co-codamol, nurofen plus, solpadeine)"},{"src":["nhs_tram_alcohol"],"food":true,"note":"nhs: more sleepy, and the risk of serious side effects rises","with":"alcohol"},{"src":["nhs_tram_interact","ndf_acugesic","nhs_tram_about"],"note":"nhs: tell your doctor about medicines that help you sleep, reduce tension or treat mental health problems; sg label contraindicates acute intoxication with alcohol, hypnotics, analgesics or other cns-acting drugs","with":"sleeping tablets, sedatives and medicines for depression or anxiety"},{"src":["nhs_tram_interact"],"note":"nhs: these may weaken or shorten the effect of tramadol","with":"carbamazepine, rifampicin, ondansetron or buprenorphine"},{"src":["nhs_tram_interact"],"note":"nhs lists medicines that help prevent blood clots, treat allergy symptoms or treat an infection among those to tell the doctor about before starting tramadol","with":"warfarin, antihistamines and antibiotics"}],"sources":[{"id":"hsa_register","url":"https://data.gov.sg/datasets/d_767279312753558cbf19d48344577084/view","label":"HSA Register of Therapeutic Products (open data, data.gov.sg d_767279312753558cbf19d48344577084) — datastore_search API, 5,511 rows","quote":"ACUGESIC CAPSULE 50 mg [SIN08953P] … TRAMADOL HCl … Prescription Only … MABRON CAPSULE 50 mg … TRAMADOL 50 STADA CAPSULE 50 mg … TRADOL INJECTION 50 mg/ml … TRACIDOL INJECTION 50mg/ml … ULTRACET TABLET … Prescription Only","accessed":"2026-08-27"},{"id":"ndf_acugesic","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin08953p/","label":"MOH National Drug Formulary — ACUGESIC CAPSULE 50 MG [SIN08953P] (HSA-registered SG product record, updated 28 July 2026)","quote":"TRAMADOL HCL - 50 MG … PRESCRIPTION ONLY MEDICINES … INDICATION: Severe acute and chronic pain … In general, the daily dose should not exceed 400 mg Tramadol HCl (equivalent to 8 TRAMADOL capsules/tablets). In impaired renal or hepatic function it may be necessary to adjust the dose … CONTRAINDICATIONS: Acute intoxication with alcohol, hypnotics, analgesics or other CNS-acting drugs … In patients who are receiving MAO inhibitors or who have taken them within the last 14 days … In patients with epilepsy not adequately controlled by treatment","accessed":"2026-08-27"},{"id":"nhs_tram_about","url":"https://www.nhs.uk/medicines/tramadol/about-tramadol/","label":"NHS — About tramadol (reviewed 4 February 2026)","quote":"Tramadol is a strong painkiller from a group of medicines called opioids, or narcotics. It's used to treat moderate to severe pain … Tramadol is available only on prescription … usually starts working to relieve your pain in 30 to 60 minutes … It's possible to become addicted to tramadol … It's best not to drink alcohol with tramadol","accessed":"2026-08-27"},{"id":"nhs_tram_how","url":"https://www.nhs.uk/medicines/tramadol/how-and-when-to-take-tramadol/","label":"NHS — How and when to take tramadol (reviewed 4 February 2026)","quote":"standard tablets and capsules – usually 3 to 4 times a day … slow-release tablets and capsules – usually once or twice a day … Dosage varies from person to person. Your doctor will decide the right dose for you … Swallow each tramadol tablet or capsule whole with a glass of water … If you have been taking tramadol for more than a few weeks, do not stop taking it without speaking to your doctor first","accessed":"2026-08-27"},{"id":"nhs_tram_who","url":"https://www.nhs.uk/medicines/tramadol/who-can-and-cannot-take-tramadol/","label":"NHS — Who can and cannot take tramadol (reviewed 4 February 2026)","quote":"have a condition which causes seizures or fits … have a head injury … have an addiction to alcohol, strong painkillers or recreational drugs … have breathing difficulties … have kidney or liver problems … are pregnant, breastfeeding, or trying to get pregnant","accessed":"2026-08-27"},{"id":"nhs_tram_se","url":"https://www.nhs.uk/medicines/tramadol/side-effects-of-tramadol/","label":"NHS — Side effects of tramadol (reviewed 4 February 2026)","quote":"These common side effects of tramadol happen to more than 1 in 100 people … Feeling sleepy, tired, dizzy or 'spaced out' … Feeling or being sick … Constipation … Dry mouth … Sweating … Serious side effects happen in less than 1 in 100 people … have a seizure or fit … have breathing difficulties or short shallow breathing","accessed":"2026-08-27"},{"id":"nhs_tram_interact","url":"https://www.nhs.uk/medicines/tramadol/taking-tramadol-with-other-medicines-and-herbal-supplements/","label":"NHS — Taking tramadol with other medicines and herbal supplements (reviewed 4 February 2026)","quote":"Do not take medicines called monoamine oxidase inhibitors or MAOIs with tramadol … The combination can cause serious side effects such as anxiety, confusion and hallucinations … It's safe to take tramadol with paracetamol, ibuprofen or aspirin … Do not take medicines that contain codeine with tramadol because you are more likely to get side effects","accessed":"2026-08-27"},{"id":"nhs_tram_alcohol","url":"https://www.nhs.uk/medicines/tramadol/common-questions-about-tramadol/","label":"NHS — Common questions about tramadol","quote":"Drinking alcohol while you’re taking tramadol can make you feel more sleepy or increase the risk of serious side effects.","accessed":"2026-08-29"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:33.302383+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}