GlobalRPh Renal Dosing Masterv6.6
GlobalRPh source record

Tramadol - immediate release

Local RX List renal extractBase record retrieved 2026-09-05See the evidence for this drug2 sources available - open source summaries, references and comparisons
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Rxlist source

GlobalRPh RX List - Ultram

Product / population
Adult immediate-release ULTRAM; not ER, pediatric or combination-product dosing.
Renal measure
CrCl in mL/min

RX mirror: this is not independent corroboration of its underlying label. Check dated-label and formulation limitations.

Renal dosing, restrictions and evidence limits

For creatinine clearance below 30 mL/min, extend the immediate-release dosing interval to 12 hours and limit the total to 200 mg/day. The source states dialysis patients may receive their regular dose on the dialysis day because only about 7% is removed. This does not mean the usual normal-renal maximum applies during dialysis. Patients older than 75 years have an additional 300-mg/day ceiling; use the more restrictive applicable constraint. Accumulation may take several days, so reassess sedation and respiratory effects after initiation or changes. Extended-release and fixed-combination products have separate guidance.

Source revision: Source revision date not established in selected retrieval. | Retrieved: 2026-09-07. Retrieval date is not the revision date.

Source: https://globalrph.com/rx-list/ultram-drug/

Scope: Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph. GlobalRPh v6.6.

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Source-first renal review

Evidence sources and renal implications

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Preserved GlobalRPh source

Preserved original GlobalRPh source

Preserved historical content; not revalidated as current prescribing guidance.

Renal method: Read the measure and population stated in the original source sections.
Retrieved: 2026-09-05

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GlobalRPh RX List

GlobalRPh RX List - Ultram

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Adult immediate-release ULTRAM; not ER, pediatric or combination-product dosing.

Renal method: CrCl in mL/min
Retrieved: 2026-09-07

Read local renal resultOpen original reference

Source presence is not independent validation. A label mirror is not a second independent source; review the original reference and exact formulation.

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Renal dosing and precautions

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New source summary - independent clinical review pending. Summaries of the identified label sections are included locally. Source import and numeric transcription checks are not independent two-reference validation. Do not treat this card as an approved institutional dosing protocol.

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Original content / product scopeGlobalRPh RX List - Ultram
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Historical source content is not a current prescription. Original GlobalRPh recommendations are preserved, not automatically certified as current. Product-label and professional additions below are separately attributed. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.

Important source distinctions

Immediate-release tablets only; not extended-release tramadol. Original age scope is not a current pediatric safety-label review.

Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/tramadol/

Usual dosing

Original age scope: 17 years or older. For chronic moderate/moderately severe pain without need for rapid onset, titration improves tolerability: increase total daily dose by 50 mg every 3 days as tolerated to 200 mg/day (50 mg four times daily). After titration, 50-100 mg as needed every 4-6 hours, maximum 400 mg/day.

When rapid onset is needed and benefits outweigh adverse-event/discontinuation risk, the source permits 50-100 mg every 4-6 hours initially, maximum 400 mg/day. Individualize to the lowest beneficial dose; low initial doses and titration improve tolerability and reduce discontinuation.

Cirrhosis: 50 mg every 12 hours. Older than 65: start cautiously at the low end because of organ-function decline, comorbidities and other drugs. Older than 75: maximum 300 mg/day.

GRPH-tramadol-01 · Source section: Usual dosingRenal section finder

Renal Dosing

CrCl above 30 mL/min: no change in the summary. Below 30: 50-100 mg every 12 hours, maximum 200 mg/day.

GRPH-tramadol-02 · Source section: Renal DosingRenal section finder

Hemodialysis

The label narrative reports only 7% removal and permits the regular renal-adjusted dose on HD days. The separate GlobalRPh HD summary calls data insufficient and considers the below-30 instructions reasonable.

GRPH-tramadol-03 · Source section: HemodialysisRenal section finder
Locally imported selected renal sections

GlobalRPh RX List renal information

Rxlist

GlobalRPh RX List - Ultram

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GlobalRPh-hosted RX List · Adult immediate-release ULTRAM; not ER, pediatric or combination-product dosing.

Renal method: CrCl in mL/min
Source date: Source revision date not established in selected retrieval.
Retrieved: 2026-09-07

Label mirror, not independent corroboration. This is selected locally stored RX List content. Full monograph import and current official-label review are not implied.
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.

Renal dosing, restrictions and evidence limits

For creatinine clearance below 30 mL/min, extend the immediate-release dosing interval to 12 hours and limit the total to 200 mg/day. The source states dialysis patients may receive their regular dose on the dialysis day because only about 7% is removed. This does not mean the usual normal-renal maximum applies during dialysis. Patients older than 75 years have an additional 300-mg/day ceiling; use the more restrictive applicable constraint. Accumulation may take several days, so reassess sedation and respiratory effects after initiation or changes. Extended-release and fixed-combination products have separate guidance.

RDM36-rxlist-tramadol-e9f7693f39-C1 · Source locator: Dosage: renal and geriatric modifications; renal/hepatic impairment.

Source identity and provenance
Source family
product_label_mirror
Source
https://globalrph.com/rx-list/ultram-drug/
Retrieved
2026-09-07
Renal-function method
CrCl in mL/min
Source date/version
Source revision date not established in selected retrieval.
Hash meaning
SHA-256 of local authored summary only; not original HTML, PDF or SPL bytes.
Local summary SHA-256
42310ec2b8ff20de439e68908aa8ea5e6f023eef21d0762f96cca9107ff31075

Provenance and preservation

Additional summaries stored on this page: 0 official-label, 1 RX List, 0 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/tramadol/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
61f574e74724d7c18b2067a04ea7a2c70c1d42e694e79d2b2f88ebce671d5f5b
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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