Tramal long®

Explanation / definition

Tramal ® is a centrally (in the brain) acting pain reliever from the group of opioids and is used for moderate to severe pain of various causes.

The active ingredient of the drug achieves its pain therapeutic effect by influencing specific nerve cells in the spinal cord and the brain.

The term "long" (retarded) describes the longer-lasting effect (> 12 hours) in contrast to non-retarded preparations.

Trade names

Tramal® long 100 mg

from Grünenthal GmbH.

Chemical name

Tramadol hydrochloride

application areas

Use for moderate and severe pain of various causes.

In the orthopedic field, these include:

  • Osteoarthritis pain (osteoarthritis).
    • Hip osteoarthritis
    • Knee osteoarthritis
  • Post-operative pain.
    • Hip prosthesis
    • Knee prosthesis
    • Cruciate ligament tear
    • hallux valgus
  • Rheumatism pain (rheumatism).
    • Rheumatoid arthritis
    • Psoriatic arthritis
    • ankylosing spondylitis
  • Spine pain
    • Back pain
    • disc prolapse
    • Degenerative spinal disease
    • Cervical spine syndrome
    • Lumbar spine syndrome
  • Fracture pain / hernia pain
    • Vertebral fracture
    • Broken spoke
    • break of collarbone
    • Outer ankle fracture
    • Femoral neck fracture
    • Broken rib
  • u.a.m.

Dosage form

  • Tablets / film-coated tablets
  • drops


Tramadol (the active ingredient in Tramal) binds to central (brain / spinal cord) opiate receptors and, by inhibiting the transmission of excitation (transmission of pain via nerves), leads to a reduced perception of pain.


Tramal® long 100 mg can be taken independently of meals. It is recommended to take it after a meal.

The prolonged-release tablets are swallowed whole with plenty of liquid. The tablets should not be broken up, otherwise the delayed release of the active ingredient can be impaired.

The daily dose should be divided into two individual doses, morning and evening.

When taking tablets, fixed times should ideally be adhered to. The intake takes place every 12 hours (e.g. 8 a.m. and 8 p.m.).


Since Tramal is a prescription drug for the treatment of pain, we recommend that you consult a doctor who can work with you to adjust the dosage more precisely to your needs and your current illness situation.

Tramadol is in Dosages between 50 and 100 mg available. The most common forms of administration are Capsules, droplets or Suppositories. The starting dose, the dose with which you start taking, depends on the severity of the pain and your body weight. The subsequent dosages are also determined by the severity of the pain.

While taking it, care should be taken to ensure that Tramal is dosed in a sufficiently high dose for pain relief Side effectsHowever, like nausea, dizziness, headache and dry mouth all rolled into one tolerable framework hold.

Dosage for adults


In adults are depending on the severity of the pain Dosages between 50-100 mg common. At the beginning, in the case of moderate pain, a whole capsule with a dose of 50 mg, whole and not broken, should be with plenty of water be taken. If there is no pain relief after 30-60 minutes, another 50 mg capsule can be taken. Afterwards, however, there should be an interval of 4-6 hours before the next dose. The Maximum dose of 400 mg Tramal not be exceeded. With a dosage of 100 mg this would correspond to 4 capsules, with a dosage of 50 mg 8 capsules etc.


20 to 40 droplets can be taken every 4-6 hours, depending on the severity of the pain. 20 droplets correspond to a dosage of 50 mg Tramal. In the case of moderate pain, 20 droplets should be taken, and pain relief should be felt after 30-60 minutes. If this is not the case, another 20 drops can be taken once. Then an interval of at least 4 hours should be observed. The duration of action, i.e. the time in which the drug relieves pain, is around 4 to 8 hours. The maximum daily dosage is 160 droplets, which corresponds to a dose of 400 mg Tramal.

Dosage for adults over 75 years of age

For adults older than 75 years, there should be a longer interval between ingestion of both capsules and droplets, as the drug contained in Tramal The active ingredient tramadol is broken down more slowly than in younger people and for this reason stays longer in the body and can develop its effect there. Your doctor can make a dosage recommendation based on your condition and illness.

Dosage for children from 1 year


For children from the age of 12, the same dosage recommendations apply as for adults. Children aged 1 to 11 receive doses of 1-2 mg Tramal per kilogram of body weight.


Children under 2 years of age should not take Tramal drops due to the risk of laryngeal spasms. An extra dropper bottle is available for children from 2 years of age, from which the child 4 to 8 drops per 10 kilograms of body weight can get. This corresponds to a dose of 1 to 2 mg tramadol per kg of body weight. Assuming a one-year-old child weighs 10 kilograms, it receives 4-8 drops, depending on how much is needed for pain relief. From the age of 12, it is recommended that the drops be given in the doses intended for adults.


The Tramal suppositories are in a dosage of 100 mg available. It is not suitable for children and adolescents younger than 14 years. The daily dose of 400 mg tramadol corresponds to 4 suppositories must not be crossed. The effect lasts for 4-8 hours, depending on the severity of the pain.

Summary Dosage of Tramal ® long

  • The maximum daily dose should not exceed 400 mg daily.
  • The lowest pain therapy dose that is just sufficient should always be selected.
  • The required dose level is determined by the attending physician according to the pain therapeutic effect. Deviations from the maximum recommended dose are possible, but only if your doctor deems it necessary and correct.
  • Tramal ® long 100 mg can lead to emotional and physical dependence.
  • If Tramal ® long 100 mg is taken for a long time, the pain-therapeutic effect of the drug may decrease (tolerance development).

Ending drug therapy with Tramal ® long 100 mg should be done gradually. Abrupt discontinuation of Tramal ® long 100 mg generally does not lead to any side effects. After taking Tramal ® long 100 mg for a very long time, sudden discontinuation of the medication can lead to unpleasant side effects:

  • Restlessness
  • Anxiety
  • Panic attack
  • Hallucinations
  • nervousness
  • insomnia
  • Abnormal sensations (tingling, numbness, etc.)
  • Tinnitus
  • Gastrointestinal complaints

At Poor kidney function (Renal failure) or Liver failure (Liver failure) should Tramal ® long 100 mg Not be taken.

A special dose adjustment for the elderly (over 75 years) is not necessary considering the general side effects. Occasionally, due to a reduced excretion of the active ingredient, it may be necessary to take the individual medication longer.

Side effects

Painkillers from the group of Opioids have in therapeutic doses in contrast to the pain relieving drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) fewer side effects that cause lasting damage to the organism.
Yet they show numerous undesirable effects which can be very stressful for those affected.

As one of the common side effects occur when treating with Tramal ® Nausea, dizziness and Vomit on (>10%).
They come from stimulation Dopamine receptors in the so-called Vomiting center in the area postrema im Central nervous system come about and can accordingly, if necessary, by the gift of Dopamine antagonists how Metoclopramide or similar active ingredients are reduced.
Farther frequent (1-10%) occurring during therapy with Tramal ® Side effects are sweat, Drowsiness such as a headache, Dry mouth and Constipation.
The Constipation is one of the few side effects of opioids that comes with long-term therapy not subject to getting used to, so it can become a permanent problem during treatment with Tramal ®.
Accordingly, it can be individually weighed whether prophylactic, i.e. right at the start of therapy, or in the course of a Comedication is done with a drug that prevents the Stimulates bowel activity (Laxative). Frequently be here Movicol® (contains macrogol, potassium chloride, sodium chloride, sodium hydrogen carbonate) and Bifiteral® (contains lactulose) applied.
Uncommon side effects under the therapy with Tramal ® are skin symptoms like Reddening of the skin (Flush), skin rash (Rash) and itching (Pruritus), diarrhea and Bloating as well as a increased heartbeat (Tachycardia) With Palpitations (Palpitations).
There are also numerous Side effects that rarely occur. These include a Decrease in muscle strength, Changes in appetite, Tingling sensations (Paresthesia) and Tremble (tremor).
The dreaded in opioid therapy Respiratory depression occurs during therapy with Tramal ® therapeutic dosage very rarely on. At a Overdose or in combination with substances that also inhibit the respiratory center, such as Sleeping pills, some Psychotropic drugs such as alcohol however, it can occur.
Also the appearance of Seizures is under dose-adapting therapy with Tramal very rarely, but can with Overdose or in combination occur with other active substances that lower the seizure threshold. These include some, for example Antidepressants (amongst other things Amitriptyline) and Antipsychotics (for example haloperidol).
Also Rare occur when treating with Tramal ® symptoms such as sleep disorders and nightmares, Hallucinations and confusion as well as mood changes in the sense of a euphoria or Dysphoria (irritability) on.
Change in activity in terms of a Increased activity or -Damping, blurred vision, Slowing of the heartbeat (Bradycardia), Increase in blood pressure (hypertension), Difficulty urinating (Micturition disorders) and allergic reaction are other rare side effects that can occur during treatment with Tramal ®.

The feared development of an opioid therapy Dependency occurs at Tramal ® Rare on because Tramal ® in the group of opioids a rather low potential for dependence having.
Nonetheless, after a longer period of therapy, a dependency can develop, which will develop after stopping Tramal ® Withdrawal symptoms makes noticeable. These include tremors, sweating, restlessness, muscle cramps, feeling cold, racing heart, nausea, vomiting, diarrhea, perception and sleep disorders. Mood swings as well as anxiety attacks.
At a Overdose (Intoxication) from Tramal ® can Vomit, Circulatory collapse, Impaired consciousness up to coma, Respiratory depression up to Respiratory paralysis, Seizures as well as one characteristic of opioid intoxication Constriction of the pupils (Miosis) come.
As Antidote (Antidote) in respiratory depression Naloxone given for cramps Diazepam used intravenously.
When treating with Tramal ® it should be noted that a Impairment of the ability to react can occur so that active participation in the Road traffic and the Operate machines should be avoided in this case. If side effects occur during treatment with Tramal ®, the Doctor informed become.


Tramal Long can have several interactions.

The pain therapeutic effect of Tramal ® long 100 mg may be reduced if drugs containing carbamacepin are taken at the same time (drugs against epileptic seizures).

Tramal ® long 100 mg can increase the effects on the central nervous system if sedatives or alcohol are taken at the same time.

Simultaneous use with other opioids (e.g. Valoron ®) should be omitted. The resulting effect cannot be assessed.

There are Interactions with certain antidepressants (Drugs used to treat a depression) and drugs in general that lower the seizure threshold.

When taking Marcumar ® (Phenprocoumon), small areas of bleeding may occur.


Who must / should not take Tramal ® long 100 mg:

  • Patients with an allergy to the active ingredient tramadol hydrochloride or other drug components.
  • Patients with a lactose intolerance (milk sugar intolerance).
  • Patients with addiction to opiates.
  • Patients in pregnancy and lactation.
  • Patients with other addiction disorders.
  • Patients with severe liver dysfunction.
  • Patients prone to seizures.
  • Patients under or after MAO inhibitor medication (antidepressant, therapy for depression; up to 14 days after the last dose).
  • u.a.m.


Since there is always talk of cost pressure in the healthcare sector, we believe it is important to also find out prices for drugs (prices are exemplary and not recommended):

  • Tramal ® long 100 mg: 10 tablets (N1) - € 14.41
  • Tramal ® long 100 mg: 20 tablets (N1) - € 18.98
  • Tramal ® long 100 mg: 50 tablets (N2) - € 32.20
  • Tramal ® long 100 mg: 100 tablets (N3) - € 53.52

Prescription requirement

There is a prescription requirement for all dosages!