Zyrotram Dosage/Direction for Use

The dose should be adjusted to the intensity of the pain and the sensitivity of the individual patient. The lowest effective dose for analgesia should generally be selected. The total daily dose of 400 mg tramadol hydrochloride should not be exceeded, except in special clinical circumstances.
Unless otherwise prescribed, ZYROTRAM should be administered as follows: Adults and adolescents above the age of 12 years: Tramadol HCl injection is not approved for use in patients below the age of 12 years.
The usual dose is 50 or 100 mg 4-6 hourly.
Intravenous injections must be given slowly over 2-3 minutes.
For post-operative pain, administer an initial bolus of 100 mg. During the 60 minutes following the initial bolus, further doses of 50 mg may be given every 10-20 minutes, up to a total dose of 250 mg including the initial bolus. Subsequent doses should be 50 mg-100 mg 46 hourly up to a total daily dose of 400 mg.
Paediatric population: The safety and efficacy of ZYROTRAM has not been studied in the paediatric population. Therefore, use of ZYROTRAM is not recommended in patients under 12 years of age.
Geriatric patients: A dose adjustment is not usually necessary in elderly patients (up to 75 years) without clinically manifest hepatic or renal insufficiency. In elderly patients (over 75 years) elimination may be prolonged. Therefore, if necessary the dosage interval is to be extended according to the patient's requirements.
Renal insufficiency/dialysis and hepatic insufficiency: In patients with renal and/or hepatic insufficiency the elimination of tramadol is delayed. In these patients prolongation of the dosage intervals should be carefully considered according to the patient's requirements.
Method of administration: ZYROTRAM Injection administered intramuscularly, or diluted in solution (water for injections, sodium chloride solution for injection 0.9% and glucose solution for injection 5%) for administration by infusion or patient controlled analgesia.
Duration of administration: Tramadol hydrochloride injection should under no circumstances be administered for longer than absolutely necessary. If long-term pain treatment with Tramadol hydrochloride injection is necessary in view of the nature and severity of the illness, then careful regular monitoring should be carried out (if necessary with breaks in treatment) to establish whether and to what extent further treatment is necessary.
Route of Administration: Intravenous and Intramuscular Route.