BNF for Children 2011-2012

BNFC 2011–2012 4.7.2 Opioid analgesics 211. By intravenous injection (over 2–3 minutes) orby intravenous infusion or by intramuscularinjectionChild 12–18 years 50–100 mg every 4–6 hoursPostoperative pain. By intravenous injection (over 2–3 minutes)Child 12–18 years 100 mg initially then 50 mgevery 10–20 minutes if necessary up to total max.250 mg (including initial dose) in first hour, then50–100 mg every 4–6 hours; max. 600 mg dailyAdministration for intravenous infusion, dilute withGlucose 5% or Sodium Chloride 0.9%Tramadol Hydrochloride (Non-proprietary) ACapsules, tramadol hydrochloride 50 mg, net price30-cap pack = £1.22, 100-cap pack = £2.07. Label: 2Brands include Tramake cInjection, tramadol hydrochloride 50 mg/mL, netprice 2-mL amp = 95pMarol c (Morningside) ATablets, m/r, tramadol hydrochloride 100 mg, netprice 60-tab pack = £9.12; 150 mg, 60-tab pack =£13.68; 200 mg, 60-tab pack = £18.24. Label: 2, 25DoseModerate to severe pain. By mouthChild 12–18 years 100 mg twice daily increased ifnecessary; usual max. 200 mg twice dailyMaxitram SR c (Chiesi) ACapsules, m/r, tramadol hydrochloride 50 mg(white), net price 60-cap pack = £4.55; 100 mg (yellow),60-cap pack = £12.14; 150 mg (yellow), 60-cappack = £18.21; 200 mg (yellow), 60-cap pack = £24.28.Label: 2, 25DoseModerate to severe pain. By mouthChild 12–18 years initially 100 mg twice dailyincreased if necessary; usual max. 200 mg twice dailyZamadol c (Meda) ACapsules, tramadol hydrochloride 50 mg, net price100-cap pack = £8.00. Label: 2Orodispersible tablets (Zamadol Melt c ), tramadolhydrochloride 50 mg, net price 60-tab pack = £7.12.Label: 2, counselling, administrationExcipients include aspartame (section 9.4.1)Counselling Zamadol Melt c should be sucked and thenswallowed. May also be dispersed in waterInjection, tramadol hydrochloride 50 mg/mL, netprice 2-mL amp = £1.10Zydol c (Grünenthal) ACapsules, green/yellow, tramadol hydrochloride50 mg, net price 30-cap pack = £2.29, 100-cap pack =£7.63. Label: 2Soluble tablets, tramadol hydrochloride 50 mg, netprice 20-tab pack = £2.79, 100-tab pack = £13.33.Label: 2, 13Injection, tramadol hydrochloride 50 mg/mL, netprice 2-mL amp = 80pModified-release 12-hourly preparationsLarapam c SR (Sandoz) ATablets, m/r, tramadol hydrochloride 100 mg, netprice 60-tab pack = £17.55; 150 mg, 60-tab pack =£27.35; 200 mg, 60-tab pack = £36.50. Label: 2, 25DoseModerate to severe pain. By mouthChild 12–18 years initially 100 mg twice daily increasedif necessary; usual max. 200 mg twice dailyMabron c (Morningside) ATablets, m/r, tramadol hydrochloride 100 mg, netprice 60-tab pack = £18.26; 150 mg, 60-tab pack =£27.39; 200 mg, 60-tab pack = £36.52. Label: 2, 25DoseModerate to severe pain. By mouthChild 12–18 years 100 mg twice daily increased ifnecessary; usual max. 200 mg twice dailyTramquel SR c (Meda) ACapsules, m/r, tramadol hydrochloride 50 mg (darkgreen), net price 60-cap pack = £7.20; 100 mg (white),60-cap pack = £14.39; 150 mg (dark green), 60-cappack = £21.59; 200 mg (yellow), 60-cap pack = £28.78.Label: 2, counselling, administrationDoseModerate to severe pain. By mouthChild 12–18 years 50–100 mg twice daily increased ifnecessary; usual max. 200 mg twice dailyAdministration Swallow whole or open capsule and swallowcontents immediately without chewingZamadol c SR (Meda) ACapsules, m/r, tramadol hydrochloride 50 mg(green), net price 60-cap pack = £7.20; 100 mg, 60-cappack = £14.39; 150 mg (dark green), 60-cap pack =£21.59; 200 mg (yellow), 60-cap pack = £28.78.Label: 2, counselling, administrationDoseModerate to severe pain. By mouthChild 12–18 years 50–100 mg twice daily increased ifnecessary to 150–200 mg twice daily; total of more than400 mg daily not usually requiredAdministration Swallow whole or open capsule and swallowcontents immediately without chewingZeridame c SR (Actavis) ATablets, m/r, tramadol hydrochloride 100 mg, netprice 60-tab pack = £17.21; 150 mg, 60-tab pack =£25.82; 200 mg, 60-tab pack = £34.43. Label: 2, 25DoseModerate to severe pain. By mouthChild 12–18 years 100 mg twice daily, increased ifnecessary; usual max. 200 mg twice dailyZydol SR c (Grünenthal) ATablets, m/r, f/c, tramadol hydrochloride 50 mg(yellow), net price 60-tab pack = £4.60; 100 mg, 60-tab4 Central nervous system