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Publications

Published: 2 March 2017

Tramadol in Children

Prescriber Update 38(1): 4
March 2017

Key Messages

  • Tramadol is contraindicated in children under two years of age due to the limited data on efficacy and safety in this patient group.
  • The strength of tramadol oral drops funded by PHARMAC in the DHB hospitals is changing. Please take care when prescribing, dispensing and administering tramadol oral drops.


The use of tramadol in children was discussed by the Medicines Adverse Reactions Committee (MARC) in 2016 (www.medsafe.govt.nz/profs/adverse/Minutes166.htm#3.2.3).

Tramadol is indicated for the relief of moderate to severe pain in adults and children. Most of the studies conducted in children investigated the use of tramadol in postoperative pain. The MARC considered that there is a role for the use of tramadol in children. However, as there is very limited data on the efficacy and safety in younger children, the MARC recommended that tramadol should be contraindicated in children aged two years and under. The tramadol data sheets are in the process of being updated with this contraindication as well as additional information on use following tonsillectomy, adenoidectomy or throat surgery.

Further information on the use of tramadol is available at www.medsafe.govt.nz/profs/PUArticles/December2014Tramadol.htm.

Recent Funding Change

PHARMAC has released its decision on the funding of tramadol oral drops in Section H of the Pharmaceutical Schedule (hospital pharmaceuticals). The decision is to:

Please take care when prescribing, dispensing and administering tramadol oral drops during this transition period to ensure the correct dose is given to the patient.

Further information on this change in funding is available on the PHARMAC website (www.pharmac.govt.nz/news/notification-2016-12-13-tramadol-hydrochloride/).

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