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Tramadol

Prescription
Centrally acting analgesic — atypical opioid + monoaminergic
Last reviewed 19 Apr 2026 · PetCare.AI Editorial Team
Species
Dog, Cat
Brands
4 available
Interactions
22 documented
Formulations
4

Mechanism of action

Weak mu-opioid receptor agonist; also inhibits noradrenaline and serotonin reuptake, providing multimodal analgesia

At a glance

Class
Centrally acting analgesic — atypical opioid + monoaminergic
Schedule
Prescription
Storage
Store below 25°C

Dosing

🐕

Dog

Moderate pain (musculoskeletal, post-operative adjunct)
Dose
2–10 mg/kg
Route
PO
Frequency
BID-TID
Max dose
300 mg/dose; 600 mg/day
Duration: 3-7 days (limited evidence for chronic use in dogs)
🐈

Cat

Moderate pain
Dose
1–4 mg/kg
Route
PO
Frequency
BID
Max dose
50 mg/dose; 100 mg/day
Duration: 3-5 days

Formulations

💊

Tablet — 2

Strength
50mg
Available in India
Strength
100mg
Available in India
💉

Injectable — 1

Strength
50mg/mL
Available in India
💊

Capsule — 1

Strength
50mg
Available in India

Storage

Store below 25°C

Safety

Absolute contraindications — do not use

  • Concurrent MAOIs (selegiline)
    Risk of serotonin syndrome — potentially fatal
    SelegilineAmitraz
  • Concurrent SSRIs/SNRIs
    Serotonin syndrome risk
    FluoxetineClomipramine

Use with caution

  • Seizure disorders
    Lowers seizure threshold
  • Hepatic impairment
    Active metabolite (M1) formed hepatically — reduced efficacy in dogs with poor CYP2D6

Adverse effects

Common
Sedation
Constipation
Panting (dogs)
Dysphoria/mydriasis (cats)
Serious
Seizures
Serotonin syndrome
Respiratory depression (high doses)

Monitoring parameters

Pain assessmentSedation levelNeurological signsRespiratory rate

Interactions

Contraindicated — 2

Selegiline (L-Deprenyl)
contraindicated
Risk of serotonin syndrome — selegiline (MAO-B inhibitor) + tramadol (serotonin reuptake inhibitor)
Management: Do not combine. Allow 14-day washout from selegiline before starting tramadol.
Procarbazine
contraindicated
Procarbazine has MAO inhibitor activity. Tramadol is a serotonin reuptake inhibitor. Combined: serotonin syndrome.
Management: NEVER combine. Use non-serotonergic analgesic during procarbazine (MOPP) chemotherapy.

Major — 11

Fentanyl
major
Dual opioid agonism: risk of serotonin syndrome and severe respiratory depression
Management: Avoid concurrent use. Discontinue tramadol before starting fentanyl CRI.
Fluoxetine
major
Both increase serotonin; risk of serotonin syndrome (agitation, tremors, hyperthermia, seizures)
Management: Avoid concurrent use. If both needed, use lowest doses and monitor closely for serotonin syndrome signs.
Sertraline
major
Both increase serotonin; risk of serotonin syndrome (agitation, tremors, hyperthermia)
Management: Avoid combination. If essential, use lowest doses and monitor closely for serotonin syndrome signs.
Clomipramine
major
Tramadol (serotonin reuptake inhibitor) + clomipramine (TCA with strong serotonin reuptake inhibition): high serotonin syndrome risk.
Management: Do not combine. Use pure mu-agonist opioid instead of tramadol.
Amitriptyline
major
Additive serotonin reuptake inhibition. TCAs + tramadol: serotonin syndrome and seizure risk.
Management: Avoid combination. If both pain and behavioral indications, use non-serotonergic opioid.
Linezolid
major
Linezolid has weak reversible MAO-A inhibitory activity. Tramadol inhibits serotonin reuptake. Combined: serotonin syndrome risk.
Management: Avoid. If antibiotic needed with tramadol, use non-MAO-inhibiting antibiotic. If linezolid essential, use non-serotonergic opioid.
Paroxetine
major
Paroxetine potently inhibits CYP2D6, blocking tramadol conversion to active metabolite M1 (reduced analgesia) while increasing serotonin syndrome risk.
Management: Avoid. Paroxetine renders tramadol ineffective as analgesic while increasing toxicity risk.
Fluvoxamine
major
Both serotonergic. Fluvoxamine also inhibits CYP1A2 and CYP2D6, altering tramadol metabolism.
Management: Avoid. Use non-serotonergic analgesic.
Imipramine
major
Both inhibit serotonin reuptake. Additive serotonin syndrome risk.
Management: Avoid combination. Use non-serotonergic opioid for pain.
Doxepin
major
Both serotonergic (doxepin: SRI/antihistamine; tramadol: SRI/opioid). Serotonin syndrome risk.
Management: Avoid combination. Use non-serotonergic analgesic.
Naltrexone
major
Naltrexone blocks tramadol's mu-opioid component of analgesia. Tramadol's serotonergic component may be partially preserved but overall analgesic efficacy greatly reduced.
Management: Tramadol will be largely ineffective while on naltrexone.

Moderate — 9

Metronidazole
moderate
Both drugs lower seizure threshold; combined use increases CNS depression risk
Management: Monitor closely for neurological signs. Consider dose reduction of tramadol.
Gabapentin
moderate
Additive CNS depression; both cause sedation and ataxia
Management: Common multimodal analgesic combination. Reduce doses of both. Monitor for excessive sedation.
Trazodone
moderate
Both have serotonergic activity: trazodone (SARI — serotonin antagonist/reuptake inhibitor) + tramadol (serotonin reuptake inhibitor). Additive serotonin risk.
Management: Use with caution. Lower doses of both. Monitor for serotonin syndrome signs (agitation, hyperthermia, tremors).
Metoclopramide
moderate
Metoclopramide (D2 antagonist) + tramadol (serotonin reuptake inhibitor): increased extrapyramidal and serotonergic risk. Also, tramadol slows GI motility opposing metoclopramide.
Management: Use with caution. Monitor for extrapyramidal signs and serotonin syndrome. Maropitant may be preferred antiemetic with tramadol.
Ondansetron
moderate
5-HT3 antagonism by ondansetron may partially block tramadol's serotonin-mediated analgesic component.
Management: Clinical significance debated. Monitor pain scores if using both. Consider alternative analgesic if control inadequate.
Amantadine
moderate
Amantadine (NMDA antagonist with weak dopaminergic activity) + tramadol (serotonin reuptake inhibitor): theoretical serotonin syndrome risk, though clinical reports are rare.
Management: Often used together intentionally for multimodal pain management. Monitor for serotonin syndrome signs (agitation, hyperthermia, tremors). Generally considered safe at standard doses.
Mirtazapine
moderate
Both serotonergic. Additive serotonin effect.
Management: Use with caution. Monitor for serotonin syndrome signs.
Cyproheptadine
moderate
Cyproheptadine antagonizes serotonin receptors, potentially reducing tramadol's serotonin-mediated analgesic component.
Management: May reduce tramadol analgesic efficacy. Monitor pain control. Useful as serotonin syndrome antidote if tramadol toxicity occurs.
Diphenhydramine
moderate
Additive CNS depression. Diphenhydramine also weakly inhibits serotonin reuptake — theoretical additive serotonergic effect with tramadol.
Management: Monitor sedation. Usually well-tolerated at standard doses.

Brands

International

Ultram
Janssen

India

Tramadol
Zydus
Contramal
Abbott
Domadol
Dr. Reddy's

FAQs

Frequently asked questions

›What is Tramadol?
Tramadol is a centrally acting analgesic — atypical opioid + monoaminergic used in pets. Weak mu-opioid receptor agonist; also inhibits noradrenaline and serotonin reuptake, providing multimodal analgesia
›What is Tramadol used for in pets?
Tramadol is used in veterinary medicine for: Moderate pain (musculoskeletal, post-operative adjunct); Moderate pain.
›What is the Tramadol dose for dogs?
For dogs, Tramadol is typically dosed as follows — Moderate pain (musculoskeletal, post-operative adjunct): 2–10 mg/kg PO BID-TID. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›What is the Tramadol dose for cats?
For cats, Tramadol is typically dosed as follows — Moderate pain: 1–4 mg/kg PO BID. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
›What are the side effects of Tramadol?
Common: Sedation, Constipation, Panting (dogs), Dysphoria/mydriasis (cats). Serious (call your vet immediately): Seizures, Serotonin syndrome, Respiratory depression (high doses).
›Does Tramadol need a prescription?
Yes. Tramadol is a prescription medication and should only be administered under veterinary supervision.
›When should Tramadol not be used?
Do not use Tramadol if: Concurrent MAOIs (selegiline); Concurrent SSRIs/SNRIs.

References

References

Textbooks & handbooks

  • Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
  • Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
  • Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
  • National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
  • The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

  • Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
  • American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

  • Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
  • Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
  • ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

  • Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

  • Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →