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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

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

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

Frequency

BID

Max dose

50 mg/dose; 100 mg/day

Duration: 3-5 days

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 →

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

Educational reference only

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.

Educational reference only

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.

Educational reference only

References

The PetCare.AI drug reference is built from 13 authoritative sources cited across 580 drug monographs.

Textbooks & handbooks — 5

Plumb's Veterinary Drug Handbook
Withrow & MacEwen's Small Animal Clinical Oncology
Merck Veterinary Manual
NRC Nutrient Requirements of Dogs and Cats
Veterinary Pharmacology and Therapeutics (Riviere & Papich)

Clinical guidelines & consensus — 4

ASPCA Animal Poison Control Center Guidelines
AAHA Diabetes Management Guidelines
ASPCA Poison Control Guidelines
RECOVER CPR Guidelines

Journals & peer-reviewed studies — 2

EPIC Study (J Vet Intern Med 2016)
JVIM FAT CAT Study

Regulatory & approvals — 1

CDSCO Veterinary Drug Approval Registry (1969–2026)

Databases — 1

Washington State University VCPL MDR1 Database