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Acema (Tramadol)

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Acema is an oral medication that is used to help relieve ongoing moderate to moderately severe pain. Acema is similar to opioid (narcotic) analgesics. It works in the brain to change how your body feels and responds to pain.

Other names for this medication:
Accupain, Adamon, Axedol, Bludol, Cosdol, Cradol, Dolomed, Esgiypyrin, Mydol, Nobligan, Omodol, Pacadon, Paxmax, Pentazen, Radol, Ramadol, Ramax, Siatram, Tragesic, Tramaflam, Trampar, Trandy, Trapain, Trazac, Tromar, Trugesic, Typhon

Similar Products:
Lamisil, Kemadrin, Klonopin, Artane, Uroxatral

Also known as: Tramadol


{name} ER is an pain medicine similar to an opioid. This medicine is used to treat moderate to severe pain.

The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.


Usual Adult Dose for Pain:

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain -For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain:

Extended-Release (ER): 18 years or older (tramadol-naive): 100 mg orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day For patients CURRENTLY receiving Immediate-Release (IR) Acema: Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day Conversion from OTHER Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy -Initial dose: 100 mg ER orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day.

Usual Geriatric Dose for Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Geriatric Dose for Chronic Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Pediatric Dose for Pain:

Acema is not recommended for use in pediatric patients 17 years or older: See Adult Dose.

Detailed Acema dosage information


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.


Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Side effects

The most common side effects associated with Acema are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


You should not take Acema if you are allergic to tramadol, or if you have:

severe asthma or breathing problems; a stomach or bowel obstruction (including paralytic ileus); if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications; or if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine).

Acema should not be given to a child younger than 12 years old. Acema ER should not be given to anyone younger than 18 years old.

Do not give Acema to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.

Seizures have occurred in some people taking Acema. Your seizure risk may be higher if you have ever had:

a head injury, epilepsy or other seizure disorder; drug or alcohol addiction; or a metabolic disorder.

To make sure Acema is safe for you, tell your doctor if you have ever had:

breathing problems, sleep apnea; liver or kidney disease; urination problems; problems with your gallbladder, pancreas, or thyroid; a stomach disorder; or mental illness, or suicide attempt.

If you use tramadol during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Ask a doctor before using tramadol if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

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Host-associated microbial interactions may involve genome complementation, driving-enhanced communal efficiency and stability. Multiple Molecular Data Sets and the Classification of Adult Diffuse Gliomas. The determination and evaluation of capillary resistance--a review of methodology. Ecology of cultivable yeasts in pristine forests in northern Patagonia (Argentina) influenced by different environmental factors. The use of laparoscopic appendectomy for complicated appendicitis is controversial. Structural and functional characterization of an RNase HI domain from the bifunctional protein Rv2228c from Mycobacterium tuberculosis. Catalytic Oxidative Carbonylation of Amino Moieties to Ureas, Oxamides, 2-Oxazolidinones, and Benzoxazolones. These properties offer characteristics similar to an artificial chromosome combined with an efficient delivery system and merit its continual development as a possible gene delivery vector for the future. Ultrasonographic findings are so characteristic that we would like to emphasize the usefulness of ultrasonography not only in distinguishing between recurrence and operative scar but also in defining the diagnosis as fibromatosis of the breast.

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The distribution of a 14.4 kDa S-type lectin was examined in murine neuroblastoma cells, either undifferentiated or after differentiation induced by dibutyryl-cyclic adenosine monophosphate. Impact of Diabetes Status and Medication on Presentation, Treatment, and Outcome of Stage II Colon Cancer Patients. The objective of KAVAS-2 is the development of a tool, named KAVIAR, with which domain experts can make their knowledge explicit. In contrast, three of the seven chimeras were capable of synthesizing RNA, albeit to reduced levels compared to that of wild-type PV1 RNA. However, the septal lesion reduced the amplitude of both spontaneous and odor-induced dentate fast wave activity. This study explored the experiences of truck drivers and their perspectives regarding factors contributing to traffic accidents. Additional studies were performed to check that the activation of descending tracts by transmastoid stimulation was likely to involve excitation of direct corticospinal paths. Current debates in antiphospholipid syndrome: the acquired antibody-mediated thrombophilia. C3-C4 propriospinal system: an example of integration in the motor control and a possible pathway for motor recovery. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events, for hydration and body cooling opportunities, when competitions are held in the heat.

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Experimental studies with ultrasonics on eyes with intraocular foreign bodies. Specific labeling of diaminopimelate: a radioassay for the determination of the peptidoglycan cross-linking index. Extraintestinal pathogenic Escherichia coli (ExPEC) are among the most frequently isolated bacterial pathogens in hospitals. Suicide behaviour in psychosis is a significant clinical and social problem. Our system prompts a user with the appropriate motion commands during 6-DOF visual simultaneous localization and mapping with a handheld camera. These data show that Epo induces phenotypic changes in the behavior of breast cancer cell lines and establishes links between individual cell signaling pathways and the potential for cancer spread. Stress reactivity to an electronic version of the Trier Social Stress Test: a pilot study. The primary endpoint was event-free survival and the analyses was conducted on an intention-to-treat basis. Lens fragments in the retrocapsular space occurred relatively frequently after uneventful phacoemulsification surgery.

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On the question of the specificity of the saliva test in the histochemical determination of glycogen. Impact of isoniazid preventive therapy for HIV-infected adults in Rio de Janeiro, Brazil: an epidemiological model. Australian glyburide 5mg tablet and New Zealand Clinical Trials Registry ACTRN12613000528752. Tenascin-R (and -C) is prominent in the nervous system and has an impact on neurite outgrowth and synaptic functions, and tenascin-W is found in the extracellular matrix of bone, muscle, and kidney. Substitution effects of diborane on the interaction with borazine (inorganic benzene). The aspirates were stained and observed under a light microscope (LM). This case describes the successful management of a case of distal radial metaphyseal osteomyelitis in an immature cat using surgical intervention and antibacterial therapy.

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