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Acema (Tramadol)

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Acema is a pain medicine similar to an opioid. It acts in the central nervous system (CNS) to relieve pain. Acema is used to treat moderate to severe pain in adults. The extended-release form of Acema is for around-the-clock treatment of pain. This form of Acema is not for use on an as-needed basis for pain.

Other names for this medication:
Arodol, Avdol, Combitram, Cormadol, Damadol, Dolstar, Domadol, Eltram, Formador, Hyperdol, Kamadol, Leedol, Medol, Meridol, Movon, Nictram, Nosdol, Ospidol, Pacadon, Ramadol, Ramax, Servodol, Sigmadol, Simol, Soztram, Stemadol, Supridol, Tandam, Tradol, Traiz, Tramache, Tramacon, Tramadol, Tramatas, Tramazol, Tramol, Tramot, Trampar, Trandol, Tranzat, Trapain, Trydol, Ubitdol, Ultracon, Unidol, Vardol, Zotadol

Similar Products:
Risperdal, Urispas, Zanaflex, Strattera, Xeloda, Adipex, Klonopin, Persantine, Mellaril, Elocon, Foracort, Storvas, Ulticadex, Zalzol, Terbact, Laricid, Sotomycin,

Also known as: Tramadol


Acema 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.


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture, light and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

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 ER if you are allergic to it, 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 ER 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 ER 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 ER. 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.

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 Acema ER 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 Acema ER if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

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