Tramadol hydrochloride extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Tramadol is used primarily to treat mild to severe pain, both acute and chronic. Its analgesic effects take about one hour to come into effect and 2 to 4 h to peak after oral administration with an immediate-release formulation. HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use tramadol hydrochloride extended-release capsules safely and effectively. Table 2: Some important drug interactions with tricyclic antidepressants (TCAs) Interacting drugs(s) Possible effect(s) Importance and management Post-operative use in children. There have been reports in the published literature that tramadol given post-operatively in children after tonsillectomy and/or adenoidectomy for obstructive sleep apnoea, led to rare, but life threatening adverse events. Tricyclic antidepressants (TCAs) are a class of medications that are used primarily as antidepressants. TCAs were discovered in the early 1950s and were marketed later in the decade. They are named after their chemical structure, which contains three rings of atoms. Tramadol hydrochloride, USP is a white, bitter, crystalline and odorless powder. It is readily soluble in water and ethanol and has a pKa of 9.41. Learn about ConZip (Tramadol Hydrochloride Extended-release Capsules) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications. Learn about Ultram (Tramadol Hcl) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications. Tramadol drops is contraindicated - in hypersensitivity to the active substance or any of the excipients listed in section 6.1, - in acute intoxication with alcohol, hypnotics, analgesics, opioids or other psychotropic medicinal products.