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MotherToBaby

Medications and More during pregnancy and breastfeeding

Tramadol

Selected References: 

  • Bloor M, et al. 2012. Tramadol in pregnancy and lactation. Int J Obstet Anesth 21:163-7. 
  • Bowie AC, et al. 2022. Prescribed opioid analgesics in early pregnancy and the risk of congenital anomalies: a population-based cohort study. CMAJ. 194(5):E152-E162. 
  • Ferrer E, et al. 2025. Tramadol during pregnancy: risk of adverse pregnancy outcome and major congenital anomalies. A comparative study in the EFEMERIS database. Pharmacoepidemiol Drug Saf. 34(4):e70143. 
  • Hartenstein S, et al. 2010. Neonatal abstinence syndrome (NAS) after intrauterine exposure to tramadol. J Perinat Med 38: 695–6. 
  • Ilett KF, et al. 2008. Use of a sparse sampling study design to assess transfer of tramadol and its o-desmethyl metabolite into transitional breast milk. Br J Clin Pharmacol. 65:661-6. 
  • Kallen B & Reis M. 2015. Use of tramadol in early pregnancy and congenital malformation risk. Reprod Toxicol. 23;58:246-251.  
  • Kaur Makkar J, et al. 2015. Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor. Clin Anesth. 27(2):159-63.  
  • Meyer FP, et al. 1997. Tramadol withdrawal in a neonate. Eur J Clin Pharmacol 53: 159–60. 
  • O’Mara K, et al. 2010. Treatment of neonatal withdrawal with clonidine after long-term, high-dose maternal use of tramadol. Ann Pharmacother 44: 1342–4. 
  • Sawaddiruk P. 2011. Tramadol hydrochloride/acetaminophen combination for the relief of acute pain. Drugs Today (Barc). 47(10):763-772.  
  • Schuckit MA. 2016. Treatment of opioid-use disorders.  N Engl J.Med. 375:357–68 
  • Sørensen AMS, et al. 2022. Exposure to tramadol during early pregnancy and risk of spontaneous abortion or major congenital malformations. Obstet Gynecol.139(4):545-553.  
  • Subedi A. et al. 2013. Analgesic effects of intrathecal tramadol in patients undergoing caesarean section: a randomised, double-blind study. Int J Obstet Anesth. 22(4):316-21.  
  • U.S. Food & Drug Administration. Updated 10/2023. FDA drug safety communication: FDA restricts use of prescription codeine pain and cough medicines and tramadol pain medicines in children; recommends against the use in breastfeeding women. Available from URL: https://www.fda.gov/Drugs/DrugSafety/ucm549679.htm  
  • Willaschek C, et al. 2009. Tramadol withdrawal in a neonate after long-term analgesic treatment of the mother. Eur J Clin Pharmacol 65: 429–30. 

MotherToBaby cuenta con el apoyo de la Administración de Recursos y Servicios de Salud (HRSA) del Departamento de Salud y Servicios Humanos de los Estados Unidos (HHS) como parte de una adjudicación por un total de $6,000,000 con cero porcentaje financiado con fuentes no gubernamentales. Los contenidos son los del autor/es y no representan necesariamente los puntos de vista oficiales de, ni un respaldo, por HRSA, HHS o el Gobierno de los Estados Unidos.