title: Tramadol can selectively manage moderate pain in children following European advice limiting codeine use.
abstract: The European Medicine Agency recommendations limiting codeine use in children have created a void in managing moderate pain. We review the evidence on the pharmacokinetic, pharmacodynamic and safety profile of tramadol, a possible substitute for codeine.
  
  
  CONCLUSIONS
  Tramadol appears to be safe in both paediatric inpatients and outpatients. It may be appropriate to limit the current use of tramadol to monitored settings in children with risk factors for respiratory depression, subject to further safety evidence.
authors.affiliation: M.D. Department of Women and Children and General and Specialized Surgery, Seconda Università degli Studi di Napoli, Naples, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Marzuillo
authors.affiliation: M.D. Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Calligaris
authors.affiliation: M.D. Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Egidio
authors.initials: E
authors.lastname: Barbi
mesh_terms: D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D003061:Codeine / Q000627:therapeutic use; D005060:Europe; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D012720:Severity of Illness Index; D014147:Tramadol / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol; D003061:Codeine
keywords: Codeine; Pain; Tramadol; Tramadol pharmacodinamic; Tramadol pharmacokinetic