Check out our most popular compounded medications! Get Started
Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
This is a compounded oral liquid containing tramadol hydrochloride, prepared to a prescriber's order for one patient. Compounded preparations are not FDA-approved. Tramadol is a Schedule IV controlled substance.
These listings cover every salt or ester form of each drug in the FDA National Drug Code Directory.
FDA-approved products containing tramadol are listed in tablet, capsule and solution forms.
Liquid bases can be aqueous or nonaqueous, and USP <795> classifies the preparation by its water activity. Aqueous preparations carry shorter default beyond-use dates than nonaqueous ones. The date printed on the label is the one to follow.
Tramadol is a Schedule IV opioid pain reliever that also inhibits serotonin and norepinephrine reuptake; compounding pharmacies prepare it by prescription in several forms.
Tramadol is an opioid agonist that also weakly blocks reuptake of norepinephrine and serotonin. Much of its opioid activity comes from its metabolite M1, formed in the liver through CYP2D6, which binds mu-opioid receptors more strongly than tramadol itself. Tramadol hydrochloride tablets (for example Teva) are FDA-approved for adults with pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. Extended-release tablets and capsules, an oral solution, and tramadol with acetaminophen tablets are also manufactured. A prescriber may order tramadol compounded when a patient needs a strength, flavor or vehicle that the manufactured products do not offer. Compounded preparations are not FDA-approved and require a prescription. Tramadol is a federally controlled Schedule IV substance.
Tramadol carries a boxed warning covering addiction, abuse and misuse; life-threatening breathing problems, especially when starting or after a dose increase; fatal accidental swallowing, especially by children; profound sedation, coma or death when combined with benzodiazepines, alcohol or other sedatives; neonatal opioid withdrawal syndrome; the opioid REMS program; breathing deaths in children who are ultra-rapid CYP2D6 metabolizers; and interactions with drugs that affect CYP3A4 or CYP2D6. Do not use it under age 12, after tonsil or adenoid surgery under age 18, with significant breathing problems, with acute or severe asthma without monitoring, with bowel blockage, or within 14 days of an MAO inhibitor. It can also cause seizures, serotonin syndrome, low sodium, low blood sugar and adrenal insufficiency. Long-term use in pregnancy can cause newborn withdrawal. The label says breastfeeding is not recommended, and LactMed notes the FDA recommends against it. Talk to your prescriber or pharmacist about side effects.
Tramadol is a racemic opioid agonist and weak serotonin and norepinephrine reuptake inhibitor; M1 (O-desmethyltramadol) has higher mu-receptor affinity and was up to 6 times more potent than tramadol in animal models. Per the Teva label, mean absolute oral bioavailability is about 75%, peak tramadol and M1 levels occur at about 2 and 3 hours, plasma protein binding is about 20%, and mean half-lives are about 6.3 hours for tramadol and 7.4 hours for M1. Metabolism is through CYP2D6, CYP3A4 and conjugation; about 30% of a dose is excreted unchanged in urine and 60% as metabolites. The label says use with CYP3A4 inducers or inhibitors or CYP2D6 inhibitors requires careful consideration of effects on both tramadol and M1. Labeled indication: pain severe enough to require an opioid analgesic when alternatives are inadequate. StatPearls lists off-label use for restless legs syndrome and premature ejaculation when refractory to other medications. Dosing is per prescriber, with adjustment in renal and hepatic impairment (Teva label). Monitor respiratory status, sedation, misuse, serotonin syndrome, seizures and liver function. Tramadol is Schedule IV. Electronic prescribing of controlled substances is voluntary under federal DEA rules, CMS applies a prescriber-level threshold for Part D, and CMS notes that its program is separate from state EPCS requirements.
Shake the bottle if your label says to. Measure each dose with the oral syringe or dosing cup the pharmacy gave you, never a kitchen spoon. Give the liquid slowly into the mouth. Rinse the syringe with water after each use. Call the pharmacy if you are unsure how to measure.
Storage depends on the vehicle. Water-based liquids with a preservative usually carry a USP <795> beyond-use date of up to 35 days; without a preservative they are kept refrigerated for up to 14 days. Oil-based (nonaqueous) oral liquids may carry up to 90 days. Your label states whether to refrigerate and the beyond-use date. Keep out of reach of children and discard after that date.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Take orally
