Is Tramadol part of your Narc count?

morte, LPN, LVN · Oct 20, 2009

Just wondering. I work a couple of LTCs and LTACs as agency. Some places have Ultram in their lock boxes and its part of the narc count. Others have it in the regular pill drawer. What is your facility practice, and do you know the rationale for locking it up? Is it a highly diverted pain med?

apparently, every once and awhile it does "go missing" when not on count......i wonder what the DEA thinks of having a noncountable in the narc drawer?

Meriwhen, ASN, BSN, MSN, RN · Oct 20, 2009

It's in our narc box--we primarily use it in detox with phenobarbital.

SunnyAndrsn · Oct 20, 2009

no, it's not. No issues with refills, does not require pre-authorization for meds.

XingtheBBB, BSN, RN · Oct 20, 2009

Well, although it's non-narcotic, it has some action as a Mu (opioid) receptor agonist. I don't think it's had much problem with diversion/ recreational use but I have heard of some. I seem to remember (but very well could be wrong) that it was C-IV when it first came out then was approved as a no scheduled substance? I was in peds when it was introduced so only saw it if I floated.

Oh, and no, we don't count it where I work now.

StNeotser, ASN, RN · Oct 20, 2009

I've never noticed them going missing. We do not count them.

Alibaba · Oct 20, 2009

Thanks for all the replies. Just think its weird that some places count it and some do not. This one place (LTC), I think the doc is in love with ultram coz in a count of 60, 15 are ultrams. Sooo time consuming. But I guess if it prevents diversion, then so be it.

The other strange thing is that the pharmacy (omnicare) sends count sheets with the ultrams in one facility but the same pharmacy does not send the count sheets in another facility where they are not counted. So I guess each facilty has a different pharmacy protocol. Maybe I will speak to a pharmacist one of these days about it.

SuesquatchRN, BSN, RN · Oct 20, 2009

It is where I am now.

Not_A_Hat_Person, RN · Oct 20, 2009

Tramadol is a narc at my job. Apparently, it was the pharmacy's decision.

Elvish, BSN, DNP, RN, NP · Oct 20, 2009

Nope, not at my place.

HM2VikingRN, RN · Oct 20, 2009

Tramadol can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor. Call your doctor if you find that you want to take extra medication or if you notice any other unusual changes in your behavior or mood.

I think we count it at my job but this is probably d/t the number of pain med addicted vets.....

SwedishOmorfia · Oct 20, 2009

No. Not in any of the hospital wards I've worked.