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Patients who have been taking an opioid for a short period of time for acute pain, e.g. one to two weeks, can usually stop it abruptly without the need for tapering the dose. However, a slower withdrawal may be considered for patients who have been taking frequent, higher doses.11 There is no specific guidance for a structured tapering regimen for short-term use of tramadol, but a pragmatic approach would be to reduce the dose by 25–50% each day. Ensure that when tramadol is withdrawn (either abruptly or tapered), analgesic cover is provided by concurrent use of paracetamol or a NSAID, until the pain is manageable without pharmacological treatment.