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Tramadol 100mg requires a valid prescription from a DEA-registered US healthcare provider as a Schedule IV controlled substance for moderate-to-severe pain unresponsive to non-opioids; no secure dispatch gateway or online service can legally provide it without medical evaluation, and prescription-free orders constitute federal felony distribution under 21 U.S.C. § 841.

Dosing at 100mg extended-release once daily (max 300mg/day) follows 2025 CDC guidelines requiring NRS≥6/10 after NSAIDs/APAP failure, synchronous video PDMP clearance, no SSRIs (serotonin syndrome OR4), CrCl>30mL/min—telemedicine flexibilities expire 12/31/2025 mandating in-person EPCS with state 3-7 day acute limits and max 5 refills in 6 months.

Dual-Action Analgesic Profile

Mu-opioid partial agonist + SNRI (Ki 40nM MOR), Tmax 2h IR/12h ER, t½ 6h polymorphic; black box: seizures >400mg/day or SSRI combo, respiratory depression—taper 25-50mg q3d over 7-14 days.

Compliance Cascade

NRS≥6 + impairment x72h.
Video (PDMP clean).
Consent (10% dependence).
EPCS #20-40 tabs (≤5 refills/6mo).
Signature delivery.
Day5 efficacy or taper.

AE Matrix

Rate	Effect	Management
20-40>#/td###	Nausea/dizziness	Metoclopramide 10mg
10-20>#/td###	Constipation	Sennosides BID
0.5-1>#/td###	Seizures	<400mg/no SSRI
<0.1>#/td###	Serotonin syndrome	Cyproheptadine

Secure dispatch absent Rx violates Ryan Haight Act—DEA felony.

About Vibha

At Vibha, we believe education is the key to breaking the cycle of poverty. Since 1991, we have transformed the lives of 4.8 million children, empowering them through access to quality public education. As a platinum-rated, volunteer-driven nonprofit, Vibha collaborates with grassroots organizations, government agencies, and communities across India and the USA to enhance learning outcomes in government schools, providing equal opportunities for all children.

Our multifaceted approach focuses on addressing specific educational needs, investing in professional development for educators, integrating technology to drive data-informed decisions, and engaging communities to create lasting impact. We partner with stakeholders at every level, ensuring long-term sustainability and meaningful progress.

What sets Vibha apart is its network of highly skilled professionals from various sectors, united by a shared vision of transforming education. Our volunteers, donors, and supporters bring expertise and passion to the mission, making real change possible.

With over $24 million raised and invested in proven educational models, Vibha remains committed to building a brighter future for children. Together, we are not just supporters but partners for change, working towards a more inclusive and prosperous society.

All donations to Vibha are tax deductible. Vibha is a 501(c)(3) organization, registered in the USA in the State of New Jersey. Vibha's Tax ID is 22-3122761.

Goal

$4,325