I just had cause to research this very subject and here's what I found:
http://opioids.com/tramadol/prescribe.htmlFrom that page:
DOSAGE AND ADMINISTRATION
For the treatment of painful conditions Ultram (tramadol hydrochloride) 50 mg to 100 mg can be administered as needed for relief every four to six hours, not to exceed 400 mg per day. For moderate pain Ultram 50 mg may be adequate as the initial dose, and for more severe pain Ultram 100 mg is usually more effective as the initial dose.
Individualization of Dose: Available data do not suggest that a dosage adjustment is necessary in elderly patients 65 to 75 years of age unless they also have renal or hepatic impairment. For elderly patients over 75 years old not more than 300 mg/day in divided doses as above is recommended.
In all patients with creatine clearance less than 30 ml/min, it is recommended that the dosing interval of Ultram be increased to 12 hours with a maximum daily dose of 200 mg. Since only 7% of an administered dose is removed by hemodialysis, dialysis patients can receive their regular dose on the day of dialysis. The recommended dose for patients with cirrhosis is 50 mg every 12 hours. Patients receiving chronic carbamazepine doses up to 800 mg daily require up to twice the recommended dose of Ultram.
Hope that's helpful.