Here we go again, starting the it's dangerous--no it's not wars! Tramadol @50 mg is one baby step up from Tylenol and just about as effective for me. So I double my prescribed 'safe' dose when I'm in severe pain and hope that maybe I'll get a little relief in a couple of hours. Just a bit of info, my dog is allowed 100mg of Tramadol four times a day for pain while I am limited to 50mg twice a day as needed.