| Drug Name |
Tramadol hydrochloride |
| Drug ID |
BADD_D02255 |
| Description |
Tramadol is a centrally acting synthetic opioid analgesic and SNRI (serotonin/norepinephrine reuptake-inhibitor) that is structurally related to [codeine] and [morphine]. Due to its good tolerability profile and multimodal mechanism of action, tramadol is generally considered a lower-risk opioid option for the treatment of moderate to severe pain. It is considered a Step 2 option on the World Health Organization's pain ladder and has about 1/10th of the potency of [morphine].
Tramadol differs from other traditional opioid medications in that it doesn't just act as a μ-opioid agonist, but also affects monoamines by modulating the effects of neurotransmitters involved in the modulation of pain such as serotonin and norepinpehrine which activate descending pain inhibitory pathways.[A182279] Tramadol's effects on serotonin and norepinephrine mimic the effects of other SNRI antidepressants such as [duloxetine] and [venlafaxine].
Tramadol exists as a racemic mixture consisting of two pharmacologically active enantiomers that both contribute to its analgesic property through different mechanisms and are also themselves metabolized into active metabolites: (+)-tramadol and its primary metabolite (+)-O-desmethyl-tramadol (M1) are agonists of the μ opioid receptor while (+)-tramadol inhibits serotonin reuptake and (-)-tramadol inhibits norepinephrine reuptake. These pathways are complementary and synergistic, improving tramadol's ability to modulate the perception of and response to pain.[A4269,A183842]
Tramadol has also been shown to affect a number of other pain modulators within the central nervous system as well as non-neuronal inflammatory markers and immune mediators.[A183728,A183734,A183761,A17159,A182300] Due to the broad spectrum of targets involved in pain and inflammation, it's not surprising that the evidence has shown that tramadol is effective for a number of pain types including neuropathic pain, post-operative pain, lower back pain, as well as pain associated with labour, osteoarthritis, fibromyalgia, and cancer. Due to its SNRI activity, tramadol also has anxiolytic, antidepressant, and anti-shivering effects which are all frequently found as comorbidities with pain.[A182300]
Similar to other opioid medications, tramadol poses a risk for development of tolerance, dependence and abuse. If used in higher doses, or with other opioids, there is a dose-related risk of overdose, respiratory depression, and death.[A183830,F4679] However, unlike other opioid medications, tramadol use also carries a risk of seizure and serotonin syndrome, particularly if used with other serotonergic medications.[A183836,A179926] |
| Indications and Usage |
Tramadol is approved for the management of moderate to severe pain in adults.[L9257,F4679]
Tramadol is also used off-label in the treatment of premature ejaculation.[A173986] |
| Marketing Status |
approved; investigational |
| ATC Code |
N02AX02 |
| DrugBank ID |
DB00193
|
| KEGG ID |
D01355
|
| MeSH ID |
D014147
|
| PubChem ID |
63013
|
| TTD Drug ID |
D05GKD
|
| NDC Product Code |
76420-538; 29967-0002; 70859-010; 76420-950; 76420-951; 68025-072; 68071-2732; 70518-0942; 70518-1254; 70518-3397; 71093-119; 71205-468; 71205-708; 71335-1676; 76420-205; 38779-2781; 47621-002; 62350-0046; 29300-355; 52817-615; 55700-029; 55700-864; 61919-893; 68025-071; 70518-3418; 70518-3598; 71205-066; 71335-1319; 71610-006; 72888-080; 80425-0274; 80425-0276; 83008-009; 58624-0201; 61281-8500; 45865-115; 45865-976; 47335-531; 59651-441; 61919-073; 63187-615; 68071-2648; 70518-2795; 70518-3586; 71205-303; 71205-569; 71335-1675; 71610-398; 63187-063; 63629-8319; 63629-8324; 68025-073; 68134-402; 68180-698; 68180-699; 68788-7601; 71205-389; 71205-656; 71335-0521; 72888-008; 65372-1112; 65862-613; 13811-691; 45865-120; 50090-2215; 57664-377; 63187-597; 67296-1834; 68071-2923; 68071-2952; 68071-4119; 68071-5142; 68071-5204; 70518-0886; 71335-9658; 76420-244; 76420-537; 51927-4763; 76420-094; 13811-690; 35356-790; 47335-537; 50090-5789; 55700-996; 58118-0377; 61919-229; 63629-4899; 68071-5261; 70518-0118; 70518-0258; 70518-3386; 71205-463; 71335-9670; 47335-859; 53002-4322; 60760-772; 61919-597; 63629-8323; 68788-7321; 68788-8121; 69238-2348; 0615-8005; 83008-021; 49452-7875; 51552-1288; 13811-689; 45865-876; 45865-969; 47335-533; 60219-2348; 60760-377; 61919-892; 65162-627; 68084-808; 68382-319; 72189-311; 63275-9908; 16571-716; 0093-0058; 45865-709; 50090-5790; 50090-6033; 55700-016; 68180-697; 68788-7762; 68788-8367; 71511-301; 76420-127; 76420-245; 76420-246; 0395-8091; 0904-7179; 46438-1108; 51927-0123; 65085-0021; 71901-601; 45865-900; 47335-861; 50090-0806; 52817-195; 53002-4320; 60429-588; 65841-754; 68071-2945; 68788-7763; 70934-461; 72189-154; 76420-536; 62991-3079; 33342-201; 47335-860; 51655-152; 52817-196; 55700-997 |
| UNII |
9N7R477WCK
|
| Synonyms |
Tramadol | Tramundin | Biodalgic | Jutadol | K-315 | K 315 | K315 | MTW-Tramadol | MTW Tramadol | MTWTramadol | Nobligan | Prontofort | Zytram | Takadol | Theradol | Tiral | Tramadol Lindo | Topalgic | Tradol | Tradol-Puren | Tradol Puren | TradolPuren | Tradonal | Tralgiol | Trama AbZ | Trama KD | Trama-Dorsch | Trama Dorsch | TramaDorsch | Biokanol | Tramabeta | Tramadin | Tramadol-ratiopharm | Tramadolratiopharm | Tramadol Ratiopharm | Tramadoc | Tramadol PB | Tramadol acis | Tramadol AL | Tramadol Basics | Tramadol Bayvit | Tramadol Bexal | Tramadol 1A | Ranitidin 1A Pharma | Trama 1A Pharma | Tramadol Cinfa | Tramadol Edigen | Tramadol Hydrochloride | Trasedal | Ultram | Tramadol Heumann | Xymel 50 | Zamudol | Zumalgic | Zydol | Tramadol Kern | Tramadol Lichtenstein | Tramadol Mabo | Tramadol Normon | Tramadol Stada | Tramadol-Dolgit | Tramadol Dolgit | TramadolDolgit | Tramadol-Hameln | Tramadol Hameln | TramadolHameln | Tramadolor | Tramadura | Tramagetic | Tramagit | Tramake | Tramal | Tramex | Adolonta | Contramal | Amadol | Tramadol Asta Medica |
