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Tramadol is an opioid agonist that may be used to treat moderate to moderately severe chronic pain in adults.

Extended-release forms of tramadol may be used in adults who require around-the-clock treatment of their pain for an extended period.
Brands of tramadol include ConZip, Qdolo, Ultram, and Ultram ER. Generic tramadol is available.

Taking tramadol in combination with other pain-relieving medicines such as acetaminophen, ibuprofen, or aspirin can provide better pain relief than just taking one pain-relieving medicine by itself (see Can you take tramadol in combination with acetaminophen, ibuprofen, or aspirin?)

Tramadol first gained FDA approval on March 3, 1995. Originally it was classified as a non-controlled substance but it was reclassified in 2014 to Schedule IV of the Controlled Substances Act with restrictions on its prescribing. Tramadol is an opioid (see Is tramadol an opioid?). 

A person's genetics can affect the pain-relieving properties of tramadol (see How do genetics affect tramadol?).

Tramadol uses
Tramadol is used for the management of moderate to moderately severe pain in adults, including postoperative pain (pain after surgery).

Tramadol treats pain severe enough to require opioids and may be used as an alternative to other forms of pain relief that did not relieve pain well enough or were not tolerated. 

Tramadol extended-release capsules may be used by adults who require around-the-clock treatment of their moderate to moderately severe chronic pain for an extended time.

Tramadol should not be used in children younger than 12 years old, or anyone younger than 18 years old with other risk factors (such as breathing problems), or who have recently had surgery to remove their tonsils or adenoids.

Extended-release tramadol (Ultram ER) should not be given to anyone younger than 18 years.
Is Tramadol an opioid?
Yes, tramadol is an opioid. The opioid activity of tramadol is due to its binding to mu-opioid receptors.

Tramadol side effects
Common side effects
The most common side effects of tramadol are:

nausea
constipation
dry mouth
drowsiness
dizziness
vomiting.
A person's genetics can affect their response to tramadol, including their risk of side effects (see How do genetics affect tramadol?).

Serious tramadol side effects and warnings
Tramadol may cause serious side effects, some of which may be fatal.

Tramadol can slow or stop your breathing and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep this medicine where others cannot get to it. Do not take more tramadol than prescribed as an overdosage can be fatal. Selling or giving away this medicine is against the law.

A person caring for you should give naloxone and seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you find it hard to wake up. Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.
Call your doctor at once if you have:
noisy breathing, sighing, shallow breathing, breathing that stops during sleep
a slow heart rate or weak pulse
a light-headed feeling, like you might pass out
seizure (convulsions) or
low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Seizures have been reported in patients taking tramadol. Your risk of seizures is higher if you are taking higher doses than recommended. Seizure risk is also higher in those with a seizure disorder or those taking certain antidepressants or opioid medications.

You should not take tramadol if you have severe breathing problems, a head injury or increased pressure inside your skull, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others). Tramadol should not be used if you are suicidal or prone to addiction.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing. People taking extended-release forms of tramadol should not consume alcohol-containing beverages at the same time. Alcohol is also not advised with immediate-release forms of tramadol.

Serious allergic reactions, including anaphylaxis, have occurred with tramadol, some of which caused death. People who are allergic to other opioids are at higher risk. Other hypersensitivity reactions include itching, hives, narrowing of the airways, swelling of the face and airways (angioedema), and serious skin reactions such as Stevens-Johnson Syndrome. Get emergency medical help if you have signs of an allergic reaction to tramadol (symptoms include hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, a red or purple skin rash that spreads and causes blistering and peeling).

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Soma is a muscle relaxer that blocks pain sensations between the nerves and the brain.

Soma is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Soma should only be used for short periods (up to two or three weeks) because there is no evidence of its effectiveness in long term use and most skeletal muscle injuries are generally of short duration.

 

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Tramadol is used to relieve moderate to moderately severe pain, including pain after surgery. It is also used to treat pain severe enough to require opioid treatment and when other pain medicines did not work well enough or cannot be tolerated. The extended-release capsules or tablets are used for chronic ongoing pain.

 

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