{"ATC Code":"N02AX02","Abbreviation":"","Aliases":["27203-92-5","Ralivia flashtab","Ralivia ER","Tramadon","Racemic tramadol","Biomadol","Contramid","Labesfal","Tradolan","Tramadis"],"Biological Half-Life":"Tramadol reported a half-life of 5-6 hours while the M1 metabolite presents a half-life of 8 hours.","CAS":"123154-38-1","ChEBI":"CHEBI:9648","ChEMBL":"CHEMBL201531","ChemicalClasses":[],"Chirality":"racemic","Classes":["Opioid"],"Decomposition":"When heated to decomposition it emits very toxic fumes of /nitrogen oxides/.","Drug Classes":"Breast Feeding; Lactation; Milk, Human; Analgesics, Opioid; Narcotics","Drug Indication":"Tramadol is approved for the management of moderate to severe pain in adults.  Tramadol is also used off-label in the treatment of premature ejaculation.","Drug Warnings":"The U.S. Food and Drug Administration (FDA) is warning about several safety issues with the entire class of opioid pain medicines. These safety risks are potentially harmful interactions with numerous other medications, problems with the adrenal glands, and decreased sex hormone levels. We are requiring changes to the labels of all opioid drugs to warn about these risks. Opioids can interact with antidepressants and migraine medicines to cause a serious central nervous system reaction called serotonin syndrome, in which high levels of the chemical serotonin build up in the brain and cause toxicity. Taking opioids may lead to a rare, but serious condition in which the adrenal glands do not produce adequate amounts of the hormone cortisol. Cortisol helps the body respond to stress. Long-term use of opioids may be associated with decreased sex hormone levels and symptoms such as reduced interest in sex, impotence, or infertility.","DrugClasses":["opioid","antidepressant","hormone","depressant"],"DurationOfAction":"6 hours\u003ca href='#cite_note-5'\u003e\u003csup\u003e[5]\u003c/sup\u003e\u003c/a\u003e","EINECS":"248-319-6","EliminationHalfLife":"6.3 ± 1.4\u0026nbsp;h\u003ca href='#cite_note-4'\u003e\u003csup\u003e[4]\u003c/sup\u003e\u003c/a\u003e","Erowid Experience Reports":[{"Author":"MrMcX","Id":"100555","Title":"More Prozacspeed Than Hydrocodone"},{"Author":"Butterfly","Id":"102416","Title":"Euphoria and Irritability"},{"Author":"Jhimmi_the_non-dhimi","Id":"103482","Title":"This Is How Life Is Supposed to Feel"},{"Author":"Jason S","Id":"103650","Title":"Two Years What a Time It Has Been"},{"Author":"Not_Gonzo","Id":"103667","Title":"My Dance With Insanity"},{"Author":"slicktrippy","Id":"104967","Title":"Effective Not Fun"},{"Author":"Huntress","Id":"106372","Title":"An Old Familiar Lover"},{"Author":"Kidekone","Id":"106502","Title":"Withdrawal Nightmare"},{"Author":"Ragnar","Id":"106778","Title":"Overdose Spasms It All Snapped"},{"Author":"actoplasma","Id":"10766","Title":"Ya Are Me Perfect Drug"},{"Author":"TheMind","Id":"108522","Title":"My Mind Was Clearly Dulled"},{"Author":"Pstranger","Id":"108771","Title":"Good Pain Reliever but Not Worth Side Effects"},{"Author":"InConSciOUS","Id":"108824","Title":"Self-Inflicted Seizures"},{"Author":"FxShire","Id":"109888","Title":"Slow and Steady Warm and Fuzzy"},{"Author":"Scotty","Id":"110872","Title":"Comfort Until the Auditory Hallucinations"},{"Author":"Bernard","Id":"111244","Title":"Better Than Life"},{"Author":"Anonymous_","Id":"111295","Title":"All Good Effects Except Some Nausea"},{"Author":"Nyan","Id":"111366","Title":"Gallbladder Godsend"},{"Author":"Holmes","Id":"111520","Title":"A Sweaty Mess and Lagging"},{"Author":"lightweight","Id":"111506","Title":"Like a Warm Bath"},{"Author":"Anon","Id":"111957","Title":"Good, but Left Me Sick the Whole Next Day"},{"Author":"TD","Id":"112280","Title":"One of the Best Drugs for Me"},{"Author":"Basicdog42","Id":"113030","Title":"Unexpectedly Uncomfortable"},{"Author":"Silverbowl","Id":"112912","Title":"Time to Stop"},{"Author":"El Chico De Miami","Id":"114665","Title":"My Wonderful Dates With Mrs. White"},{"Author":"Uncle Tom","Id":"114904","Title":"Somewhat Interesting, but Not a Huge Deal"}],"European Community (EC) Number":"248-319-6","FDA Pharmacological Classification":"39J1LGJ30J","FullSalts":["Tramadol hydrochloride"],"HMDB ID":"HMDB0014339","HeavyAtomCount":19,"Human Drugs":"Breast Feeding; Lactation; Milk, Human; Analgesics, Opioid; Narcotics","IUPACName":"(1R,2R)-2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexan-1-ol","InChI":"InChI=1S/C16H25NO2/c1-17(2)12-14-7-4-5-10-16(14,18)13-8-6-9-15(11-13)19-3/h6,8-9,11,14,18H,4-5,7,10,12H2,1-3H3/t14-,16+/m1/s1","InChIKey":"TVYLLZQTGLZFBW-ZBFHGGJFSA-N","MeSH Pharmacological Classification":"Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS. (See all compounds classified as Narcotics.)","Melting Point":"178-181 °C","MolecularFormula":"C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e25\u003c/sub\u003eNO\u003csub\u003e2\u003c/sub\u003e","MolecularWeight":"263.37 g/mol","Opticalactivity":"( + / - )","Pharmacodynamics":"Tramadol modulates the descending pain pathways within the central nervous system through the binding of parent and M1 metabolite to μ-opioid receptors and the weak inhibition of the reuptake of norepinephrine and serotonin.   Apart from analgesia, tramadol may produce a constellation of symptoms (including dizziness, somnolence, nausea, constipation, sweating and pruritus) similar to that of other opioids.   **Central Nervous System**  In contrast to [morphine], tramadol has not been shown to cause histamine release. At therapeutic doses, tramadol has no effect on heart rate, left-ventricular function or cardiac index. Orthostatic hypotension has been observed.  Tramadol produces respiratory depression by direct action on brain stem respiratory centres. The respiratory depression involves both a reduction in the responsiveness of the brain stem centres to increases in CO2 tension and to electrical stimulation.   Tramadol depresses the cough reflex by a direct effect on the cough centre in the medulla. Antitussive effects may occur with doses lower than those usually required for analgesia.  Tramadol causes miosis, even in total darkness. Pinpoint pupils are a sign of opioid overdose but are not pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origin may produce similar findings). Marked mydriasis rather than miosis may be seen with hypoxia in the setting of oxycodone overdose.  Seizures have been reported in patients receiving tramadol within the recommended dosage range. Spontaneous post-marketing reports indicate that seizure risk is increased with doses of tramadol above the recommended range. Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections), or with concomitant use of other drugs known to reduce the seizure threshold.  Tramadol can cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs (e.g., anti-depressants, migraine medications). Treatment with the serotoninergic drug should be discontinued if such events (characterized by clusters of symptoms such as hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, mental status changes including confusion, irritability, extreme agitation progressing to delirium and coma) occur and supportive symptomatic treatment should be initiated. Tramadol should not be used in combination with MAO inhibitors or serotonin-precursors (such as L-tryptophan, oxitriptan) and should be used with caution in combination with other serotonergic drugs (triptans, certain tricyclic antidepressants, lithium, St. John’s Wort) due to the risk of serotonin syndrome.  **Gastrointestinal Tract and Other Smooth Muscle**  Tramadol causes a reduction in motility associated with an increase in smooth muscle tone in the antrum of the stomach and duodenum. Digestion of food in the small intestine is delayed and propulsive contractions are decreased. Propulsive peristaltic waves in the colon are decreased, while tone may be increased to the point of spasm resulting in constipation. Other opioid-induced effects may include a reduction in gastric, biliary and pancreatic secretions, spasm of the sphincter of Oddi, and transient elevations in serum amylase.  **Endocrine System**  Opioids may influence the hypothalamic-pituitary-adrenal or -gonadal axes. Some changes that can be seen include an increase in serum prolactin and decreases in plasma cortisol and testosterone. Clinical signs and symptoms may be manifest from these hormonal changes.  Hyponatremia has been reported very rarely with the use of tramadol, usually in patients with predisposing risk factors, such as elderly patients and/or patients using concomitant medications that may cause hyponatremia (e.g., antidepressants, benzodiazepines, diuretics). In some reports, hyponatremia appeared to be the result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and resolved with discontinuation of tramadol and appropriate treatment (e.g., fluid restriction). During tramadol treatment, monitoring for signs and symptoms of hyponatremia is recommended for patients with predisposing risk factors.  **Cardiovascular**  Tramadol administration may result in severe hypotension in patients whose ability to maintain adequate blood pressure is compromised by reduced blood volume, or concurrent administration of drugs such as phenothiazines and other tranquillizers, sedative/hypnotics, tricyclic antidepressants or general anesthetics. These patients should be monitored for signs of hypotension after initiating or titrating the dose of tramadol.  **QTc-Interval Prolongation**  The maximum placebo-adjusted mean change from baseline in the QTcF interval was 5.5 ms in the 400 mg/day treatment arm and 6.5 ms in the 600 mg/day mg treatment arm, both occurring at the 8h time point. Both treatment groups were within the 10 ms threshold for QT prolongation. Post-marketing experience with the use of tramadol containing products included rare reports of QT prolongation reported with an overdose. Particular care should be exercised when administering tramadol to patients who are suspected to be at an increased risk of experiencing torsade de pointes during treatment with a QTc-prolonging drug.  **Abuse and Misuse**  Like all opioids, tramadol has the potential for abuse and misuse, which can lead to overdose and death. Therefore, tramadol should be prescribed and handled with caution.  **Dependence/Tolerance**  Physical dependence and tolerance reflect the neuroadaptation of the opioid receptors to chronic exposure to an opioid and are separate and distinct from abuse and addiction. Tolerance, as well as physical dependence, may develop upon repeated administration of opioids, and are not by themselves evidence of an addictive disorder or abuse. Patients on prolonged therapy should be tapered gradually from the drug if it is no longer required for pain control. Withdrawal symptoms may occur following abrupt discontinuation of therapy or upon administration of an opioid antagonist. Some of the symptoms that may be associated with abrupt withdrawal of an opioid analgesic include body aches, diarrhea, gooseflesh, loss of appetite, nausea, nervousness or restlessness, anxiety, runny nose, sneezing, tremors or shivering, stomach cramps, tachycardia, trouble with sleeping, unusual increase in sweating, palpitations, unexplained fever, weakness and yawning.","Physical Description":"Solid","PrevSalts":["hydrochloride"],"PubChemId":33741,"Record Description":["(R,R)-tramadol is a 2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexanol in which both stereocentres have R-configuration; the (R,R)-enantiomer of the racemic opioid analgesic tramadol, it exhibits ten-fold higher analgesic potency than the (S,S)-enantiomer. It has a role as a delta-opioid receptor agonist, a kappa-opioid receptor agonist, a mu-opioid receptor agonist, an adrenergic uptake inhibitor, an antitussive, a capsaicin receptor antagonist, a muscarinic antagonist, a nicotinic antagonist, a NMDA receptor antagonist, an opioid analgesic, a serotonergic antagonist, a serotonin uptake inhibitor and a metabolite. It is a conjugate base of a (R,R)-tramadol(1+). It is an enantiomer of a (S,S)-tramadol.","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. 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.   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. 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.  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. However, unlike other opioid medications, tramadol use also carries a risk of seizure and serotonin syndrome, particularly if used with other serotonergic medications.","Tramadol is an Opioid Agonist. The mechanism of action of tramadol is as a Full Opioid Agonist.","Tramadol is an opioid analgesic used for the therapy of mild-to-moderate pain. Tramadol overdose can cause acute liver failure. Pharmacologic doses of tramadol has not been associated with cases of clinically apparent drug induced liver disease.","Tramadol is a synthetic codeine analogue, Tramadol has central analgesic properties with effects similar to opioids, such as morphine and codeine, acting on specific opioid receptors. Used as a narcotic analgesic for severe pain, it can be addictive and weakly inhibits norepinephrine and serotonin reuptake. (NCI04)","A narcotic analgesic proposed for moderate to severe pain. It may be habituating. Tramadol is also prepared as a variable release capsules, marketed under the brand name ConZip. For example, a 150 mg capsule will contain 37.5 mg of the immediate release form and 112.5 mg of the extended release form. Tramadol is only found in individuals that have used or taken this drug. It is a narcotic analgesic proposed for moderate to severe pain. It may be habituating. Tramadol and its O-desmethyl metabolite (M1) are selective, weak OP3-receptor agonists. Opiate receptors are coupled with G-protein receptors and function as both positive and negative regulators of synaptic transmission via G-proteins that activate effector proteins. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine and noradrenaline is inhibited. The analgesic properties of Tramadol can be attributed to norepinephrine and serotonin reuptake blockade in the CNS, which inhibits pain transmission in the spinal cord. The (+) enantiomer has higher affinity for the OP3 receptor and preferentially inhibits serotonin uptake and enhances serotonin release. The (-) enantiomer preferentially inhibits norepinephrine reuptake by stimulating alpha(2)-adrenergic receptors.","A narcotic analgesic proposed for severe pain. It may be habituating.","See also: Tramadol Hydrochloride (has salt form); Celecoxib tramadol hydrochloride CO-crystal (is active moiety of).","(R,R)-tramadol is a 2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexanol in which both stereocentres have R-configuration; the (R,R)-enantiomer of the racemic opioid analgesic tramadol, it exhibits ten-fold higher analgesic potency than the (S,S)-enantiomer. It has a role as a delta-opioid receptor agonist, a kappa-opioid receptor agonist, a mu-opioid receptor agonist, an adrenergic uptake inhibitor, an antitussive, a capsaicin receptor antagonist, a muscarinic antagonist, a nicotinic antagonist, a NMDA receptor antagonist, an opioid analgesic, a serotonergic antagonist, a serotonin uptake inhibitor and a metabolite. It is a conjugate base of a (R,R)-tramadol(1+). It is an enantiomer of a (S,S)-tramadol.","LiverTox|Analgesic|Moderate pain|Opiate"],"RefCount":6,"RefCur":"","References":[{"Name":"Wikipedia","Urls":[{"Link":"https://en.wikipedia.org/wiki/Tramadol","Name":"Tramadol","Sub":false}]},{"Name":"Wikidata","Urls":[{"Link":"https://www.wikidata.org/wiki/Q407592","Name":"Tramadol","Sub":false}]},{"Name":"DrugBank","Urls":[{"Link":"https://go.drugbank.com/drugs/DB00193","Name":"Tramadol","Sub":false}]},{"Name":"PubChem","Urls":[{"Link":"https://pubchem.ncbi.nlm.nih.gov/compound/33741","Name":"Tramadol","Sub":false}]},{"Name":"ChEMBL","Urls":[{"Link":"https://www.ebi.ac.uk/chembl/explore/compound/CHEMBL201531","Name":"Tramadol","Sub":false}]},{"Name":"ChEBI","Urls":[{"Link":"https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:9648","Name":"Tramadol","Sub":false}]},{"Name":"Common Chemistry","Urls":[{"Link":"https://commonchemistry.cas.org/detail?cas_rn=123154-38-1","Name":"Tramadol","Sub":false}]},{"Name":"HMDB","Urls":[{"Link":"https://hmdb.ca/metabolites/HMDB0014339","Name":"Tramadol","Sub":false}]},{"Name":"KEGG","Urls":[{"Link":"https://www.kegg.jp/entry/C07153","Name":"Tramadol","Sub":false}]},{"Name":"UNII","Urls":[{"Link":"https://gsrs.ncats.nih.gov/ginas/app/ui/substances/39J1LGJ30J","Name":"Tramadol","Sub":false}]},{"Name":"EPA DSSTox","Urls":[{"Link":"https://comptox.epa.gov/dashboard/chemical/details/DTXSID90858931","Name":"Tramadol","Sub":false}]}],"Refs":["National Center for Biotechnology Information. PubChem Compound Summary for CID 33741, Tramadol. Accessed June 28, 2025. \u003ca href=https://pubchem.ncbi.nlm.nih.gov/compound/33741\u003ehttps://pubchem.ncbi.nlm.nih.gov/compound/33741\u003c/a\u003e","U.S. Food and Drug Administration; National Center for Advancing Translational Sciences. Tramadol. UNII: 39J1LGJ30J. Global Substance Registration System. Accessed June 28, 2025. \u003ca href=https://gsrs.ncats.nih.gov/ginas/app/beta/substances/39J1LGJ30J\u003ehttps://gsrs.ncats.nih.gov/ginas/app/beta/substances/39J1LGJ30J\u003c/a\u003e","Tramadol Lupin tramadol hydrochloride 50 mg capsule blister pack (441970). August 3, 2024. Accessed June 28, 2025. \u003ca href=https://www.tga.gov.au/resources/artg/441970\u003ehttps://www.tga.gov.au/resources/artg/441970\u003c/a\u003e","Ultram, Ultram ER (tramadol) dosing, indications, interactions, adverse effects, and more. WebMD. Accessed June 28, 2025. \u003ca href=https://reference.medscape.com/drug/ultram-conzip-tramadol-343324#showall\u003ehttps://reference.medscape.com/drug/ultram-conzip-tramadol-343324#showall\u003c/a\u003e","Dayer P, Desmeules J, Collart L. [Pharmacology of tramadol]. Drugs. 1997; 53(Suppl 2):18–24."],"Reported Fatal Dose":"... Reported is a suicidal case of lethal tramadol poisoning in a 48-year-old woman. ... The tramadol concentration in femoral blood was 61.83 ug/mL which is approximately 30 times higher than that believed to be lethal ...","SMILES":"CN(C)C[C@H]1CCCC[C@@]1(C2=CC(=CC=C2)OC)O","Salts":["hydrochloride"],"SaltsAcidCount":[1],"SaltsAmineCount":[1],"SaltsUNII":["9N7R477WCK"],"Scheduling":[{"gov":"Australia","ref":["3"],"schedule":"S4 substance"},{"gov":"Brazil","ref":[],"schedule":"A2 substance"},{"gov":"Canada","ref":[],"schedule":"Schedule I substance"},{"gov":"New Zealand","ref":[],"schedule":"Class C substance"},{"gov":"United Kingdom","ref":[],"schedule":"prescription only substance"},{"act":"Controlled Substances Act (CSA)","gov":"United States","ref":[],"schedule":"Schedule I"},{"gov":"European Union","ref":[],"schedule":"prescription only substance"},{"gov":"United Nations","ref":[],"schedule":"Unscheduled substance"}],"Solubility":"\u003e39.5 [ug/mL] (The mean of the results at pH 7.4)","Stability/Shelf Life":"Stable under recommended storage conditions. /Tramadol hydrochloride/","StereoisomerRacemic":"(RS)-Tramadol","Stereoisomers":["(+)-Tramadol"],"StereoisomersUNII":[""],"StoreUNII":["39J1LGJ30J"],"StructureBase64":"<svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" height="64.166mm" version="1.2" viewBox="0 0 83.916 64.166" width="83.916mm">
      
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