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Tramadol is used primarily to treat mild to severe pain, both acute and chronic.[17][18] There is fair evidence for use as a second-line treatment for fibromyalgia but is not FDA approved for this use


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Tramadol, sold under the brand name Ultram among others,[1] is an opioid pain medication used to treat moderate to moderately severe pain.[3] When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour.[3] It is also available by injection.[9] It may be sold in combination with paracetamol (acetaminophen) or as longer-acting formulations.[3][9]

As is typical of opioids, common side effects include constipationitchiness, and nausea.[3] Serious side effects may include seizures, increased risk of serotonin syndrome, decreased alertness, and drug addiction.[3] A change in dosage may be recommended in those with kidney or liver problems.[3] It is not recommended in those who are at risk of suicide or in those who are pregnant.[3][9] While not recommended in women who are breastfeeding, those who take a single dose should not generally stop breastfeeding.[10] Tramadol is converted in the liver to O-desmethyltramadol, an opioid with stronger binding to the μ-opioid receptor.[3][11] Tramadol is also a serotonin–norepinephrine reuptake inhibitor (SNRI).[3][12]

Tramadol was patented in 1963 and launched under the name “Tramal” in 1977 by the West German pharmaceutical company Grünenthal GmbH.[12][13] In the mid-1990s, it was approved in the United Kingdom and the United States.[12] It is available as a generic medication and marketed under many brand names worldwide.[3][1] In the United States, the wholesale cost is less than US$0.05 per dose as of 2018.[14] In 2017, it was the 32nd most commonly prescribed medication in the United States, with more than 21 million prescriptions.[15][16]


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