Tramadol is a novel analgesic with an appealing property of having both opioid and non-opioid modes of action. This property, however, complicates its safe and effective use.
What is tramadol?
Tramadol (Tramal, Zydol) is a centrally acting, synthetic analgesic chemically unrelated to other analgesics. It exists as an equal mixture of two stereoisomers [(+)-tramadol and (-)-tramadol], each with slightly different effects on central nervous system monoamine neurotransmission. Both isomers are metabolised to active metabolites with modest opioid activity. The opioid and non-opioid effects contribute equally to overall analgesia but may vary in individual circumstances.