Tramadol: An Alternative Analgesic to Traditional Opioids and NSAIDs

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Abstract
Tramadol is a centrally acting analgesic with two distinct, yet complementary, mechanisms of action. The analgesic activity of tramadol is similar to traditional centrally acting (i.e., opioid) analgesics, but it causes minimal tolerance and abuse potential, which are common to this class of analgesics. Although tramadol is new to the United States, it has been marketed in Germany since 1977. Because it has had such widespread use, a wealth of information has been published on this analgesic. These data, combined with research completed in the United Slates, form the basis of this review. This article presents the pharmacology, pharmacokinetics, clinical efficacy, and safety of tramadol. Additionally, detailed guidelines regarding dosing and administration of tramadol are provided for the practicing clinician.