Tramadol is converted in the liver to O-desmethyltramadol (desmetramadol), an opioid with a stronger affinity for the μ-opioid receptor. While not recommended in women who are breastfeeding, those who take a single dose should not generally have to stop breastfeeding.

It is not recommended in those who are at risk of suicide or in those who are pregnant. A change in dosage may be recommended in those with kidney or liver problems. Serious side effects may include hallucinations, seizures, increased risk of serotonin syndrome, decreased alertness, and drug addiction. It is available in combination with paracetamol (acetaminophen).Īs is typical of opioids, common side effects include constipation, itchiness, and nausea. When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour. Tramadol, sold under the brand name Ultram among others, is an opioid pain medication and a serotonin–norepinephrine reuptake inhibitor (SNRI) used to treat moderately severe pain.

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