Tramadol, brand names; Ultram®, Ultram ER®, Conzip®, Rybix® ODT, Ryzolt®, is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time. This drug is associated with the serious risks of potent narcotics, some of which are potentially fatal. It is contraindicated in patients who have previously demonstrated hypersensitivity to the drug or any other components, or other opioids.

This pain reliever is also contraindicated in any situation where other opioids are contraindicated, including acute with alcohol, hypnotics, narcotics, centrally acting analgesics, opioids or psychotropic drugs, due to the risk of worsening central nervous system (CNS) and respiratory depression.

Source: FDA

In the body, tramadol is converted in the liver to the active form of the opioid, called O-desmethyltramadol. Some people have genetic variations that cause tramadol to be converted to the active form of the opioid faster and more completely than usual. These people, called ultra-rapid metabolizers, are more likely to have higher-than-normal amounts of the active form of the opioid in their blood after taking this drug, which can result in breathing difficulty that may lead to death. Recently, a 5-year-old child in France experienced severely slowed and difficult breathing requiring emergency intervention and hospitalization after taking a single prescribed dose of tramadol oral solution for pain relief following surgery to remove his tonsils and adenoids. The child was later found to be an ultra-rapid metabolizer and had high levels of O-desmethyltramadol in his body.

Other Sources

Drug Identification Guide

CDC Facts

CDC Addiction Info

CDC Substance Treatment

Samhsa Workplace Programs


Federal Register Codification

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