Tramadol: does it have a role in cancer pain management?

Eric E. Prommer

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


Tramadol (Ultram, Ortho-McNeil Pharmaceutical, Inc., Raritan, NJ) is considered a Step 2 analgesic under the World Health Organization's guidelines for the treatment of patients with cancer pain. It is a centrally acting analgesic that has affinity for opioid receptors and influences the action of norepinephrine and serotonin at the synapse. This dual mechanism of analgesia makes it unique among Step 2 agents. It is metabolized by CYP2D6, which increases the potentialfor drug interactions. Unlike other opioids, it does not cause respiratory depression. Tramadol has been studied in cancer pain and neuropathic pain. It compares well with low-dose morphine as an analgesic. The purpose of this review is to critically examine the pharmacodynamics, pharmacology, drug interactions, and adverse effects of the drug, and, based on the data presented, discuss the drug's role in cancer care.

Original languageEnglish (US)
Pages (from-to)131-138
Number of pages8
JournalJournal of opioid management
Issue number3
StatePublished - 2005

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Anesthesiology and Pain Medicine


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