Tramadol - Revision history

MDElliottMD: parser-claude: Tramadol MedTemplate refill, Top 300 stub upgrade

2026-05-23T06:31:24Z

parser-claude: Tramadol MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 06:31, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Tramadol		\| generic = Tramadol
	\| brand = Ultram		\| brand = Ultram (IR), Ultram ER, ConZip ER
	\| structure =		\| structure =
	\| classes = Opioid, Analgesic		\| classes = [[:Category:Opioid analgesics\|Opioid analgesic (atypical, weak μ-agonist with serotonin/norepinephrine reuptake inhibition)]], [[:Category:Schedule IV controlled substances\|Schedule IV controlled substance]], [[:Category:Analgesics\|Analgesic]]
	\| ~~mechanism~~ = Mu-opioid ~~agonist; serotonin–norepinephrine reuptake inhibitor~~		\| uses = <vote slug="moderate-severe-pain-use">Moderate to moderately severe pain (FDA)</vote>, <vote slug="chronic-pain-tramadol-use">Chronic pain in opioid-sparing regimens (off-label)</vote>, <vote slug="restless-legs-syndrome-use">Restless legs syndrome (off-label, second-line)</vote>, <vote slug="neuropathic-pain-broad-use">Neuropathic pain (off-label)</vote>
	\| ~~uses~~ =		\| starting_dose = IR: 25-50 mg PO every 4-6 hours as needed, titrate as tolerated. ER: 100 mg PO once daily, titrate by 100 mg every 5 days
	\| ~~starting_dose~~ =		\| preparations = IR tablets 50 mg; ER tablets 100, 200, 300 mg (Ultram ER, ConZip); oral solution 5 mg/mL; combination products with acetaminophen (Ultracet)
	\| ~~preparations~~ =		\| fda_max = 400 mg/day (IR, adult); 300 mg/day (ER); 300 mg/day in elderly >75 years
	\| ~~fda_max~~ =		\| pill_id =
	\| routes =		\| routes = Oral
	\| onset =		\| onset = 30-60 minutes (IR)
	\| duration =		\| duration = 4-6 hours (IR); 24 hours (ER)
	\| halflife =		\| halflife = Tramadol 6-7 hours; M1 active metabolite 7-9 hours<ref name="ultram-label">FDA Prescribing Information, Ultram (tramadol hydrochloride), Janssen, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020281s048lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~75% (IR, rises with multi-dose administration due to saturable first-pass)<ref name="ultram-label" />
	~~\| pregnancy~~ =		\| pregnancy = Chronic third-trimester exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Schedule IV\|Schedule IV controlled substance]] in US (federally scheduled 2014); some states schedule higher<ref name="ultram-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="tramadol-mech-claim">Weak μ-opioid receptor agonist whose major analgesic activity comes from CYP2D6 conversion to O-desmethyltramadol (M1), a ~6-fold more potent μ-agonist. Tramadol also inhibits serotonin and norepinephrine reuptake (the SNRI-like component), which contributes meaningfully to analgesia and distinguishes the agent from traditional opioids. CYP2D6 ultra-rapid metabolizers produce dangerously high M1 levels with risk of fatal respiratory depression, particularly in children; CYP2D6 poor metabolizers get reduced opioid analgesic benefit and rely on the SNRI component.</vote> '''Serotonin syndrome''' risk with SSRIs, SNRIs, MAOIs, and other serotonergic agents. '''Seizure''' risk is dose-dependent and elevated in patients with epilepsy, head trauma, or concurrent serotonergic medicines. CPIC provides CYP2D6 genotype-guided opioid selection guidance<ref name="cpic-opioid-cyp2d6">CPIC Guideline for CYP2D6, OPRM1, and COMT and Opioid Use, 2021. https://cpicpgx.org/guidelines/cpic-guideline-for-codeine-and-cyp2d6/</ref>.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	\| ~~effects~~ =
	~~\| interactions = <pharmaInteractions~~/>
	\| ~~pregnancy_details =~~
	~~\| monitoring~~ =
	~~\| counseling~~ =
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

			== References ==
			<references />

	[[Category:~~Opioids~~]]		[[Category:Opioid analgesics]]
	[[Category:~~Synthetic opioids~~]]		[[Category:Schedule IV controlled substances]]
	[[Category:Analgesics]]		[[Category:Analgesics]]
	~~[[Category:Mu-Opioid Receptor Agonists]]~~

MDElliottMD: Comprehensive categorization: +Mu-Opioid Receptor Agonists

2026-05-15T18:42:15Z

Comprehensive categorization: +Mu-Opioid Receptor Agonists

← Older revision		Revision as of 18:42, 15 May 2026
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	[[Category:Synthetic opioids]]		[[Category:Synthetic opioids]]
	[[Category:Analgesics]]		[[Category:Analgesics]]
			[[Category:Mu-Opioid Receptor Agonists]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:07:01Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:07, 14 May 2026
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	}}		}}


			[[Category:Opioids]]
			[[Category:Synthetic opioids]]
	[[Category:Analgesics]]		[[Category:Analgesics]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:31:11Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:31, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:52Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:49Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Analgesics]]		[[Category:Analgesics]]

MDElliottMD: Expand stub to full MedTemplate parameter set

2026-05-13T01:00:00Z

Expand stub to full MedTemplate parameter set

@@ Line 1: / Line 1: @@
 {{MedTemplate
-| generic           = Tramadol
+| generic            = Tramadol
-| brand             = Ultram
+| brand              = Ultram
-| classes           = Opioid, Analgesic
+| structure          =
-| mechanism         = Mu-opioid agonist; serotonin–norepinephrine reuptake inhibitor
+| classes            = Opioid, Analgesic
 }}
 [[Category:Analgesics]]

MDElliottMD: Auto-created stub

2026-05-13T00:00:00Z

Auto-created stub

New page

{{MedTemplate
| generic = Tramadol
| brand = Ultram
| classes = Opioid, Analgesic
| mechanism = Mu-opioid agonist; serotonin–norepinephrine reuptake inhibitor
}}
[[Category:Analgesics]]