Tramadol, a synthetic, centrally acting analgesic agent used to treat acute and chronic moderate pain, may be useful for the treatment of allodynia.1
Tramadol-mediated analgesia is improved when administered in conjunction with NSAIDs, especially in patients with chronic pain conditions.1,2 Because tramadol is a weak opioid and has a nonopioid mechanism of action, it may be less likely than morphine to induce tolerance.1
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Tramadol can be administered orally or parenterally, but only the oral form is available in the United States. Tramadol is not currently controlled by Drug Enforcement Agency regulations in all regions of the country, but some states are instituting regulatory control. In February 2013, New York recognized tramadol as a Schedule IV drug.
Mechanism of Action & Pharmacokinetics
Tramadol has two synergistic mechanisms of action.1 It acts as a weak mu-receptor agonist and an inhibitor of norepinephrine and serotonin reuptake in the CNS.1 The chemical structure of tramadol is related to those of morphine and codeine. The action on the mu-receptor agonist can be reversed with the opioid antagonist naloxone, which partially reverses the analgesic effect.1