Episode 990: Tramadol, or rather, Trama-don't
Published: January 12, 2026
Duration: 5:15
Contributor: Taylor Lynch, MD
Educational Pearls:
What is tramadol and how does it work?
Tramadol is a Schedule IV opioid analgesic used for moderate pain and is often perceived as safer than other opioids due to lower abuse potential.
It is a prodrug with weak direct μ-opioid receptor activity.
The parent compound also inhibits serotonin and norepinephrine reuptake, giving it SSRI/SNRI-like properties.
Tramadol is metabolized by CYP2D6 into O-desmethyltramadol (ODT), which has significantly stronger μ-opioid receptor agonism than the parent drug.