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In 2019, it was the 35th most commonly prescribed medication in the United States, with more than 19 million prescriptions. It is available as a generic medication and marketed under many brand names worldwide. In the mid-1990s, it was approved in the United Kingdom and the United States. Tramadol was patented in 1963 and launched under the name "Tramal" in 1977 by the West German pharmaceutical company Grünenthal GmbH. Tramadol is also a serotonin–norepinephrine reuptake inhibitor (SNRI). Tramadol is converted in the liver to O-desmethyltramadol (desmetramadol), an opioid with a stronger affinity to the μ-opioid receptor.
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While not recommended in women who are breastfeeding, those who take a single dose should not generally stop breastfeeding. It is not recommended in those who are at risk of suicide or in those who are pregnant. A change in dosage may be recommended in those with kidney or liver problems. Serious side effects may include seizures, increased risk of serotonin syndrome, decreased alertness, and drug addiction. Īs is typical of opioids, common side effects include constipation, itchiness, and nausea. It may be sold in combination with paracetamol (acetaminophen) or as longer-acting formulations. When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour. Tramadol, sold under the brand name Ultram among others, is an opioid pain medication used to treat moderate to moderately severe pain.