Skip to main content

Is tramadol an opioid?

Medically reviewed by Carmen Pope, BPharm. Last updated on Oct 8, 2024.

Official answer

by Drugs.com

Yes, tramadol is an opioid pain-relieving medicine but it also has non-opioid effects. It differs from other opioids in that it is a prodrug and requires metabolism in the body before it is active.

Tramadol itself has very little activity at the mu opioid receptor (MOR) but its M1 metabolite (O-desmethyl-tramadol) has an affinity only 10 times less than morphine. Binding to the mu-opioid receptor triggers events inside the cell that reduce the transmission of pain signals, which blunts the emotional response to pain, providing pain relief.

The non-opioid effects of tramadol are due to its ability to block the reuptake of monoamines, such as norepinephrine (NE) and serotonin (5HT). Increases in NE are known to mediate the body's natural pain-relief systems. Some of its pain-relieving effects are due to increased levels of NE that act on other receptors, such as alpha2 adrenergic receptors, associated with various other processes within the body, and are completely independent of its effects on opioid receptors.

References
  • Edinoff, A. N., Kaplan, L. A., Khan, S., Petersen, M., Sauce, E., Causey, C. D., Cornett, E. M., Imani, F., Moradi Moghadam, O., Kaye, A. M., & Kaye, A. D. (2021). Full Opioid Agonists and Tramadol: Pharmacological and Clinical Considerations. Anesthesiology and pain medicine, 11(4), e119156. https://doi.org/10.5812%2Faapm.119156
  • Terman G. Is Tramadol an Opioid or a Nonopioid Analgesic? Yes! Washington Medical Commission. https://wmc.wa.gov/sites/default/files/public/Newsletter/IsTramadolanOpioid.pdf

Read next

Can you take tramadol with acetaminophen, ibuprofen, or aspirin?

Yes, it is safe for most people to take tramadol with acetaminophen, ibuprofen, or aspirin if they are old enough (aspirin is not recommended for children less than 16 years and tramadol should not be taken by children under the age of 12). Continue reading

How much tramadol should I give my dog?

How much tramadol you give your dog depends on the size of your dog. Smaller dogs do not need as much tramadol as larger dogs need to relieve pain. If you give too much tramadol your dog is likely to have more severe side effects. The tramadol dosage for dogs is usually between 0.45 to 1.8 mg per pound of body weight (1mg to 5 mg/kg). The frequency varies depending on what you are giving it for. For general pain, it is given every 8 to 12 hours, but for cancer-related pain, it can be administered every 6 hours. Continue reading

How long does tramadol withdrawal last?

Symptoms of tramadol withdrawal can start 8-24 hours after the last dose. Untreated, withdrawal symptoms usually last for 4-10 days. Withdrawal is caused by stopping the drug suddenly. Continue reading

Related medical questions

Drug information

Related support groups