Talk:Tramadol

This is the talk page for discussing improvements to the Tramadol article.
This is not a forum for general discussion of the article's subject.

Put new text under old text. Click here to start a new topic.
New to Wikipedia? Welcome! Learn to edit; get help.

Article policies

Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL

Archives: 1, 2: 31 days

Pharmacology High‑importance

	This article is within the scope of WikiProject Pharmacology, a collaborative effort to improve the coverage of Pharmacology on Wikipedia. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.PharmacologyWikipedia:WikiProject PharmacologyTemplate:WikiProject Pharmacologypharmacology
High	This article has been rated as High-importance on the project's importance scale.

Medicine Mid‑importance

	Medicine portal This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Wikipedia talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine
Mid	This article has been rated as Mid-importance on the project's importance scale.

Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Tramadol.

PubMed provides review articles from the past five years (limit to free review articles)
The TRIP database provides clinical publications about evidence-based medicine.
Other potential sources include: Centre for Reviews and Dissemination and CDC

Archives

1, 2

This page has archives. Sections older than 31 days may be automatically archived by when more than 4 sections are present.

Mix with Benzos

Why is there no warning about mixing a narcotic with Benzodiazepines?? Or did I miss it?? Lady Meg (talk) 05:26, 27 July 2023 (UTC)[reply]

WADA ban

Tramadol will be banned for all international sport by WADA effective January 1, 2024. I don't have time to find the citation for this but should be easy to verify. 207.180.169.36 (talk) 14:25, 16 October 2023 (UTC)[reply]

Mechanism of action

Tramadol is a SYNTHETIC opioid analgesic Kenntex (talk) 02:04, 9 November 2023 (UTC)[reply]

"Dependence liability": moderate or low?

There have been some edits changing the classification of the "dependence liability" in the drug infobox. I reverted the first, unexplained, edit after cursorily checking the quoted literature, Dunn et al. 2019, and not directly seeing something to back up the change. Now the classification has been changed again. Can someone please point me to the proper section and quote in this paper that the classification should be based on? What I found was: "This review summarized 13 human laboratory studies that empirically examined the abuse potential of tramadol. [...] Overall, the reviewed data provide evidence that tramadol has a risk for abuse, but that its risk is generally lower than most of the opioids to which it was compared." https://pmc.ncbi.nlm.nih.gov/articles/PMC6775208/ Lower is not necessarily low. I suggest that the classification should not be based on this reference at all. Biologos (talk) 14:09, 12 November 2024 (UTC)[reply]

Since the dependence liability is poorly sourced, i.e. with a review of studies investigating the abuse potential in laboratory settings, which does not explicitly mention a classification at all, I will remove this section from the drug box for now and invite everyone to find a good reference to re-add it. Biologos (talk) 13:01, 17 November 2024 (UTC)[reply]

A systematic review is the highest tier in the evidence hierarchy. The source has some limitations but the studies it included in its review seem typical for the investigation of abuse potential: they were within-subject, double-blind, placebo-controlled designs, comparing tramadol to other opioids using the PRISMA guidelines. So it is hardly fair to see it is poorly sourced. The text doesn't have to be found verbatim - even if it was, you would need to ask if it meant the same thing as it means on Wikipedia.

However, I think epidemiological and comprehensive post-marketing surveillance studies would certainly allow us to make a more robust claim. They show us that patients are no more likely to abuse Tramadol than non steroidal anti inflammatory drugs (NSAIDs)[1] and that there is extensive post-marketing and epidemiological data indicating relatively low abuse/dependence[2]. However, if you go to higher than prescribed doses of around 300mg you see more typical opioid-like reinforcement and newer post-marketing and epidemiological reports suggest uptick in abuse and some wonder if risk of dependency was previously underestimated (I think the uptick is due to increased awareness of its easier access and its abuse liability, particularly at doses higher than those prescribed, especially as access to other opioids has become more restrictive)[3].

Adams EH, Breiner S, Cicero TJ, Geller A, Inciardi JA, Schnoll SH, Senay EC, Woody GE (2006) A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain. Journal of Pain and Symptom Management, 31, 465–476
Cicero TJ, Inciardi JA, Adams EH, Geller A, Senay EC, Woody GE, Munoz A (2005) Rates of abuse of tramadol remain unchanged with the introduction of new branded and generic products: results of an abuse monitoring system, 1994-2004. Pharmacoepidemiology and Drug Safety, 14, 851–859
Babalonis S, Lofwall MR, Nuzzo PA, Siegel AJ, Walsh SL. Abuse liability and reinforcing efficacy of oral tramadol in humans. Drug Alcohol Depend. 2013 Apr 1;129(1-2):116-24.

For those curious about this from pharmacological perspective and some history, see Raffa RB's Basic pharmacology relevant to drug abuse assessment: tramadol as example in J Clin Pharm Ther (2008), though be sure to note the disclosure.

Low, Low-Medium, or Medium seem all fine to me. If I recall (but could be wrong), I had set it to Low-Medium and that seems to be the best reflection of the evolving understanding and I suspect the most likely to have consensus. Tacitusmd (talk) 13:08, 16 April 2025 (UTC)[reply]