Tramadol: Does it have a role in cancer pain management?

Eric E. Prommer, MD

doi:10.5055/jom.2005.0032

Authors

Eric E. Prommer, MD

DOI:

https://doi.org/10.5055/jom.2005.0032

Keywords:

tramadol, cancer pain, neuropathic pain, analgesia, pharmacology

Abstract

Tramadol (Ultram, Ortho-McNeil Pharmaceutical, Inc., Raritan, NJ) is considered a Step 2 analgesic under the World Health Organization’s guidelines for the treatment of patients with cancer pain. It is a centrally acting analgesic that has affinity for opioid receptors and influences the action of norepinephrine and serotonin at the synapse. This dual mechanism of analgesia makes it unique among Step 2 agents. It is metabolized by CYP2D6, which increases the potential for drug interactions. Unlike other opioids, it does not cause respiratory depression. Tramadol has been studied in cancer pain and neuropathic pain. It compares well with low-dose morphine as an analgesic. The purpose of this review is to critically examine the pharmacodynamics, pharmacology, drug interactions, and adverse effects of the drug, and, based on the data presented, discuss the drug’s role in cancer care.

Author Biography

Eric E. Prommer, MD

Assistant Professor of Medicine, UCLA School of Medicine, Division of Hematology/Oncology, and VIP Palliative Care Program, Greater Los Angeles Healthcare, Los Angeles, California.

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