Extended-release formulations of tramadol in the treatment of chronic pain

Expert Opin Pharmacother. 2011 Aug;12(11):1757-68. doi: 10.1517/14656566.2011.576250. Epub 2011 May 24.


Introduction: Tramadol is a centrally acting analgesic available throughout the world. Its dual opioid and non-opioid mechanisms of action, favorable efficacy and safety clinical profiles and non-controlled regulatory status in most markets contribute to its widespread use. A drawback of the immediate-release formulation of tramadol (four-times-a-day dosing) might be addressed by an extended-release formulation. Extended-release formulations also can offer advantages in the management of chronic pain: convenience, reduced pill burden (possibly leading to improved compliance) and the attenuation of peaks and troughs in serum concentration (possibly leading to reduced adverse effects).

Areas covered: The authors review tramadol's mechanisms of action and the clinical literature regarding the use of tramadol extended-release formulations for the management of conditions involving chronic pain, such as neuropathic pain syndromes, osteoarthritis and cancer pain.

Expert opinion: Based on the literature cited, extended-release formulations of tramadol seem to offer a rational and important addition to the analgesic armamentarium. As is true for all such options, the benefits and risks must be assessed for each patient.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Animals
  • Chronic Disease
  • Delayed-Action Preparations
  • Humans
  • Medication Adherence
  • Pain / drug therapy*
  • Pain / etiology
  • Tramadol / administration & dosage
  • Tramadol / adverse effects
  • Tramadol / therapeutic use*


  • Analgesics, Opioid
  • Delayed-Action Preparations
  • Tramadol