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Tramadol, sold under the brand name Ultram among others, 1 is an opioid pain medication and a serotonin—norepinephrine reuptake inhibitor SNR used to treat moderately severe pain. As is typical of opioids, common side effects include constipation, itchiness, and nausea. Tramadol is used primarily to treat mild to severe pain, both acute and chronic. For severe pain it is less effective than morphine. Pain reducing effects last approximately six hours. The potency of analgesia varies considerably as it depends on an individual's genetics. People with specific variants of CYP2D6 enzymes may not produce adequate amounts of the active metabolite desmetramadol for effective pain control. Individuals with certain genetic variations of CYP2D6 enzymes, which convert tramadol into an inactive molecule, may not experience enough pain relief from tramadol. Tramadol's use in pregnancy is generally avoided, as it may cause some reversible withdrawal effects in the newborn. No evidence of this dose harming the newborn was seen.

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