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Tramadol (Ultram)

Analgesicprescriptionoral · inferred

Centrally acting analgesic with dual mechanism: weak mu-opioid agonism (parent compound) and serotonin/norepinephrine reuptake inhibition. Active metabolite O-desmethyltramadol (M1) has 200x higher mu-opioid affinity than parent, CYP2D6 poor metabolizers get reduced analgesia. Seizure risk at high doses and with serotonergic drug combinations. Schedule IV controlled substance. Lower abuse potential than typical opioids but dependence occurs with chronic use.

Projected serum levels — 50 mg, as needed (shown daily)

Tramadol (Ultram)
Tramadol (Ultram) modeled serum levels, 50 mg as needed (shown daily) over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 12.5 25 37.5 50 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1

Maintenance schedule: 50 mg as needed (shown daily) (oral).

Modeled steady state after ~1 days: peak ≈ 29.7 mg, trough ≈ 2.5 mg body load. Population-based estimate over 15 days for a 50 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Analgesic
Route modeled
Oral
Model confidence
inferred
Half-life
6 h
Common dose
50 mg
Suggested maximum
400 mg/day
Reference dose range
25–400 mg (single dose)
Suggested cadence
as needed (shown daily)
Validated against
100 mg oral — Cmax 0.28 mg/L at 2 h

Documented interactions

  • danger
    1,4-BDO (1,4-Butanediol) + Tramadol (Ultram) Contraindicated

    1,4-BDO converts to GHB. Tramadol adds opioid respiratory depression plus seizure risk. Avoid in combination.

  • danger
    1P-LSD (1-Propionyl-LSD) + Tramadol (Ultram) Serotonin risk

    1P-LSD (1-Propionyl-LSD) and Tramadol (Ultram) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    25I-NBOMe + Tramadol (Ultram) Serotonin risk

    25I-NBOMe and Tramadol (Ultram) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-I (2,5-Dimethoxy-4-iodophenethylamine) + Tramadol (Ultram) Serotonin risk

    2C-I (2,5-Dimethoxy-4-iodophenethylamine) and Tramadol (Ultram) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) + Tramadol (Ultram) Serotonin risk

    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) and Tramadol (Ultram) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    4-AcO-DMT (Psilacetin) + Tramadol (Ultram) Serotonin risk

    4-AcO-DMT (Psilacetin) and Tramadol (Ultram) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

Serum checks 231 modeled interaction pairings for tramadol (ultram) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Tramadol: a review of its use in perioperative pain Scott LJ, Perry CM · Drugs, 2000 DOI

    Comprehensive review establishing tramadol's efficacy for moderate pain with analgesic potency approximately 1/10th that of morphine, dual mechanism of action, and lower respiratory depression risk.

  2. Clinical pharmacokinetics of tramadol Grond S, Sablotzki A · Clinical Pharmacokinetics, 2004 DOI

    Definitive PK review establishing tramadol half-life of 5-7 hours, 70% bioavailability, CYP2D6-dependent formation of active M1 metabolite (half-life 8h, 200x higher opioid affinity), and the clinical impact of CYP2D6…

2 published studies referenced in the app, each with a plain-language summary.