A review on tramadol toxicity: mechanism of action, clinical presentation, and treatment

Abstract Aims As an analgesic that acts upon the central nervous system (CNS), tramadol has gained popularity in treating moderate to severe pain. Recently, it been increasingly reported as a drug of misuse with intentional overdoses or intoxications. This review focuses on intoxication humans and its effects different systems. Subject method narrative provides comprehensive view pharmacokinetics, mechanism action, incidence toxicity in-depth look at side effects. In addition, main approaches management poisoning are described. Results Tramadol can affect multiple organ systems: gastrointestinal, (seizure, CNS depression, low-grade coma, anxiety, over time anoxic brain damage), cardiovascular (palpitation, mild hypertension life-threatening complications such cardiopulmonary arrest), respiratory system, renal (renal failure higher doses intoxication), musculoskeletal (rhabdomyolysis), endocrine (hypoglycemia), well as, cause serotonin syndrome. Seizure, serious disturbance, is more common than other opioids. Fatal intoxications uncommon, except ingestion cases concurrent medications, particularly depressants, most commonly benzodiazepines, ethanol. Conclusion With increasing tramadol, physicians must be aware adverse effects, substantial abuse potential, interactions, weigh risk–benefit ratio for pain management. Alternative therapies might considered patients previous overdose history reduce risks outcomes.