Compatibility of tramadol hydrochloride injection with selected drugs and solutions.

T ramadol hydrochloride is a centrally acting synthetic analgesic with a dual mechanism of action. Tramadol and its Odesmethyl metabolite (M1) bind to opioid receptors, with M1 having a 200-fold higher affinity for binding to these receptors. Tramadol has also been shown to inhibit the uptake of norepinephrine and serotonin, suggesting that its antinociceptive activity is mediated by both opioid and nonopioid mechanisms. In patients with diabetic neuropathy, therapy with oral tramadol resulted in low pain scores and high painrelief scores. Tramadol produced effective analgesia with minimal adverse effects in cancer patients with chronic pain. Tramadol is also a useful alternative in patient-controlled epidural analgesia when patients cannot receive combined spinal– epidural analgesia for labor pains. There are some clinical situations in which tramadol must be combined with other drugs, such as for patients with postoperative pain who require NORAH O. ABANMY, M.SC., is Lecturer; IMAN Y. ZAGHLOUL, PH.D., is Associate Professor; and MAHASEN A. RADWAN, PH.D., is Professor, Department of Clinical Pharmacy, College of Pharmacy, University Center for Women Students, King Saud University, Riyadh, Saudi Arabia. Address correspondence to Dr. Zaghloul at the College of Pharmacy, University Center for Women Students, King Saud University, P.O. Box 22452, Riyadh 11459, Saudi Arabia ([email protected]).