Tramadol

Atypical Opioid

Drug Class: Atypical Opioid
Mechanism of Action (MOA): Weak µ-opioid agonist plus serotonin/norepinephrine reuptake inhibition.
Black Box Warning: Addiction/abuse; respiratory depression; fatal with benzodiazepines or alcohol; risk with ultra-rapid CYP2D6 metabolizers.
Clinical Notes: Moderate pain. Lowers the seizure threshold; serotonin syndrome (esp. with SSRIs). Less constipation/euphoria than classic opioids.
Source: FDA label