tramadol hydrochloride / Generic mfg. - LARVOL DELTA

BUP-TRA-PAIN: Comparison of Efficacy of Bupivacaine Alone vs. Bupivacaine-Tramadol in Lower Limb Surgery (clinicaltrials.gov) - P4 | N=60 | Completed | Sponsor: Farooq Hospital / Akhtar Saeed Medical college Rawalpindi

New P4 trial • Pain

PAMAVOC: Adaptive Platform Trial for Pain Management in Sickle Cell Vaso-Occlusive Crisis (clinicaltrials.gov) - P4 | N=400 | Not yet recruiting | Sponsor: Assistance Publique - Hôpitaux de Paris

New P4 trial • Genetic Disorders • Hematological Disorders • Pain • Sickle Cell Disease

Persistent Opioid Use Patterns Following Facial Trauma (AAO-HNSF 2026) - "Post-fracture opioid prescription results in a higher risk of persistent opioid use, highlighting the need for judicious opioid prescribing in facial trauma patients to prevent dependency. Future studies are needed to elucidate optimal non-opioid regimen."

Addiction (Opioid and Alcohol) • Musculoskeletal Diseases • Orthopedics

A Comparative Study of the Analgesic Efficacy of Tramadol and Diclofenac Sodium in Patients Following Cesarean Section. (PubMed, Cureus) - "Both diclofenac sodium and tramadol are effective in reducing postoperative pain following a cesarean section. Diclofenac provides a faster onset of analgesia, while tramadol offers sustained pain relief. Adverse drug reaction incidence was similar in both groups, although gastrointestinal symptoms were more common with diclofenac. Analgesic choice should be individualized based on patient factors, contraindications, and clinical context."

Journal • Pain

The Impact of Common Medications on Male Fertility: An Updated Systematic Review. (PubMed, Andrology) - "In this updated review, evidence-based recommendations for clinical management and for possible fertility preservation or contraception in men of reproductive age receiving common acute or chronic medical treatment are provided, with the goal of making these data more readily available to medical staff."

Journal • Review • Infertility

An Analysis of Treatment Preferences of Patients With Opioid Use Disorders: Findings From A Tertiary Drug Dependence Treatment Center in India. (PubMed, Addict Health) - "The options included naltrexone (oral, depot, and implant), buprenorphine (sublingual and injection), methadone, tramadol, counselling/psychotherapy, long-term residential treatment, Narcotics Anonymous meetings, and no treatment. A wider availability of medications for opioid agonist maintenance treatment could improve treatment-seeking rates. Further research on treatment preference could include diverse patient groups, caregivers, and treatment providers."

Journal • Addiction (Opioid and Alcohol) • Substance Abuse

Opioid Allergy Registrations in Danish Electronic Health Records: A Multihospital Register-Based Study With Journal Audit. (PubMed, Basic Clin Pharmacol Toxicol) - "The likelihood of an allergy registration being 'probable' was universally low, although slightly higher for intravenously administered opioids compared with orally administered morphine (OR = 0.26, 95% CI: 0.21; 0.32) and tramadol (OR = 0.36, 95% CI: 0.25; 0.46). Opioid allergy registrations frequently misrepresent expected adverse drug reactions as true hypersensitivity, particularly for oral formulations. Improved diagnostic differentiation and documentation accuracy are imperative to optimise patient pain management protocols in hospitals."

Journal • Allergy • Dermatology • Immunology • Pain • Pruritus

Suzetrigine for Opioid-Sparing Postoperative Analgesia Following Transvaginal Pelvic Reconstructive Surgery (clinicaltrials.gov) - P4 | N=120 | Not yet recruiting | Sponsor: University of California, Los Angeles | Initiation date: Jul 2026 ➔ Nov 2026

Trial initiation date • Pain • Urinary Incontinence • Urology

Prevalence of pharmacogenomically implicated prescriptions in multi-ethnic populations in Singapore. (PubMed, Br J Clin Pharmacol) - "Pharmacogenomically implicated medication prescriptions are common in Singapore and are particularly prevalent in elderly populations. Strategic investments in infrastructure and policy development will be pivotal to the successful integration of pre-emptive PGx into clinical practice."

Biomarker • Journal • CYP2C19

Ten-year outcomes of medical cannabis for chronic low back pain: opioid reduction, pain relief, and functional improvement in 1,000 patients. (PubMed, Eur Spine J) - "In this uncontrolled observational study, medical cannabis therapy was associated with reductions in opioid use, pain intensity, and functional disability over 10 years, accompanied by polypharmacy reduction and acceptable tolerability. Effect sizes substantially exceeded RCT benchmarks (e.g., - 0.6 NRS difference vs. placebo in a recent phase 3 trial), suggesting observational biases contribute to these findings. These hypothesis-generating data warrant validation in randomized controlled trials."

Journal • Back Pain • Lumbar Back Pain • Musculoskeletal Pain • Pain • Psychiatry

Outcomes Associated With Opioid Dose Reduction in Veterans With Chronic Low Back Pain (PAINWeek 2026) - "The CDC's 2016 guideline advised reassessing risks and benefits at doses at or above 50 morphine milligram equivalents (MED) per day and caution above 90 MED/day; many VA facilities, including the Orlando VA Medical Center (VAMC), adopted internal thresholds requiring multidisciplinary review above 90 MED/day...Sensitivity analyses excluding tramadol-exposed veterans did not materially change the primary outcome (86.2% achieving 30% or greater reduction vs 87.7% in the full cohort)... Fifty-seven veterans met eligibility criteria (mean age 64.4 +/- 13.8 years; range 31-94). Mean baseline MED was 31.9 mg, decreasing to a mean final MED of 16.1 mg, a 49.5% average reduction; 87.7% of veterans achieved the pre-specified 30% or greater MED reduction. The proportion prescribed 50 MED/day or more fell from 14.0% (8/57) at enrollment to 3.5% (2/57) at follow-up, and 8.8% of veterans (5/57) reached a final MED of 0."

Addiction (Opioid and Alcohol) • Back Pain • CNS Disorders • Lumbar Back Pain • Musculoskeletal Pain • Pain

MR-107A-02 Demonstrates Significant Analgesic Benefit in Both Moderate and Severe Postoperative Pain: A Post-Hoc Subgroup Analysis of Two Phase 3 Studies (PAINWeek 2026) - "Background: MR-107A-02 is a novel, fast-absorbing meloxicam that has demonstrated efficacy and safety in Phase 3 trials in patients with moderate or severe postoperative pain... Patients reporting pain scores ≥4 on NRS-R and/or NRS-A were randomized to receive MR-107A-02 (15 mg BID), placebo, or tramadol (50 mg QID) in bunionectomy and herniorrhaphy studies... Across both studies,192 patients presented with moderate pain and 536 with severe pain at baseline. MR-107A-02 significantly improved SPID 0-48 versus placebo across both pain subgroups. In bunionectomy, MR-107A-02 demonstrated a LS mean SPID 0-48 of 134.94 vs 67.40 in moderate pain (LSMD: 67.54; p =0.001) and 202.25 vs 112.0 in severe pain (LSMD: 90.25; p < 0.001)."

P3 data • Retrospective data • CNS Disorders • Pain

Improvement in Pain and Functional Outcomes during the first 24 hours with Fast-Absorbing Meloxicam Following Surgery: Results from Two Phase 3 Studies (PAINWeek 2026) - "Comparisons were performed versus placebo and the active control tramadol to further characterize the early clinical benefits of MR-107A-02 in patients experiencing moderate-to-severe acute postoperative pain. A total of 410 patients undergoing bunionectomy and 579 patients undergoing herniorrhaphy were randomized, with study completion rates exceeding 95% in both trials. Baseline pain severity was comparable across treatment groups. At 24 hours after first study drug administration, MR-107A-02 demonstrated statistically significant improvements in pain reduction versus placebo across both surgical models."

P3 data • Surgery • CNS Disorders • Pain

Global Patterns of Opioid Analgesic Prescribing: a Cross-National Comparative Analysis (PAINWeek 2026) - "Germany demonstrated a distinctive pattern in which tilidine, a prodrug opioid analgesic with limited international availability, ranked among the most commonly prescribed opioids along with tramadol, reflecting both regulatory specificity and prescribing culture...In Japan, a culturally conservative prescribing environment has historically limited opioid utilization, with morphine and transdermal fentanyl predominantly reserved for cancer pain and palliative indications; this has resulted in comparatively low per-capita opioid consumption, but also documented undertreatment of pain in non-cancer populations... The United States exhibited the highest per-capita opioid prescribing of any nation, with hydrocodone and oxycodone the most dispensed opioid analgesics. Canada similarly exhibited high per-capita opioid consumption, with oxycodone and hydromorphone predominating. In Western Europe, prescribing patterns diverged considerably from North American norms."

Clinical • CNS Disorders

Extubation-to-First Mobilisation Interval in Major Spine Surgery: A Prospective Study. (PubMed, Cureus) - "Higher analgesic requirements, including tramadol-containing combinations and rescue Butrum analgesia, were associated with relatively higher pain scores and delayed mobilisation...Earlier mobilisation was associated with lower postoperative pain scores and favourable recovery trends. Larger prospective multicentre studies with adjustment for potential confounders are required to determine whether earlier mobilisation independently influences postoperative outcomes."

Journal • Orthopedics • Pain

Intrathecal Nalbuphine Versus Intrathecal Tramadol in Subarachnoid Block for Lower Limb Orthopaedic Surgeries (clinicaltrials.gov) - P=N/A | N=40 | Completed | Sponsor: CMH Lahore Medical College and Institute of Dentistry | Active, not recruiting ➔ Completed

Trial completion • Anesthesia • Orthopedics

Role of OPRM1 A118G polymorphism in tramadol analgesia following third molar surgery: a pharmacogenomic study. (PubMed, Pharmacogenomics) - "OPRM1 A118G was not significantly associated with early tramadol analgesic response following third molar surgery. Larger studies incorporating both OPRM1 and CYP2D6 genotyping are needed to clarify the genetic determinants of tramadol analgesia as CYP2D6 gene is required for tramadol metabolism."

Biomarker • Journal • Pain • CYP2D6 • OPRM1

Tramadol for Refractory Restless Legs Syndrome Following Methadone Intolerance: A Case Report. (PubMed, Cureus) - "We present a 52-year-old woman with refractory RLS who failed multiple pharmacologic therapies, including ropinirole, carbidopa/levodopa, gabapentin, and pregabalin. Transition to tramadol 50 mg nightly resulted in sustained symptom control without recurrence of these adverse effects, allowing discontinuation of gabapentin and improved daytime functioning. This case highlights the importance of individualized opioid selection in refractory RLS and suggests that tramadol may be an effective alternative for carefully selected patients with methadone intolerance."

Journal • CNS Disorders • Insomnia • Migraine • Mood Disorders • Movement Disorders • Pain • Psychiatry • Restless Legs Syndrome • Sleep Disorder

Assessment of drug allergy and determination of safe alternative medications: a retrospective observational study. (PubMed, Front Med (Lausanne)) - "Among 167 patients with beta-lactam hypersensitivity, 104 underwent a standardized alternative non-beta-lactam antibiotic challenge protocol routinely implemented in our clinic, consisting of azithromycin, ciprofloxacin, metronidazole, clindamycin, tetracycline, and sulfamethoxazole-trimethoprim...Tramadol induced urticaria/angioedema in a subset of patients with NSAID-induced or NSAID-exacerbated cutaneous disease but was tolerated by all patients with NSAID-exacerbated respiratory disease...Celecoxib emerged as a safe alternative for patients with NSAID hypersensitivity, while azithromycin and tetracycline were well tolerated among selected patients with beta-lactam allergy. These findings support the use of structured diagnostic assessment to improve patient safety, prevent unnecessary drug avoidance, and guide evidence-based selection of alternative therapies."

Journal • Observational data • Retrospective data • Allergy • Anesthesia • Cardiovascular • Dermatology • Immunology • Respiratory Diseases • Urticaria

Prospective Pharmacogenetic Cohort Study of CYP2D6 Metabolizer Phenotype, Analgesic Failure, and Adverse Effects in Postoperative Patients Receiving Tramadol by Elastomeric Infusion Pump (clinicaltrials.gov) - P=N/A | N=200 | Recruiting | Sponsor: Research Inc

Adverse events • Biomarker • New trial • Pain

Sex-specific pharmacovigilance signals and time-to-onset patterns of drug-related myoclonus and epileptic seizures: a real-world pharmacovigilance analysis. (PubMed, Front Pharmacol) - "Bupropion had the highest report count (1,412; 265 myoclonus and 1,147 epileptic seizure reports), followed by tramadol (829). For myoclonus, gabapentin showed strong signals in males (ROR = 23.31, 95% CI: 20.95-25.95) and females (ROR = 18.06, 95% CI: 16.24-20.08), whereas tranexamic acid showed the strongest male signal (ROR = 128.41, 95% CI: 98.29-167.75)...CVARD identified 498 myoclonus-related and 940 seizure-related drugs and reproduced core signals, including clozapine, gabapentin, baclofen, pregabalin, sertraline, bupropion, quetiapine, and olanzapine. Integrating signal detection, sex-stratified analysis, TTO modeling, and cross-database validation identified core risk drugs and monitoring windows, supporting earlier recognition and individualized management of drug-related neurological adverse events."

Adverse events • Journal • Real-world evidence • Cardiovascular • CNS Disorders • Epilepsy • Metabolic Disorders • Mood Disorders • Movement Disorders • Oncology

5x-Multiplier vs 3-Tier Model for Discharge Opioid Prescriptions After Intra-abdominal Cancer Surgery: A Randomized Clinical Trial (clinicaltrials.gov) - P2 | N=165 | Completed | Sponsor: M.D. Anderson Cancer Center | Active, not recruiting ➔ Completed | Trial completion date: May 2027 ➔ Aug 2026 | Trial primary completion date: May 2027 ➔ Aug 2026

Trial completion • Trial completion date • Trial primary completion date • Oncology • Ovarian Cancer

Preoperative Risk Factors for Opioid Use Predict Self-Reported Health and Function Up to 6 Months After Anterior Cruciate Ligament Reconstruction. (PubMed, Arthrosc Sports Med Rehabil) - "Postoperatively, patients received acetaminophen, meloxicam, tramadol, gabapentin, and oxycodone. Morphine milligram equivalents (MMEs) and VAS were assessed at multiple timepoints through 6 months...Measurements of patient resilience and anxiety show little effect on postoperative pain, opioid consumption, and PROMs requiring further study. Level III, retrospective prognostic case series."

Journal • Mood Disorders • Orthopedics • Pain • Psychiatry

Multiyear Wastewater Monitoring of High-Risk Substances Surrounding an Annual Electronic Dance Music Festival, Las Vegas, Nevada, USA, 2023-2025: Surveillance Study. (PubMed, JMIR Public Health Surveill) - "Cocaine (and 3 of 4 measured metabolites), methamphetamine, amphetamine, 11-nor-9-carboxy-Δ-9-tetrahydrocannabinol (THC-COOH), and tramadol were detected in 100% of festival weekend samples; 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) was detected (at concentrations of up to nearly 2 mg/L) in all but 1 festival site sample collected prior to the start of the event in 2025. These findings demonstrate the value of wastewater monitoring as a complementary, population-level tool to support public health preparedness, harm-reduction strategies, and attendee safety during large-scale events. These data also inform wastewater utilities about expected influent composition during special events, with relevance for treatment operations and water reuse applications."

Journal • Addiction (Opioid and Alcohol)

Impact of CYP Enzyme Polymorphisms on Opioid Response in Anesthesia and Pain Medicine. (PubMed, Pain Res Manag) - "Key conclusions indicate that the CYP2D6 genotype significantly influences the bioactivation of precursor drugs such as codeine and tramadol; ultrarapid metabolizers (UMs) are at substantial risk of toxicity when using codeine, whereas slow metabolizers (PM) are at increased risk of inadequate analgesia. Polymorphisms in CYP3A4/5 primarily affect the metabolism of agents such as fentanyl and sufentanil via drug-drug interactions, although evidence supporting genotype-guided dose adjustments independent of clinical factors remains insufficient. Additionally, CYP2B6 polymorphisms are critical for methadone metabolism. Although integrating pharmacogenomic testing into clinical practice holds significant potential, current evidence supports selective testing in specific clinical scenarios rather than routine implementation across all opioid prescriptions."

Journal • Review • Addiction (Opioid and Alcohol) • Anesthesia • Pain • CYP3A4