Comparative Pharmacology
Head-to-head clinical analysis: MS CONTIN versus ULTRAM ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MS CONTIN versus ULTRAM ER.
MS CONTIN vs ULTRAM ER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Mu-opioid receptor agonist; binds to mu-opioid receptors in the CNS, modulating pain perception and emotional response to pain.
Tramadol is a centrally acting synthetic opioid analgesic that binds to μ-opioid receptors and inhibits serotonin and norepinephrine reuptake.
Oral: 15-30 mg every 8-12 hours; adjust based on pain severity and prior opioid use. Extended-release tablets must be swallowed whole; do not crush or chew. For opioid-naïve patients, start at 15 mg every 12 hours.
100 mg orally once daily initially, titrate up to 100 mg twice daily as needed; maximum 200 mg/day.
None Documented
None Documented
Terminal elimination half-life: 11-13 hours (range 8-24 hours). In elderly or hepatic impairment, half-life may be prolonged; acute dosing half-life ~2-4 hours.
The terminal elimination half-life of tramadol is approximately 6.3 hours (range 5-9 hours), while its active metabolite M1 has a half-life of about 7.4 hours. Clinically, this supports dosing every 24 hours for the extended-release formulation.
Renal: ~90% (mostly as morphine-3-glucuronide and morphine-6-glucuronide, with ~10% as unchanged morphine); Fecal: <10%
Renal excretion of tramadol and its metabolites accounts for approximately 90% of total elimination. About 10% is excreted unchanged, 30% as O-desmethyltramadol (M1), and the remainder as other minor metabolites. Biliary/fecal excretion is minimal (<10%).
Category C
Category C
Opioid Analgesic
Opioid Analgesic