Comparative Pharmacology
Head-to-head clinical analysis: STADOL versus ULTRAM ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: STADOL versus ULTRAM ER.
STADOL vs ULTRAM ER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Partial agonist at mu-opioid receptors and agonist at kappa-opioid receptors in the CNS, altering 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.
Butorphanol tartrate 1-2 mg IV or IM every 3-4 hours as needed for pain; alternatively, 0.5-1 mg IV every 3-4 hours. For nasal spray: 1 mg (one spray) in one nostril, may repeat in 60-90 minutes if needed; then 1 mg every 3-4 hours as needed.
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: 2.5-4 hours; clinically, prolonged in hepatic impairment (up to 10-12 hours) and elderly
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: 85-90% as unchanged drug and metabolites (primarily as glucuronide conjugates); Fecal: <10%; Biliary: minimal
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