Tramadol is a member of drug class narcotic analgesic or opioid medication with chemical name [2-(dimethyl aminomethyl)-1-(3-methoxyphenyl) cyclohexanol] and sold under the brand name Ultram. When taken as an immediate-release oral formulation, pain relief occurs within an hour and useful in moderate to moderately severe pain, both acute and chronic. It has one-tenth potency of morphine and approximately potent as pethidine and codeine. It will often combine with paracetamol to increase the efficacy of relieving pain. Firstly it binds to µ opioid receptor and secondly inhibits the reuptake of serotonin and norepinephrine. The most common adverse effect include vertigo, dizziness, dry mouth, abdominal pain, nausea, indigestion, constipation, vertigo, drowsiness, vomiting, and headache but compared to other opioid respiratory depression and constipation is considered less of a problem with tramadol. Seizures, serotonin syndrome, drug addiction, and increased risk of suicide are severe side effects. Tramadol will contraindicate in pregnancy and lactation, children, older persons, a person with kidney and liver failure, and labor pain during delivery. Investigational tramadol uses are diabetic neuropathy, postherpetic neuralgia, antidepressant, premature ejaculation, and adjunct to local anesthesia. Available formulation of tramadols are liquids, syrups, elixirs, an effervescent tablet, and powder for mixing with water, syrup, injection, tablets, and capsules with the extended and immediate-release formulation.