Cochrane review: only weak evidence supports tramadol for cancer pain

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  • There is only limited, very low quality evidence favoring tramadol (Ultram) for cancer pain.
  • There are no studies of tramadol's analgesic effects in children with cancer.
Why this matters
  • The Cochrane review concludes that the current place of tramadol as step 2 in the World Health Organization (WHO) analgesic ladder is uncertain.
  • The WHO ladder serves as the gold standard for pain management.
  • Tramadol is a desirable opioid because of its low risk for abuse.
Study design
  • Systematic review of 10 randomized controlled trials (n=958 adults) meeting eligibility criteria after a search of the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and LILACS.
  • The most common tramadol doses were 300-400 mg/day.
  • Funding: National Institute for He...