Background/Objectives: Chronic pain represents a core global health burden and remains a leading cause of disability and reduced quality of life. Tramadol is a widely prescribed analgesic with a dual-opioid and non-opioid mechanism of action; however, safety concerns persist. This scoping review summarizes current evidence on tramadol pharmacology, dosing, and safety. Methods: A systematic literature search was conducted across main scientific databases to identify preclinical and clinical studies evaluating tramadol pharmacokinetics, safety, and dosing. Results: The same tramadol presentations have been used for several years, with a high overdose risk due to incorrect dosing measurements. Dosing pump devices represent a viable solution to improve dosing accuracy and minimize this risk. Conclusions: Tramadol drops seem like an easier administration pathway but require careful handling when taking the prescribed dose. A dosing pump in the medication bottle will improve dosing accuracy.
Alas-Pineda et al. (Tue,) studied this question.