Tramadol is a centrally acting analgesic for moderate to severe pain. Tramadol exhibits dual actions: it inhibits the reuptake of norepinephrine and serotonin monoamines and also has a mild opioid agonist activity. Because tramadol reduces serotonin reuptake, people who take it alongside other serotonergic medications are more likely to develop serotonin syndrome. Tramadol is a racemic mixture of diastereomeric enantiomers with two chiral centers and different degrees of monoamine reuptake inhibitory activity.
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