By Rajnish Mago, MD (bio) Tramadol (brand name Ultram® and Ultram ER®) is a synthetic opioid that is widely used and has an FDA indication for the treatment of “moderate or moderately severe pain in adults.” Metabolism of tramadol and why it matters Tramadol is metabolized by cytochrome P450 2D6 and 3A4, though 30% of…