Tramadol Hcl
Brand names: Tramadol Hcl, Tramadol Hcl Er
Part of: Opioid painkillers
At a glance
- Medicare prescriptions, 2024
- 11,879,407
- Medicare drug cost
- $93.4M
- Average cost per prescription
- $7.86
- Clinicians who prescribed it
- 210,581
Where it is prescribed
List the prescribers in any state, county, city or ZIP code →
What it is used for
Section INDICATIONS AND USAGE Tramadol hydrochloride extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long term opioid treatment and for which alternative treatment options are inadequate. Limitations of Use Because of the risks of addiction, abuse, and misuse, with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve tramadol hydrochloride extended-release tablets or use in patients for whom alternative treatment options [e.g., non-opioid analgesics or immediate-release opioids], are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
From the FDA-approved prescribing information (label dated December 2024). Full labels on DailyMed (opens in a new tab)
Boxed warning
WARNING: ADDICTION, ABUSE, AND MISUSE; RISK EVALUATION AND MITIGATION STRATEGY (REMS); LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; ULTRA-RAPID METABOLISM OF TRAMADOL AND OTHER RISK FACTORS FOR LIFE-THREATENING RESPIRATORY DEPRESSION IN CHILDREN; NEONATAL OPIOID WITHDRAWAL SYNDROME, INTERACTIONS WITH DRUGS AFFECTING CYTOCHROME P450 ISOENZYMES; AND RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Tramadol hydrochloride extended-release tablets expose patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk prior to prescribing tramadol hydrochloride extended-release tablets, and monitor all patients regularly for the development of these behaviors and conditions. Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS): To…
The FDA’s strongest warning on a label. It doesn’t mean the drug is unsafe for most people; talk to your doctor or pharmacist before stopping or changing any medicine.
Who prescribes it
- Family Medicine 26.5%
- Nurse Practitioners 19.4%
- Internal Medicine 18.4%
- Physician Assistants 10.2%
- Pain Medicine 6.3%
- Orthopedic Surgery 3.2%
- Rheumatology 2.6%
- Physical Medicine & Rehabilitation (PM&R) 1.8%
- General Practice 1.0%
- Emergency Medicine 0.9%
- Geriatric Medicine 0.9%
- General Surgery 0.7%
All prescribers, by place, name or specialty →
Share of Medicare prescriptions written by each specialty. Select one to list its prescribers.
Trend, 2019–2024
Medicare prescriptions fell 7% from 2019 to 2024.
Biggest change by state since 2019
- Wyoming +17%
- Montana +8%
- Idaho +7%
- Utah +4%
- Kentucky +3%
- Puerto Rico (smallest change) −37%
- Texas (smallest change) −17%
From CMS’s yearly state and national Part D summaries, which count every prescriber, including those CMS leaves out of its per-clinician data (fewer than 11 prescriptions). That is why these totals are higher than the count at the top of this page. Prescriptions include refills.
What it looks like
Pills from 3 makers on file. The same medicine can look different depending on who made it, so check the imprint (the letters and numbers on the pill) with your pharmacist if a refill looks different.
Advanced Rx of Tennessee, LLC
| Strength | Looks like | Imprint |
|---|---|---|
| 50 mg | white round tablet, 9 mm | AN 627 |
Advanced Rx Pharmacy of Tennessee, LLC
| Strength | Looks like | Imprint |
|---|---|---|
| 200 mg | white round tablet, 11 mm | 533 |
Direct_rx
| Strength | Looks like | Imprint |
|---|---|---|
| 300 mg | white round tablet, 10 mm | L012 |
Source: DailyMed (U.S. National Library of Medicine), from each maker’s FDA drug listing. A few makers are shown, not every one. Never take a pill you can’t identify; ask a pharmacist.
Industry payments about this drug
No industry payments to clinicians named this drug in 2025.
Recalls and shortages
Not on the FDA drug shortage list.
No FDA-reported recalls since 2020.
Sources: CMS Medicare Part D Prescribers by Provider and Drug (2024; prescriptions include refills, and CMS hides counts under 11 per prescriber); U.S. Food and Drug Administration, openFDA (drug labels, NDC directory, enforcement reports, drug shortages); CMS Open Payments 2025; ClinicalTrials.gov. General information only, not medical advice; not yet reviewed by our medical reviewer.