Tramadol is well established in therapy of pain in a large spectrum of rheumatic diseases. The actual aspects of tramadol in rheumatology may be summarized as follows: 1.
Novel technology is resulting to construction once-a-day tablet of extended-release tramadol. The range of therapeutic plasma concentration is obtained within two hours with 24 hour persistence. 2.
EULAR evidence-based recommendations for management of pain in fibromyalgia syndrome classify tramadol in the highest level of evidence (Ib) and strenght (A). 3. Experimental data suggest that tramadol has also an immunomodulating potency, especially in relation to T lymphocytes.