Tramadol conversion reference
Check OpioidCalc's OME factors by route, then open the formulation-specific pharmacology, cautions and supporting sources.
Educational reference for qualified healthcare professionals. Conversion factors estimate oral morphine equivalent daily dose. They are not a recommended switching dose. Confirm the result with a current source and local guidance.
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Current OpioidCalc factors
Multiply the dose or delivery rate in the stated units by the factor to estimate mg oral morphine equivalent per day. These are the factors currently used by OpioidCalc. Methadone uses 4.7 when converting methadone to OME.
| Route | Input units | OME factor |
|---|---|---|
| Oral | mg/day | 0.2 |
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Formulations and cautions
Choose a formulation to read its pharmacology, population, limitations and source references.
OralDefault in appImmediate-release tablet
App source review: 27 August 2026
View details and sources
Immediate-release tablet
App source review: 27 August 2026
View details and sources- Peak concentration or effect
- Parent drug at 2 hours; active M1 metabolite at 3 hours
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Elimination half-life
- After a single dose, about 5.6 hours for tramadol and 6.7 hours for M1; after repeated dosing, about 6.7 and 7.0 hours
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Steady state
- Within 2 days in the cited four-times-daily regimen
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Study regimen is not a dosing recommendation.
- Tramadol hydrochloride immediate-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Bioavailability
- Approximately 75%
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Receptor activity
- Opioid agonism plus norepinephrine and serotonin reuptake effects; M1 has stronger mu-receptor affinity.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information12.1 Mechanism of Action. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Metabolism
- CYP2D6 forms active O-desmethyltramadol (M1); CYP3A4 and conjugation also contribute.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Active metabolites
- O-desmethyltramadol (M1) is pharmacologically active.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Elimination
- Parent drug and metabolites are eliminated mainly in urine.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Renal impairment
- Renal impairment reduces elimination and increases M1 exposure.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information8.7 Renal Impairment. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
- Hepatic impairment
- Cirrhosis can markedly prolong tramadol and M1 half-lives.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride immediate-release tablet prescribing information8.6 Hepatic Impairment. United States. Source revised 25 August 2026. App review 27 August 2026. Regulatory product information.
OralImmediate-release oral solution
App source review: 27 August 2026
View details and sources
Immediate-release oral solution
App source review: 27 August 2026
View details and sources- Peak concentration or effect
- Approximately 2 hours after 100 mg
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC5.2 Pharmacokinetic properties. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Elimination half-life
- Approximately 6 hours
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC5.2 Pharmacokinetic properties. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Steady state
- Approximately 36 hours in the cited every-six-hour regimen
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Study regimen is not a dosing recommendation.
- ADOLONTA oral solution SmPC5.2 Pharmacokinetic properties. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Bioavailability
- 70% to 90% after a single dose; above 90% after repeated dosing
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC5.2 Pharmacokinetic properties. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Receptor activity
- Opioid agonism plus norepinephrine and serotonin reuptake effects; M1 has stronger mu-receptor affinity.
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC12.1 Mechanism of Action. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Metabolism
- CYP2D6 forms active O-desmethyltramadol (M1); CYP3A4 and conjugation also contribute.
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC12.3 Pharmacokinetics. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Active metabolites
- O-desmethyltramadol (M1) is pharmacologically active.
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC12.3 Pharmacokinetics. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Elimination
- Parent drug and metabolites are eliminated mainly in urine.
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC12.3 Pharmacokinetics. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Renal impairment
- Renal impairment reduces elimination and increases M1 exposure.
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC8.7 Renal Impairment. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
- Hepatic impairment
- Cirrhosis can markedly prolong tramadol and M1 half-lives.
Population: Adults described in the cited product information
Applicability: Spain
- Limitation: Product-specific evidence; do not transfer to other formulations.
- ADOLONTA oral solution SmPC8.6 Hepatic Impairment. Spain. Source revised 1 October 2025. App review 27 August 2026. Regulatory product information.
OralModified-release tablet
App source review: 27 August 2026
View details and sources
Modified-release tablet
App source review: 27 August 2026
View details and sources- Peak concentration or effect
- Tramadol about 12 hours; M1 about 15 hours
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Elimination half-life
- Tramadol about 7.9 hours; M1 about 8.8 hours
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Steady state
- Within 4 days
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Bioavailability
- Approximately 85% to 90% relative to immediate-release tramadol
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Formulation behaviour
- Once-daily tablet with an absorption lag and lower concentration fluctuation than immediate-release tramadol.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Receptor activity
- Opioid agonism plus norepinephrine and serotonin reuptake effects; M1 has stronger mu-receptor affinity.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.1 Mechanism of Action. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Metabolism
- CYP2D6 forms active O-desmethyltramadol (M1); CYP3A4 and conjugation also contribute.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Active metabolites
- O-desmethyltramadol (M1) is pharmacologically active.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Elimination
- Parent drug and metabolites are eliminated mainly in urine.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information12.3 Pharmacokinetics. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Renal impairment
- Renal impairment reduces elimination and increases M1 exposure.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information8.7 Renal Impairment. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
- Hepatic impairment
- Cirrhosis can markedly prolong tramadol and M1 half-lives.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release tablet prescribing information8.6 Hepatic Impairment. United States. Source revised 13 May 2026. App review 27 August 2026. Regulatory product information.
OralModified-release capsule
App source review: 27 August 2026
View details and sources
Modified-release capsule
App source review: 27 August 2026
View details and sources- Peak concentration or effect
- Single-dose 10 to 12 hours; formulation-specific steady-state values vary for tramadol and M1
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.3 Pharmacokinetics. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Elimination half-life
- Approximately 10 hours for tramadol and 11 hours for M1
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.3 Pharmacokinetics. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Steady state
- Within 4 days
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.3 Pharmacokinetics. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Formulation behaviour
- Once-daily capsule technology; do not substitute the extended-release tablet pharmacokinetics.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.3 Pharmacokinetics. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Receptor activity
- Opioid agonism plus norepinephrine and serotonin reuptake effects; M1 has stronger mu-receptor affinity.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.1 Mechanism of Action. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Metabolism
- CYP2D6 forms active O-desmethyltramadol (M1); CYP3A4 and conjugation also contribute.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.3 Pharmacokinetics. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Active metabolites
- O-desmethyltramadol (M1) is pharmacologically active.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.3 Pharmacokinetics. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Elimination
- Parent drug and metabolites are eliminated mainly in urine.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information12.3 Pharmacokinetics. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Renal impairment
- Renal impairment reduces elimination and increases M1 exposure.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information8.7 Renal Impairment. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
- Hepatic impairment
- Cirrhosis can markedly prolong tramadol and M1 half-lives.
Population: Adults described in the cited product information
Applicability: United States
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tramadol hydrochloride extended-release capsule prescribing information8.6 Hepatic Impairment. United States. Source revised 23 January 2026. App review 27 August 2026. Regulatory product information.
Sources used on this page
- Tramadol hydrochloride immediate-release tablet prescribing informationUnited States. Revision date 25 August 2026.
- ADOLONTA oral solution SmPCSpain. Revision date 1 October 2025.
- Tramadol hydrochloride extended-release tablet prescribing informationUnited States. Revision date 13 May 2026.
- Tramadol hydrochloride extended-release capsule prescribing informationUnited States. Revision date 23 January 2026.
Other medicine references
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