Prescrire international
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Prescrire international · Feb 1998
Comparative StudyTramadol: new preparation. Capsules: central analgesic; step 2 on the WHO scale.
The clinical assessment file on tramadol is of low quality. In acute postoperative pain and chronic pain there is no proof that tramadol has a better risk-benefit ratio than the paracetamol + codeine combination or other step 2 analgesics in the World Health Organisation classification. Like all other central analgesics, tramadol can have neuropsychological adverse effects, especially a risk of dependence and misuse.