Tramadol was initially marketed by Grünenthal GmbH. Stolberg, Germany in 1977.23 Presently, immediate, extended-release, and injectable formulations of Tramadol can be purchased in over 75 countries, like the USA, Canada, United Kingdom, and also the People’s Republic of China.23 On a worldwide level, the application of Tramadol corresponds to a lot more than 823 million patient treatment days. This large worldwide clinical experience with both immediate-release and extended-release formulations has confirmed the efficacy of the analgesic effect of Tramadol in several painful diseases, and also the relatively low incidence of adverse unwanted effects.