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Tramadol is a prescription-only medication that is used to treat moderate to severe pain. It is a centrally acting opioid analgesic, which means that it works by binding to opioid receptors in the brain and spinal cord to block pain signals. Tramadol is available in both immediate-release and extended-release formulations. The immediate-release formulation is typically taken every 4 to 6 hours as needed for pain relief. The extended-release formulation is typically taken once or twice daily.