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Tutram (also known as Twotram or NZ-687) is an oral, twice-daily bilayer tablet formulation of tramadol hydrochloride developed by Nippon Zoki Pharmaceutical. It consists of a 35% immediate-release layer and a 65% sustained-release layer, designed to provide rapid onset of analgesia followed by stable, long-lasting pain relief. Tramadol acts as a weak mu-opioid receptor agonist and also inhibits the reuptake of norepinephrine and serotonin. Tutram is approved in Japan for the management of cancer pain and chronic pain that is difficult to treat with non-opioid analgesics.
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