Tramadol 200 mg is a powerful analgesic. It is used to relieve moderate to severe pain, such as after surgery or a catastrophic injury. It's also used to treat chronic pain when weaker pain relievers no longer function. Tramadol is only available with a prescription. It is available in the form of tablets, capsules, and liquid drops that must be swallowed. It can also be administered through injection, however, this is normally only done in a hospital setting. Tramadol is available as a generic as well as under brand names such as: Ultram(Immediate-release tramadol) FusePaq Synapryn ConZip (extended-release tramadol) Tramadol is commonly recommended for short-term pain treatment. Tramadol tolerance can develop fast in the body, making the dose less effective over time. How Does Tramadol 200mg Work? Tramadol, like other opioids, works by attaching to receptors on nerve endings in the brain and spinal cord that operate to stop pain signals from being conveyed. However, other experts believe that tramadol may affect levels of the neurotransmitters serotonin and norepinephrine in the same way that antidepressant medications do. Like every other opioid, the next day tramadol works much more effectively since it is usually the second dose of tramadol.