Ciramadol is a mixed agonist-antagonist for mu opioid receptors with relatively low abuse potential and a ceiling on respiratory depression which makes it a relatively safe drug. It has a slightly higher potency and effectiveness as an analgesic than codeine, but is weaker than morphine. Other side effects include sedation and nausea but these are generally less severe than with other similar drugs.
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^ Downing JW, Brock-Utne JG, Holloway AM. Ciramadol - a new synthetic analgesic. A double-blind comparison with oral codeine for postoperative pain relief. South African Medical Journal. 1983 Dec 10;64(25):978-82.
^ Powell WF. A double-blind comparison of multiple intramuscular doses of ciramadol, morphine, and placebo for the treatment of postoperative pain. Anesthesia and Analgesia. 1985 Nov;64(11):1101-7.
^ Stambaugh JE Jr, McAdams J. Comparison of the analgesic efficacy and safety oral ciramadol, codeine, and placebo in patients with chronic cancer pain. Journal of Clinical Pharmacology. 1987 Feb;27(2):162-6.