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There are also sustained release formulations, and formulations that also contain acetaminophen.   Tramadol is a synthetic opioid-like drug that has its effects primarily as an agonist (stimulator) buying tylenol 3 of the  mu opioid receptor site.  Tramadol is used primarily for moderate to severe pain control.  It has many properties in common with other opioid medications, but is different in that it acts more specifically on the opioid mu receptor than most other opioids.