Round White Pill Engraved “AN 627” – What Does It Mean?

2 white tablets



AN 627 are round white pills engraved with those letters and the numbers. They are primarily composed of Tramadol (Ultram). These pill, however, are a combination of Tramadol and hydrochloride. Hydrochlorides are a type of salt that converts insoluble amines to water-soluble amines.

  • Hydrochloride is commonly found in medications to expedite absorption of the medication in the gastrointestinal tract.
  • Tramadol (brand name Ultram) is an opioid analgesic drug prescribed by physicians to relieve acute or chronic pain.
  • They are available in 50mg dosages only.

Tramadol provides pain relief similar to the effectiveness of morphine for moderate pain. However, it is not as effective as morphine for severe pain. Doctors often prescribe both Tramadol and acetaminophen (paracetamol) to alleviate severe pain.

Tramadol is available by prescription only in tablet, liquid and capsule form. Extended release versions of it are also available that provide rapid pain relief within 30 to 60 minutes.

 Encoding Markings

The “AN” portion probably comes from the manufacturer’s name, Amneal Pharmaceuticals. So, the AN is an acronym for AmNeal. As far as the “627” part, it comes from its National Drug Code (NDC) for this particular drug which is NDC 65162-627-01.

What Does Tramadol Do To the Body?

Since Tramadol is an opioid pain reliever, users will experience side effects similar to other opioid analgesics such as drowsiness, sedation, decrease in alertness, body numbness, euphoria and dizziness. Adverse side effects of Tramadol include:

  • Nausea and vomiting
  • Dry mouth
  • Stomach cramps
  • Indigestion
  • Vertigo
  • Headache
  • Constipation
  • Itchiness

As Antidepressant

Tramadol acts on the brain like an antidepressant because it keeps higher levels of serotonin and norepinephrine in the brain (serotonin-norepinephrine reuptake inhibitor). In addition, Tramadol binds to opioid receptors like morphine and heroin do to induce strong pain relief. Tramadol is also further converted by the liver into a potent opioid called desmetramadol.

Recently, desmetramadol is being marketed as a legal substitute for street and pharmaceutical opioids. A blend of synthetic desmetramadol and Kratom is being sold under the name “Krypton”. Several overdose deaths attributed to Krypton have been reported in the past few years.

Addictive Controlled Substance

Tramadol is most commonly abused by narcotic addicts, chronic pain patients, and health professionals.

According to the government’s website Medline; “Drinking alcohol, taking prescription or nonprescription medications that contain alcohol, or using street drugs during your treatment with tramadol increases the risk that you will experience these serious, life-threatening side effects. Do not drink alcohol, take prescription or nonprescription medications that contain alcohol, or use street drugs during your treatment.”

  • Controlled Status: Tramadol is controlled in Schedule IV of the Controlled Substances Act.

According to the DEA, and the American Association of Poison Control Centers, there were a total of 12,108 tramadol exposures in 2016. Of this total, there were 5,712 single substance exposures and 3 associated deaths

  • According to the National Survey on Drug Use and Health (NSDUH) in 2016, 1.6 million people in the U.S. aged 12 or older, misused tramadol products in the past year.

Usage Statistics

Tramadol is a very popular prescription medication. According to the DEA;

  • 43.6 million tramadol prescriptions were dispensed in the U.S. in 2016.
  • 41.0 million were dispensed in 2017.
  • Approximately 16.0 million prescriptions dispensed for the first half of 2018.

Q & A

Can You Take 100mg of Tramadol?

The most common dose of Tramadol prescribed by physicians for moderate pain is between 50mg and 100mg every four to six hours.

  • The maximum Tramadol dose is 400 mg daily.

Exceeding this dosage could cause serious side effects and signs of overdose. Extended release Tramadol is a 100mg tablet taken once daily. Maximum dose of extended release Tramadol should not exceed 300 mg per day.

Does Tramadol Make You Sleepy?

Pain relieving medications naturally make a person more relaxed and capable of falling asleep once pain diminishes. Tramadol is an opioid affecting receptors that control pain sensations, sedation and to some extent mood. Some people may simply doze off for a short time while using Tramadol while others could lapse into a lengthier sleep.

  • How well people tolerate Tramadol is determined by their age, weight, health and other body chemistry factors.

How Long Does It Take for Tramadol to Kick In?

Most Tramadol users experience pain relief within 60 minutes of taking a dose. Drowsiness, sedation and dizziness may be felt before pain decreases. Mixing Tramadol with alcohol will increase the intensity and expedite the onset of Tramadol side effects.

Are There Contraindications for Tramadol?

Before taking Tramadol, users should tell their doctor if they are taking antidepressants, anxiolytics (anxiety medication), opioid analgesics such as oxycodone, codeine or fentanyl, amphetamines or antibiotics. Interaction between Tramadol and any of these drugs could cause adverse side effects requiring emergency medical treatment.