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Cancer pain treatment following the world health organization guideline is very feasible and effective for all the patients. However , the evidence supporting the use of tramadol opioids for mild to moderate and severe pain on the second step of the analgesic ladder. The present evaluation compares the safety and efficiency of high dosages of oral tramadol medicine with low dosage of oral morphine medicines. Patients were included in this nonrandomized and nonblinded study. There are so many different quantity of tramadol dosage sell in the market in cheap price, which can buy by any poor people. 

If the combination of a nonopioid tramadol analgesic and up to 250mg/d of oral tramadol dosage was in adequate. 810 patients received oral tramadol dosage for a total of 23490 days. And 848 patients received oral morphine dosage for a total of 24,690 days. The average dose of tramadol medicine was 300-600 mg and the average dose of morphine drugs was  range of 10-60 mg. Additional nonopioid analgesic tramadol dosage were given on more than 95% of all days. So high dose tramadol dosage is better comparision to low dose morphine for cancer pain relief.

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