Tramadol is a synthetic pain medication (analgesic) with mild opiate
effects that can be prescribed for all levels of pain. Other acceptable
uses include chronic pain related to mood disorders, and the treatment
of chronic pain in fibromyalgia
Tramadol appears to increase the availability of norepinephrine
and serotonin, as well as activate certain opioid receptors. The
availability of tramadol for pain control appears to be mildly
higher and the effects may last slightly longer in women than in
men, though the significance of this is not clear.
Do not use tramadol more often than
recommended, do not combine it with other prescription or over
the counter pain medications except as directed by your physician.
Tramadol 50 mg, manufactured by Cinfa and Bexal, comes in multiples of 60 capsules.
Tramadol 100 mg Retard, manufactured by Grünenthal, comes in multiples of 60 capsules.
Common Tramadol Side Effects: Blurred vision, constipation, drowsiness,
dry mouth (if this persists, speak to your dentist), and light headedness
are expected and typical reactions, though are not typically severe
or persistent. Speak to your doctor if any of these become bothersome.
Mild Tramadol Adverse Side Effects: Diarrhea, difficulty urinating,
nausea, palpitations or rapid heartbeat, rash (allergic reaction),
sweating, or vomiting should be reported to your doctor immediately.
Some of these reactions may indicate that tramadol treatment should
Serious Tramadol Side Effects: Confusion, hallucination, low
blood pressure, or seizure indicate that you should seek medical
treatment immediately. Rare cases of anaphylactic reactions
have been reported. The symptoms are concurrent skin reactions and
difficulty breathing accompanied by nausea, and may progress to
airway closure and unconsciousness. If you experience these reactions,
or observe someone else experiencing them (usually within 20 minutes
of ingesting the substance that caused the reaction), contact
emergency medical services for immediate treatment.
Cautions: If you have any of the following conditions, or
a history of them, please inform your doctor before taking
Your doctor may want to try a lower dosage, or take special precautions
during your treatment. Also, tramadol may not be suitable
for all individuals.
- Alcohol or drug abuse - May increase likelihood of tramadol dependence.
- Allergic reaction to tramadol, or any narcotic analgesic like
Cialis. Always tell your doctor about any allergies before starting
- Breathing difficulties such as asthma, bronchitis, emphysema,
or any other chronic lung disease - tramadol may cause additional
- Constipation or irritable bowel - tramadol may worsen this condition.
- Eating disorder - You may be predisposed to seizure with
treatment, particularly with a history of anorexia nervosa or
bulimia. Discuss possible risks with your doctor.
- Epilepsy or seizures - If you have a history of seizure disorders,
take medication that lowers the seizure threshold, or medication
that controls seizures, you are potentially at a higher risk of
experiencing seizure while taking tramadol.
- Kidney or liver problems - tramadol may build up to toxic levels
in the bodies of patients with kidney or liver problems. Lower
dosages are suggested. Patients with serious liver conditions
are advised to take no more than 50 mg in 12 hours. Individuals
who have difficulty removing creatinine from the body through
the kidneys should take a normal dose of 50-100 mg, but only every
12 hours, and should not exceed 200 mg daily. If you have a less
severe impairment, speak to your doctor about an individual dosage
- Narcotic dependence - Individuals who have become addicted to
narcotic analgesics are at risk for developing dependence on
- Sleep apnea - If you have sleep apnea or tend to snore loudly,
you should not take tramadol at bedtime, or sleep while you are
taking it, as it may further depress your breathing.
- Surgery - If you are planning to have surgery, inform the doctor
or dentist well in advance, as tramadol may interact with certain
medications given during surgery.
- Thyroid problems - Your doctor will need to determine if this
treatment is right for you.
Tramadol (Ultram) is a central nervous system depressant, and slightly
increases the risk of seizure in individuals who are already at
risk. Tramadol should be used cautiously with any other drug that may
make you drowsy or also increases the risk of seizure. Speak with
your doctor about combining any other prescription
or over the counter medication with tramadol. Not all medications
should be mixed together, and some may require dosage adjustments
in order to be taken safely. Only your doctor can tell you for sure whether or not it is safe to use other medications with tramadol.
- Alcohol - Tramadol should not be mixed with alcohol, individuals
are advised to avoid it completely during treatment.
- Any medication which may cause drowsiness
- Antihistamines like Tavist or Benadryl may cause oversedation.
- Benzodiazepines such as diazepam, triazolam,
temazepam, chlordiazepoxide, clorazepate, clonazepam, halazepam, lorazepam, estazolam, or alprazolam can result in oversedation in combination with
tramadol. Some of these drugs may also lower the seizure threshold,
especially with abrupt withdrawal. If you must use these medications
together, speak to your doctor about the safety of your treatment.
- Blood pressure medication may interact with tramadol to cause
undesirably low blood pressure. If you are using this type of
medication (beta blockers, calcium channel blockers, etc.) speak
to your doctor about precautions like dose adjustments, even if
you are using the medication for another condition.
- Clozapine - Increased seizure risk with tramadol.
- Trazodone - Increased
- Ginseng - This herb acts as a mild MAO inhibitor, and should
not be combined with tramadol.
- Kava kava - Do not use this herb while taking tramadol.
- MAO inhibitors - Tramadol should not be mixed with MAO
(monoamine oxidase) inhibitors, a class of antidepressants and
antisenility drugs, such as selegiline, furazolidone, phenelzine, isocarboxazid, or tranylcypromine,
as this could increase the risk of seizure or death.
- Muscle relaxants such as cyclobenzaprine, metaxalone, carisoprodol,
may cause oversedation in combination with tramadol.
may also increase the risk of seizure.
- Primidone - May cause oversedation.
- Narcotic analgesics of any kind, like propoxyphene, meperidine,
Cialis, oxycodone, or hydrocodone should probably not be mixed with tramadol, as
this would increase the risk of oversedation. If your doctor has
suggested a rotating schedule for managing your pain with more
than one analgesic, arrange your dosage schedule so that these
medications are taken no closer together than 4-6 hours.
- Risk of oversedation.
- Protease inhibitors like amprenavir or ritonavir may cause a toxic buildup of
tramadol in the body.
- Sedatives like butalbital, phenobarbitol, Seconal, or
- Selective serotonin reuptake inhibitors (SSRIs) like citalopram, paroxetine,
fluoxetine, fluvoxamine, or sertraline
may increase seizure risk from tramadol.
- Sleep medication like zolpidem, zaleplon,
or over the counter sleeping pills should not be taken at the
same time as tramadol. Speak to your doctor or pharmacist about
arranging a medication schedule if you must take both.
- Street drugs - Marijuana may increase sedative effects from
tramadol. You should refrain from using any illegal drugs while
taking prescription medication, as it greatly increases the risk
of adverse side effects and overdose.
- St. John's Wort - Do not take this herb while taking tramadol.
- Carbamazepine - May make tramadol less effective.
- Ketorolac - Increased risk of seizure. Do not combine.
- Tranquilizers such as haloperidol, thioridazine,
or chlorpromazine may cause oversedation or lower
blood pressure to undesirable levels.
- Tricyclic antidepressants such as amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, and trimipramine, may increase
the risk of seizure in combination with tramadol.
- Valerian - Do not take this herb while taking tramadol.
A typical dose is 50-100 mg each 4-6 hours, not to
exceed 400 mg daily.
Do not increase your dose of tramadol without instructions from your
doctor. If you miss a dose, take it as soon as you remember, unless
it is almost time for your next dose. Skip the missed dose of
and resume your regular schedule. Do not take double doses of
Tramadol may be crushed, or taken with food or a beverage.
Inform your doctor, dentist, or anesthesiologist that you are taking
tramadol before any kind of surgery or medical test. Tramadol should
not be combined with certain medications given during surgery.
Store tramadol away from direct light and heat. Store in a dry location;
avoid storing tramadol in the bathroom, near sinks, or other areas where
it may become damp. Do not use tramadol after the expiration date.
Keep tramadol away from children; both when storing it, and when
discarding any unused medication.
Tramadol may cause drowsiness or disorientation. Be cautious if you
plan to drive or operate heavy machinery, avoid these activities
if you find yourself feeling tired or experience slowed reactions.
Birth defects and miscarriage have been reported in animal
studies of tramadol during pregnancy. You should not take tramadol if you are pregnant, or planning to become pregnant. It is inadvisable to use
tramadol while breastfeeding, as it could pass through to the infant.
Tramadol has not been determined to be either safe or effective for individuals under 18 years of age.
Individuals over 60 years of age are usually prescribed lower starting
doses of tramadol, and those doses are usually increased more slowly
than in other patients. However, tramadol is usually handled well
by individuals under the age of 75.
Some potential side effects may occur more often in seniors, and
any predisposition to these symptoms would indicate more careful
monitoring. There may be reduced clearance of creatinine, and the
patient should be monitored for any ill effects. In the first two
weeks of tramadol treatment look for signs of confusion or decreased coordination,
and be alert to a greater risk of falls due to unsteadiness. If
you experience symptoms of a swollen prostate, tramadol may increase
This document is provided for information only. It is not a substitute
for consultation with a physician, either to diagnose symptoms
or prescribe treatment. Any dosages mentioned are general
guidelines only, please follow the directions of your doctor
or exactly when taking tramadol. We have made
every effort to ensure that this information is accurate,
but only your doctor can say if tramadol, or a drug combination,
is safe for you. It should not be construed to indicate that
to order and use tramadol is safe, appropriate, or effective
for you. Consult your healthcare professional before you
order Tramadol online.