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  • Tramadol Side Effects, Dosage, & Warnings

    Tramadol Side Effects, Dosage, & Warnings

    Tramadol is considered an opioid, a central nervous system depressant, and a pain reliever for acute and chronic pain. It’s available under the brand names Ultram, Ultram ER, ConZip, and Ryzolt. 

    While tramadol does work to relieve moderate and severe pain, it also comes with a variety of side effects that may occur after a period of use or abuse.

    Tramadol Side Effects

    Side effects of tramadol can range from mild to severe depending on the person taking it. The most common side effects include:

    • constipation
    • nausea
    • dizziness
    • headache
    • vomiting
    • anxiety
    • depression
    • mood swings
    • sleepiness
    • muscle spasms
    • weakness
    • diarrhea
    • dry mouth
    • numbness
    • seizures
    • tremors
    • high blood pressure 
    • respiratory depression
    • serotonin syndrome

    Tramadol Usage

    Tramadol is a prescription drug given as a pain medication for moderate to severe pain when treating:

    • pain after surgery
    • serious injury
    • fibromyalgia
    • back pain
    • sciatica

    Tramadol works by binding to the opioid receptors in the brain that are used to transmit pain from the body to the brain.

    Tramadol Dosages

    The dosing of any drug, including tramadol, depends on the person taking it. That being said, some dosages are more common than others and there’s a limit to how much is safe to prescribe.

    Doctors usually start people on a low dose of tramadol and then increase it as needed. The recommended dose in its immediate-release formulation is usually between 50-100 mg every 4-6 hours as needed with the maximum recommended dose being 400 mg per day.

    The recommended dose for the extended-release formulation is 100 mg per day and shouldn’t exceed more than 300 mg per day.

    These recommendations can change based on age. Children 12-16 and elderly people over 65 usually take less than adults ages 18-65.

    Tramadol Warnings

    Tramadol comes with several warnings, including the potential for abuse and addiction, dependence and withdrawal, breathing problems, drug interactions, allergies, and use during pregnancy.

    Abuse & Addiction

    Tramadol comes with a risk of abuse and addiction. After repeated use, your body can build up a physical dependence on the drug. For this reason, the Food and Drug Administration (FDA) considers it a Schedule IV controlled substance.

    Your health care provider should start you on the lowest dose possible and monitor you while on it to reduce the risk of abuse and addiction. Listening to their medical advice can be vital to lowering your risk of opioid use disorder.

    Dependence & Withdrawal

    If you suddenly stop taking tramadol, withdrawal symptoms may occur. This happens when your body grows a physical dependence on the drug and then doesn’t get it. 

    Tramadol withdrawal symptoms can include:

    • panic
    • sweating
    • difficulty falling asleep/staying asleep
    • loss of appetite
    • sneezing
    • pain
    • chills
    • nausea
    • uncontrollable shaking
    • diarrhea

    Breathing Problems

    Tramadol may also cause severe breathing problems. To lower this risk, your health care provider may try to keep you on the lowest dose possible and limit how long you take it.

    The risk of breathing problems is highest when you first start the medication and after a dose increase. It also can happen if you overdose

    Taking tramadol with alcohol can also cause breathing problems that can be fatal. 

    It’s important to get help immediately if you start experiencing slow breathing, difficulty waking up, severe drowsiness, or dizziness.

    Drug Interactions

    You and your doctor should both be aware of all the medications you’re taking so there are no adverse drug interactions. Some drugs that shouldn’t be taken with tramadol include:

    • antidepressants, MAOIs, and linezolid: can bring on serotonin syndrome causing vomiting and nausea
    • benzodiazepines: can cause slowed breathing, coma, and death
    • oxycodone and hydrocodone: can cause confusion, slowed breathing, decreased blood pressure, coma, and death

    As with any medication you’ve never taken before, there’s also a chance of an allergic reaction with tramadol.


    Babies who are breastfeeding should also be monitored if their mothers are taking tramadol. They can be exposed to tramadol through breast milk and experience symptoms such as excess sedation and respiratory depression. 

    If you’re struggling with tramadol addiction, contact our helpline today. It’s never too early or too late to receive treatment.

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Drug Enforcement Administration (DEA) - Tramadol
    Food and Drug Administration (FDA) - Tramadol Prescribing Information
    National Center for Biotechnology Information - Tramadol
    National Library of Medicine: MedlinePlus - Tramadol

    Medically Reviewed by
    Kimberly Langdon M.D.
    on February 1, 2023
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