What is tramadol?

Tramadol is a strong opioid-type painkiller (sometimes called an opiate or narcotic) that’s used to relieve moderate to severe pain. It’s only available on prescription.

Tramadol comes as tablets, capsules and oral drops, and may be given by injection or drip if you’re in hospital.

Invodol, Mabron, Maneo, Marol, Maxitram, Oldaram, Tilodol, Tradorec, Tramquel, Tramulief, Zamadol, Zeridame and Zydol are all brand names for tramadol.

Tramacet contains tramadol in combination with paracetamol.

What is tramadol used for?

Short-term relief of moderate to severe pain, for example pain following an operation or injury.

Relieving chronic moderate to severe pain when weaker painkillers haven’t been effective.

Key facts about tramadol

Tramadol is suitable for adults and children aged 12 years and over.

Tramadol comes as fast-acting forms that are usually taken three to four times a day, and slow-release forms that are taken once or twice a day.

Tramadol can be addictive, but addiction is rare when it’s taken as directed by a doctor to relieve pain.

The most common side effects are feeling sick, dizzy or sleepy.

Don’t drink alcohol while taking tramadol.

It may be an offence to drive while taking tramadol.

Tramadol is a schedule 3 controlled drug that has the potential to be abused. Keep it safe and never give it to anyone else.

How does tramadol work?

Strong opioid painkillers like tramadol relieve pain by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.

The action of our natural endorphins by combining with the same opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain and means that even though the cause of the pain may remain, less pain is actually felt.

Tramadol also enhances the activity of certain neurotransmitters in the brain and spinal cord. Neurotransmitters are chemical compounds that act as messengers between the nerve cells. Tramadol enhances the effect of the neurotransmitters serotonin and noradrenaline, and this action also helps relieve pain.

Is tramadol addictive?

Addiction can be a problem when opioids like tramadol are used recreationally. But if you’re taking tramadol to relieve pain, it’s highly unlikely that you will get addicted to it in the psychological sense, because you’re not taking it to get a ‘high’.

If you need to take tramadol for long periods of time your body can become tolerant to it, so it may get less effective and you may then need higher doses to control pain. It is also possible to become dependent on tramadol if you take it for a long time, but this is much less likely than with other opioids. It’s not usually a problem when you stop taking it, because withdrawal symptoms can generally be avoided by reducing treatment gradually.

It’s important that you don’t take a higher dose of tramadol than prescribed by your doctor, or take it for longer than they recommend. When stopping treatment always follow your doctor’s instructions.

Who can and can’t take tramadol?

Tramadol is suitable for most adults and children aged 12 years and over.

Tramadol should not be taken by:

  • Children under 12 years of age.
  • People under the influence of (intoxicated with) alcohol, sleeping tablets, tranquilizers, psychotropic drugs (those affecting mood or emotions) or other opioid painkillers, eg morphine, codeine.
  • People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days.
  • People with uncontrolled epilepsy.
  • People who are allergic to any ingredients of the medicine. If you feel you have experienced an allergic reaction, stop taking the medicine and inform your doctor or pharmacist immediately.

Some people, in particular the elderly, might need a lower tramadol dose or extra monitoring. Make sure your doctor knows if you:

  • have kidney or liver problems.
  • have a head injury or raised pressure in the brain (intracranial pressure).
  • have reduced levels of conciousness.
  • have slow, shallow breathing (respiratory depression), or other lung conditions or breathing difficulties, for example asthma.
  • have been constipated for more than a week or have inflammatory bowel disease such as ulcerative colitis or Crohn’s disease
  • have difficulty passing urine, for example due to an enlarged prostate gland
  • have an underactive thyroid gland
  • have reduced production of natural steroid hormones by the adrenal glands (adrenocortical insufficiency)
  • have a condition called myasthenia gravis, in which there is abnormal muscle weakness
  • have a history of drug dependence or abuse
  • have a history or risk of having convulsions (fits or seizures), eg epilepsy.

Can I take tramadol while pregnant or breastfeeding?

Tramadol is not normally used during pregnancy because its safety is not established and it could have harmful effects on a developing baby. It could cause withdrawal symptoms in a newborn baby if used during late pregnancy. If you are or think you could be pregnant you should get advice from your doctor before taking tramadol.

Tramadol passes into breast milk in small amounts. If you’re breastfeeding you should only take tramadol if you have discussed the risks and benefits with your doctor. If your doctor agrees you can use tramadol while breastfeeding, it’s important to monitor the baby and let your doctor know immediately if they become more sleepy than usual, or have any difficulty breastfeeding, breathing difficulties or limpness.

Dosage: How do I take tramadol and how often?

Your doctor may ask you to take tramadol on a regular basis, or only when needed to relieve pain. Always follow their instructions. These will also be printed on the label that your pharmacist has put on the packet of medicine. If you’re unsure about anything ask your pharmacist for advice.

Tramadol comes as fast-acting capsules, soluble tablets, tablets that melt in the mouth (orodispersible tablets) and oral drops. It also comes as slow-release capsules and tablets. The way to take it depends on what form you have been prescribed.

All forms of tramadol can be taken either with or without food.

How do I take fast-acting tramadol?

Tramadol capsules, soluble tablets, oral drops and orodispersible tablets start to work quickly and their effects wear off after a few hours. Fast-acting forms such as these may be prescribed to take only when needed to relieve pain, or on a regular basis, depending on the cause of your pain.

The usual dose for a healthy adult is 50mg to 100mg every four to six hours, up to a maximum of 400mg in 24 hours, but always follow the instructions given by your doctor.

Tramadol soluble tablets should be dissolved in at least 50ml water before taking.

Tramadol orodispersible tablets should be sucked and then swallowed. Alternatively they can be dispersed in half a glass of water before taking.

How do I take slow-release tramadol?

Tramadol modified-release capsules and modified-release tablets are designed to release tramadol slowly and continuously over 12 or 24 hours as the medicine passes through the gut. This provides steady blood levels of the medicine over the day and prolonged pain relief. These forms of tramadol are taken on a regular basis to control ongoing pain.

You may be given a 12-hourly or 24-hourly formulation and it’s important to know which you have been prescribed.

Brands that should be taken twice a day at 12 hour intervals (eg 8am and 8pm) include: Invodol SR, Mabron, Maneo, Marol, Maxitram SR, Oldaram, Tilodol SR, Tramquel SR, Tramulief SR, Zamadol SR, Zeridame SR and Zydol SR.

Brands that should be taken once a day at the same time each day (every 24 hours) include: Tradorec XL, Zamadol 24hr and Zydol XL.

⚠️ Tramadol modified-release capsules and tablets must be swallowed whole. Do not break, crush or chew them, as this will cause the whole dose to be rapidly absorbed into your body, which could result in an overdose.

Talk to your doctor if you have trouble swallowing, because some brands of modified-release capsules can be opened so you can swallow just the contents without chewing. Check the leaflet provided with your capsules to see if this is the case.

How long should I take tramadol for?

Keep taking tramadol for as long as your doctor tells you to. If you’ve been taking it for long periods of time you shouldn’t stop taking it suddenly – your dose should be reduced gradually. Always follow your doctor’s instructions.

What should I do if I miss a tramadol dose?

This depends on the form of tramadol you’re taking and how late you are taking the dose. Read the leaflet provided with your medicine to find out what to do, or call your doctor or pharmacist for advice. Never take a double dose of tramadol to make up for a missed dose.

What if I take too much tramadol?

If you accidentally take more than your prescribed tramadol dose, or if someone has taken a tramadol overdose, you should contact your doctor immediately, or go to the accident and emergency department of your nearest hospital. Take the container with you, even if it’s empty.

Can I drink alcohol while taking tramadol?

No, it’s best avoided. Drinking alcohol with tramadol will make you more likely to feel sleepy, dizzy or confused, or get other side effects like blurred vision.

Can I drive while taking tramadol?

It may be an offence to drive while you are taking tramadol. Do not drive if you think it affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision.

If you are driving dangerously while taking tramadol you will be breaking the law. If you feel you are safe to drive while taking tramadol, it may be sensible to carry your prescription with you in case you are asked to take a saliva test by the police. If you test positive for tramadol there is a medical defence if you are taking it as prescribed, as long as your driving is not impaired.

What are the side effects of tramadol?

It’s hard to predict how likely you are to get side effects from tramadol. It depends on the dose you’re taking and any conditions you have that might make you more susceptible to problems. In general, tramadol side effects are more likely with higher doses, but some people are more sensitive to opioids and might get side effects at lower doses – medicines and their possible side effects can affect people in different ways.

The following are some of the side effects that can be associated with tramadol. Ask your doctor or pharmacist for advice if you’re troubled by any of these, because there is often a solution.

Very common side effects (affect more than 1 in 10 people)

  • Feeling sick.
  • Dizziness. Don’t drive if affected.
  • Common side effects (affect between 1 in 10 and 1 in 100 people)
  • Feeling sleepy or tired. Don’t drive if affected.
  • Headache.
  • Vomiting.
  • Constipation.
  • Dry mouth.
  • Sweating.

Dosage

Tramadol has a half-life of 6.3 hours; however, it can take about a day and a half for the drug to completely exit your body.

Tramadol can be detected in the urine, hair, saliva, and blood:

  • In urine, tramadol can be detected within 2 hours and can be detected for up to 40 hours.
  • In hair, tramadol can be detected for up to 90 days.
  • In saliva, tramadol can be detected for up to 24 hours.
  • In blood, tramadol can be detected for up to 24 hours.

The amount of time it takes for Tramadol to exit your body can depend on multiple factors.

In 2012, it was estimated that approximately 2.1 million people in the United States suffered from substance misuse related to prescription pain pills, known as opioids. One such prescription pill is tramadol, a medication that can be detected in the body through a number of testing methods. In order to understand how this testing works, it is important to understand what tramadol is and how it affects the body.