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What is Tramadol?

Tramadol is an opioid pain medication. It is available in the market with the brand name Ultram, which helps relieve moderate to moderately severe pain. However, it also manages severe pain enough to require an opioid analgesic and for which alternative treatments are inadequate. It is also available in injection along with oral tablets/ capsules and liquid.

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There is moderate evidence of its use as a second-line treatment for fibromyalgia as a secondary painkiller. It is also available in combination with acetaminophen (paracetamol) or as longer-acting formulations. On a dosage to dosage basis, it has about one-tenth of the potency of morphine and is equally potent to pethidine and codeine.

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Important Information about Tramadol

Do not use Tramadol for patients who are suicidal or prone to addiction. Tramadol can slow down or stop breathing and may be addictive. Misuse of medicines like Tramadol can cause overdose, addiction, or death.

Tramadol may increase serotonin levels in your body and rarely cause severe serotonin syndrome. However, go for medical help if you have serotonin syndrome symptoms such as hallucinations, fast heartbeat, severe dizziness, loss of coordination, severe vomiting, nausea, diarrhea, unexplained fever, twitching muscles, unusual agitation, or restlessness.

Taking Tramadol during pregnancy can cause life-threatening withdrawal symptoms to the newborn baby. Tell the doctor about your pregnancy (if you are pregnant) or plan to conceive. If you are breastfeeding, ask your doctor before taking Tramadol.

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What to know before taking Tramadol?

You should resist taking this medicine if you are allergic to it or if you have:

Breathing problems or asthma (severe)
Stomach or bowel obstruction, including paralytic ileus
If you have recently used sedatives, tranquilizers, alcohol, or narcotic medications
If you were using an MAO inhibitor within the last two weeks
To ensure Tramadol is safe for you, tell the doctor if you ever had:


Sleep apnea
Breathing problem
Liver or kidney disease
Problem with gallbladder, pancreas, or thyroid
Urination problems
A stomach disorder
Mental illness (or suicide attempt)

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How to take Tramadol?

Take Tramadol precisely as per the doctor’s prescription and follow all the directions on your prescription label. Resist taking all other around-the-clock narcotic pain medications when you start taking Tramadol.

Use a dosing syringe or a medicine dose-measuring device to measure the liquid medicine carefully. Do not crush or open an extended-release capsule or tablet (ConZip, Ultram ER). Instead, to avoid exposure to a potentially fatal dose, swallow the whole tablet/capsule.

Never inhale the powder of the tablet or mix it into a liquid to inject the drug into your vein. It may lead to death. It is normal to use a Tramadol ER tablet, and the tablet shell may pass into your bowel movement (stool).

Do not suddenly stop taking Tramadol. A sudden stop to the use of medicine may lead to unpleasant withdrawal symptoms. Instead, take your doctor’s help to stop taking this medicine safely.

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Usual adult dosage for pain (17 years or older)
50 to 100 mg orally every 4-6 hours
For the patients who do not require rapid onset of analgesic effect: initial dosage- 25 mg/day orally; titrate in 25 mg increments every three days to reach a dose of 25 mg four times a day; increase the quantity by 50 mg as tolerated every three days.
Maximum amount- 400 mg per day
Usual adult dose for chronic pain
ER: 18 Years or older (tramadol-naive)- 100 mg orally once a week

Individually titrate in 100 mg increments every five days to an effective dose.
Maximum dose- 300 mg/day
For patients currently receiving Tramadol IR:

Calculate 24 hour IR requirement and begin with a total daily ER dosage rounded down to the next lowest 100 mg/day increment orally.
Conversion from other opioids:

100 mg/day ER orally
Individually titrate in 100 mg increments every five days to an effective dose.
Maximum dose- 300 mg/day

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Overdose

If you have symptoms of overdose, take medical help. A tramadol overdose can be deadly, especially in a child or a person taking it without a prescription. Overdose symptoms of this drug may include slow or no breathing, pinpoint pupils, severe drowsiness.

Keep naloxone with you for emergencies on the doctor’s recommendation.

What to avoid while using Tramadol?

Avoid alcohol consumption because it can cause dangerous side effects or death.

Tramadol may cause impairment in your thinking or reactions. Avoid driving any vehicle or operating heavy machinery until you know how this medicine will affect you. Severe drowsiness or dizziness can cause accidental falls or serious injuries.

Tramadol side effects

Visit for emergency medical help if you have any allergic reaction due to the use of Tramadol. Allergic reaction symptoms may include rash, swelling, or itching, especially the face, throat, tongue, trouble breathing, severe dizziness.

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Common side effects:

Nausea;
Constipation;
Vomiting;
Lightheadedness;
Headache;
Dizziness; or
Drowsiness

Some of these side effects may reduce after a while of using this medicine. However, if any of these persist or are bothersome, tell your doctor or pharmacist instantly.

To prevent constipation, drink enough water, eat dietary fiber, and exercise. You may also need a good laxative with your doctor’s consultation.

To reduce the lightheadedness and dizziness risk, get up slowly while standing up from a lying or sitting position.

Tell the doctor immediately if you have severe side effects. It may include:

Mood swings or mental changes such as agitation and hallucinations;
Sleep apnea (interrupted breathing during sleep);
Difficulty urinating;
Severe stomach or abdominal pain;
Signs of non-efficient functioning of adrenal glands such as unusual tiredness, loss of appetite, weight loss;
Severe dizziness;
Fainting;
Fast or irregular heartbeat; or
Seizure

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What drugs can interact with Tramadol?

You might have withdrawal symptoms if you take certain other medications with Tramadol. Tell your doctor or pharmacist if you also use seizure medication, an antifungal drug, antibiotics, heart or blood pressure medication, or medicine to treat HIV or hepatitis C.

Interaction of Tramadol with various drugs can lead you to dangerous side effects or death. Ensure that your doctor knows about the medicines you take, including prescription and over-the-counter (OTC) medicines, herbal products, and vitamins.