Tramadol is a painkiller used to treat moderate to severe pain. It is available only by prescription and comes as tablets, capsules or liquid to take by mouth. If taken in high dosages or for long periods, it can lead to addiction.

The interaction between this medicine and certain drugs, such as sedatives or antidepressants (isocarboxazid linezolid phenelzine rasagiline selegiline tranylcypromine) can be dangerous. It can cause serious side effects, or even death.

What is tramadol used for?

Tramadol, an opioid pain reliever that works on the brain chemicals serotonin and norepinephrine to reduce moderate to severe pain. It’s used to treat chronic pain, such as arthritis. Sometimes it’s used to treat breakthrough pain after an accident or surgery. This medicine can increase your risk of seizures if you have seizures or a history of them. It’s not for use in children under 12 years old. This drug can cause side effects that can be dangerous or life threatening, especially when taken with certain other medications.

While you are taking this drug, your doctor will need to monitor your progress frequently. Your blood and liver function may need to be tested. This medication can be habit-forming, so don’t take more than your prescribed dose. Talk to your doctor if you have a high risk of misusing or developing a substance use disorder. It’s usually safe to take non-opioid pain medications (such as acetaminophen, ibuprofen) with tramadol.

Very serious side effects, including slowed or stopped breathing, can happen if you take too much of this medication. If you have these symptoms, get emergency medical help right away: blue colored lips, trouble breathing, seizures, hives, severe sweating, fast or shallow breathing, unusual lightheadedness, or very drowsy feeling. If you mix this drug with alcohol, or any other substance that makes you sleepy or slows down your body’s ability to eliminate it, it can cause breathing problems.

This medication can also cause side effects that can be fatal if you swallow it by mouth in large amounts or for a long time. This includes tablets, crushed or chewed pills, liquid, and injectable forms of this medication. It can also be deadly if it’s mixed with other substances that are toxic to the stomach (such as antidepressants, narcotics, or antacids) or with food or drinks that are acidic or caffeinated.

Ask your pharmacist or doctor for a list of other ingredients in this medication. This medication should not be used if there is an allergy to tramadol, any opioid pain medicines, severe breathing issues, such as blockage of the stomach, intestines or paralytic Ileus (condition in which digested foods do not move through your digestive system). You should also stop breast-feeding while using this medication.

How should I take tramadol?

Before taking tramadol, tell your doctor if you have any other medical conditions, including liver disease; a blockage or narrowing of the stomach or intestines; paralytic ileus (condition in which digested food does not move through the intestines); low blood levels of sodium; problems with your nervous system, such as spinal cord injury or multiple sclerosis; a history of seizures; or if you are taking antidepressants or narcotics. Tell your doctor as well if you plan on becoming pregnant. Research in animals shows that tramadol can harm the fetus.

Take this medication with or without food as directed by your doctor. Do not chew or split extended-release tablet. Swallow them whole. Ask your doctor whether a liquid or tablet form might make it easier to swallow. For the liquid form of this medication, measure each dose carefully using a special measuring device/spoon. Do not use a household spoon because it may not give you the correct dose.

Tramadol can cause you to sleepy, so avoid alcohol and other drugs that make you sleepy. You may experience serious side effects such as death or an overdose.

This medication can cause dizziness and drowsiness. If these effects occur, do not drive or work around machinery. Get emergency medical help if you have severe dizziness or drowsiness, slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Tramadol may raise your chance of seizures, especially if you have a history of head injury or brain tumor. If you experience a seizure or other seizure symptoms, including shaking, loss in coordination, a sore back or neck, nausea, and a high temperature, you should seek emergency medical attention.

Do not share your medication, even if the symptoms are the same. MISUSE can lead to addiction, overdose, or death. Keep this medication where children cannot reach it.


Tramadol can be used by adults to relieve moderate to severe chronic pain. It belongs to a group of medications called opiate (narcotic) analgesics. The drug works on the nervous system and brain to alter how you feel and react to pain. Your doctor will decide how much tramadol to give you and how often you should take it. Please follow your doctor’s directions.

Taking too much of this medication can cause serious problems, including death. If you think you have taken too much, call your doctor or go to the nearest emergency room right away. Inform your pharmacist or doctor if you have an allergy to the medication. Also tell your doctor if you have kidney or liver disease. Your doctor may need to check your blood pressure, heart rate, and blood clotting levels while you are taking this medicine.

Do not drink alcohol or take other drugs that can make you sleepy while taking tramadol. This includes prescription and nonprescription medicines, vitamins, and supplements. Tell your doctor about any medical conditions, such as high blood pressure or diabetes. If you are pregnant or breastfeeding, do not take this medication. The medication can pass into the breast milk, which could be harmful to a child. You can ask your doctor if you should use a different type of pain medicine.

Your doctor will start you on a low dose of tramadol and gradually increase your dosage. The typical starting dose for oral or immediate-release tablets is 25 to 100mg every 4 to 5 hours, depending on the severity of pain. Your doctor will also start you on a low dose of extended-release tablets or capsules. Typical starting dosages for this form of tramadol are 50 to 100 mg every 12 to 24 hours as needed for pain. Your doctor will slowly increase your extended-release dose to the highest dose that is safe for you.

MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION OR DEATH, especially in children or people who use it without a prescription. Keep it out of the reach of children and do not share it with others. This medicine can slow or stop your breathing, and it can also become habit-forming. Do not take this medicine if you are addicted to it or have had serious breathing problems in the past, such as a blockage of your stomach or intestines, or if you are taking an MAO inhibitor, including isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, or tetracycline.


Taking too much tramadol or taking it more often than prescribed can cause an overdose. Signs of an overdose include not responding to sound or touch, extremely slowed breathing, extreme sleepiness and cold or clammy skin. If you or someone you know has these symptoms, call 911. Overdose can lead to death. Speak to your doctor if you are on other medications or have an ongoing health problem. You may need to be carefully monitored and your doses changed. Tramadol can interact with a number of other medicines, including antidepressants and anti-seizure medications, some herbal products, and some foods and drinks.

Tramadol overdose is uncommon, but can still happen. Overdoses are most often caused by taking too much tramadol or mixing it with another drug. Taking other substances increases the chance of having a life-threatening overdose because their effects usually stack. It is particularly true if your health conditions affect how you metabolize drugs. For example, a liver disorder or an obstruction in your digestive tract or paralytic ileus.

Tramadol can also interact with certain antipsychotic drugs, including methylphenidate and amphetamines, to increase the risk of seizures. Tell your doctor if you suffer from a seizure condition before using this drug. This medication can lower thresholds for seizures for some individuals and therefore is not recommended to anyone who has uncontrolled epilepsy.

Tramadol may also cause confusion or hallucinations in your brain. It can raise the levels of the chemical serotonin in your body and can cause a severe nervous disturbance known as serotonin syndrome. This can cause serious heart problems, such as low pressure, cardiac arrest, or even death.