Tramadol: Uses, Side Effects, and Safety

Tramadol is a synthetic pain reliever, or analgesic, that shares similarities with morphine in how it works. While the exact mechanism of action is not fully understood, it, like morphine, binds to opioid receptors in the brain, which are crucial for transmitting pain sensations from the body to the brain. This article aims to provide insights into what tramadol is used for, its potential side effects, and safety considerations.

Uses of Tramadol

Tramadol is prescribed by doctors to manage moderate to moderately severe pain in adults. Additionally, extended-release tramadol tablets are utilized for persistent chronic pain in adults requiring continuous treatment.

It’s important to note that tramadol should not be used to treat pain in children under 12 years old, nor should it be used for pain management after tonsil or adenoid removal in individuals under 18 years old. Furthermore, adolescents between 12 and 18 years old who are overweight or have certain breathing issues should avoid tramadol.

Common Side Effects

Tramadol is generally well-tolerated, and its side effects are typically temporary. Some commonly reported side effects include:

  1. Nausea
  2. Constipation
  3. Dizziness
  4. Headache
  5. Euphoria
  6. Indigestion
  7. Spasticity
  8. Weakness
  9. Drowsiness
  10. Vomiting

Less frequently reported side effects encompass itching, sweating, dry mouth, diarrhea, rash, visual disturbances, and vertigo. It’s essential to keep in mind that some patients using tramadol have experienced seizures, and it can induce serotonin syndrome when combined with certain other medications.

Addictive Nature of Tramadol

Tramadol falls into the category of narcotics and is recognized as addictive. It is classified as a Schedule IV controlled substance, associated with the potential for addiction, abuse, and misuse. It’s worth noting that even when taken as prescribed by a doctor, tramadol can lead to addiction. Abruptly discontinuing tramadol after long-term use can result in withdrawal symptoms.

Withdrawal symptoms may include:

  1. Restlessness
  2. Excessive tear production
  3. Yawning
  4. Sweating
  5. Chills
  6. Muscle pain
  7. Anxiety
  8. Backache
  9. Joint pain
  10. Weakness
  11. Abdominal cramps
  12. Insomnia
  13. Nausea
  14. Weight loss
  15. Vomiting
  16. Diarrhea
  17. Increased blood pressure
  18. Respiratory rate
  19. Heart rate

Additionally, infants born to mothers who used tramadol during pregnancy might exhibit withdrawal symptoms and breathing difficulties.

Dosage and Administration

Tramadol is typically administered in immediate-release tablets at 50 mg to 100 mg every 4-6 hours as needed for pain. The maximum daily dose should not exceed 400 mg. To enhance tolerance, patients often begin with 25 mg/day, with doses increased gradually by 25 mg to 50 mg every 3 days until reaching 50-100 mg/day every 4 to 6 hours.

Extended-release tablets are usually taken at 100 mg daily, with increments of 100 mg every 5 days, not exceeding 300 mg/day. Converting from immediate release to extended release involves rounding down the total daily dose to the nearest 100 mg. These tablets should be swallowed whole and not crushed or chewed. Tramadol may be taken with or without food.

Interactions with Other Drugs

Several medications can interact with tramadol, affecting its efficacy or leading to adverse effects. Some notable interactions include:

  1. Carbamazepine: Reduces tramadol’s effectiveness.
  2. Quinidine: Increases tramadol concentration.
  3. Monoamine oxidase inhibitors (MAOIs) and selective serotonin inhibitors (SSRIs): May result in severe side effects like seizures or serotonin syndrome.
  4. Alcohol, anesthetics, narcotics, tranquilizers, or sedative-hypnotics: Combining these substances with tramadol may lead to central nervous system and respiratory depression, potentially reducing consciousness levels or causing respiratory issues.

Safety During Pregnancy and Breastfeeding

The safety of tramadol during pregnancy has not been established. Pregnant individuals should exercise caution when considering its use.

Breastfeeding mothers should avoid tramadol, as it can lead to side effects in the infant and withdrawal symptoms, including breathing difficulties.


Tramadol, an opioid painkiller, is employed to manage moderate to moderately severe pain in adults. While it is generally well-tolerated, it possesses the potential for addiction and withdrawal symptoms. Adherence to prescribed dosages and medical advice is crucial. Patients should be aware of potential side effects and drug interactions, and both pregnant individuals and breastfeeding mothers should exercise caution. Tramadol is available by prescription only and should be stored at room temperature in a sealed container. Always consult with a healthcare professional for personalized guidance and recommendations regarding tramadol use.

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