Tramadol at a glance
Medicine class
Opioid analgesic.
Main licensed use
Treatment of moderate to severe pain.
Available forms
Standard capsules, orodispersible tablets, prolonged-release tablets or capsules, and injection or infusion.
Driving and alcohol
Do not drive if tramadol affects alertness or coordination. Alcohol can increase sleepiness and serious adverse effects.
Dependence
Repeated use can cause tolerance, dependence and addiction. Sudden discontinuation may cause withdrawal.
What is Tramadol used for?
The selected UK products are licensed for pain relief.
Treatment of moderate to severe pain.
The injectable formulation may be given by a healthcare professional when a parenteral route is appropriate.
How does Tramadol work?
Tramadol weakly activates opioid receptors and reduces noradrenaline and serotonin reuptake in the central nervous system. Its active metabolite contributes to opioid activity. CYP2D6 variation means effectiveness and toxicity can differ between people.
Tramadol preparations and strengths
Capsule
Route: Oral
Strengths: 50 mg, 100 mg, 150 mg, 200 mg
Modified-release capsule
Route: Oral
Strengths: 50 mg, 100 mg, 150 mg, 200 mg
How to take Tramadol
Follow the dispensing label and instructions for your specific formulation.
Swallow standard capsules whole with water.
Allow an orodispersible tablet to dissolve on the tongue without chewing, or disperse it in water if the product instructions permit.
Swallow prolonged-release tablets or capsules whole. Do not crush, chew or suck them because this can release tramadol too quickly.
Injection or infusion is prepared and administered by a healthcare professional.
Tramadol side effects
Common or expected effects
- Nausea or vomiting
- Dizziness
- Sleepiness or headache
- Constipation
- Dry mouth
- Sweating
- Tiredness
Get urgent medical advice
- Slow or shallow breathing, profound sleepiness or inability to wake
- Seizure
- Facial, tongue or throat swelling, wheezing or other signs of anaphylaxis
- Possible serotonin syndrome: agitation or confusion with fever, sweating, muscle rigidity, twitching or poor coordination
- Severe opioid toxicity, including confusion, very small pupils and reduced consciousness
Tramadol in pregnancy
Use tramadol during pregnancy only after discussion with the prescriber, when the expected benefit outweighs possible risk. Available studies do not overall suggest increased miscarriage or birth-defect risk, but exposure near delivery can cause neonatal withdrawal, feeding problems or breathing difficulties. Do not stop regular tramadol suddenly without professional advice.
Tramadol while breastfeeding
Tramadol can sometimes be used cautiously while breastfeeding a healthy, full-term infant, following clinical assessment and with infant monitoring. Seek advice if the baby is unusually sleepy, feeds poorly, vomits or is not gaining weight; call 999 for breathing difficulty. Avoid sharing a bed with the baby while taking a sedating opioid.
Tramadol interactions
Tell the prescriber or pharmacist about all medicines, alcohol, herbal products and recreational drugs. Important interactions include:
Monoamine oxidase inhibitors, including phenelzine, moclobemide, selegiline and rasagiline
The combination can cause serious central nervous system, breathing and cardiovascular reactions and is contraindicated during treatment and for the specified washout period in the product information.
Benzodiazepines, sleeping medicines, sedating antihistamines, antipsychotics and other opioids
Additive sedation can cause respiratory depression, coma or death; combined use requires careful justification and monitoring.
Common questions about Tramadol
Answers are fully visible for fast scanning and source review.
Is tramadol hydrochloride an opioid?
Yes. It is a prescription opioid analgesic for moderate to severe pain.
Can tramadol hydrochloride cause addiction?
Yes. Dependence and addiction can occur during prescribed use. Warning signs include using it for reasons other than pain control or difficulty limiting use.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.