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Tramadol is a prescription pain medication. Some side effects are more common than others. Doctors only prescribe tramadol to people over 12 years old. Adolescents with certain risk factors should speak with their doctors about the risks of taking tramadol.
Some people take tramadol for premature ejaculation and restless legs syndrome, but the Food and Drug Administration (FDA) have not approved these uses of it.
As an opioid drug, tramadol acts on the brain to relieve pain. However, tramadol is not as effective as morphine, which is another opioid. Because of its opioid activity, people can become dependent on tramadol.
Ultram and Ultram ER are the brand names of the drug tramadol. They are available in the form of immediate and extended release tablets. Tramadol is also combined with acetaminophen in the drug Ultracet.
The following table lists the available dosages of tramadol in milligrams (mg).
| Brand name | Active ingredient and dosage | Type of release |
| Ultram | tramadol 50 mg | immediate release |
| Ultram ER | tramadol 100 mg tramadol 200 mg tramadol 300 mg |
extended release |
| Ultracet | acetaminophen 325 mg tramadol 37.5 mg |
immediate release |
Tramadol acts on two compounds associated with the sensation of pain: serotonin and norepinephrine. Tramadol helps relieve pain by decreasing the amount of these two compounds in brain cells.
Liver enzymes break down tramadol into another compound called O-desmethyltramadol, which binds to the opioid receptor. This is the same receptor that morphine binds to, but tramadol is not as strong as morphine; its efficacy is “about one-tenth that of morphine.”
The FDA classify tramadol as a schedule IV drug because of its potential for misuse and addiction. It belongs to the same scheduleas Xanax, Soma, and Valium.
Doctors should choose the lowest effective dosage for the shortest period and educate people on the possible risks of taking tramadol.
Side effects
Tramadol can cause side effects in some people. They occur more often when people first start taking tramadol and can wear off over time.
The most common side effects of tramadol affect the abdominal tract and the brain.
The following list provides common side effects that occur in 5% or more of people who take tramadol:
- dizziness and vertigo
- nausea
- constipation
- headache
- drowsiness
- vomiting
- itchiness
- stimulation of the central nervous system
- weakness
- sweating
- heartburn
- dry mouth
- diarrhea
Less common side effects
People may experience other side effects that occur with an incidence of less than 5%, such as:
- whole body discomfort
- allergic reactions
- suicidal tendencies
- weight loss
- rapid heartbeat
- drop in blood pressure upon standing up
- confusion
- disturbance in coordination
- constriction of the pupil
- fainting
- rash
- hives
- visual disturbance
- menopausal symptoms
- retention of urine
- difficulty breathing
- frequent urination
- serotonin syndrome
Serious side effects
Serious side effects may also occur in some people.
Some serious side effects include:
- respiratory depression
- serotonin syndrome
- heart rhythm problems called QT prolongation
The following sections discuss these serious side effects.
Respiratory depression
Respiratory depression is a serious side effect that may occur in people taking tramadol. If a person has difficulty breathing while taking tramadol, they must seek emergency medical attention.
People can experience respiratory depression with usual dosages of tramadol. Respiratory depression usually occurs when the person starts taking tramadol or when they increase their dosage.
People who overdose on tramadol are at an even greater risk of respiratory depression. Combining certain drugs with tramadol can also increase the risk of respiratory depression.
Some people are more at risk than others. Some people’s bodies break down tramadol into O-desmethyltramadol much more quickly and completely. This can result in higher levels of this compound in the bloodstream and lead to respiratory depression.