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What is Tramadol?

Tramadol is a medicine that helps relieve ongoing moderate to moderately severe pain. It is similar to opioid analgesics, which work in the brain to change how your body feels and responds to pain.

Tramadol is available on prescription only. Therefore, you can easily order tramadol online if you have a prescription. However, many online pharmacies let you buy tramadol online without any prescription.

How to use tramadol?

Take tramadol as prescribed by your doctor. Follow all directions on your provided prescription label carefully. Take tramadol with or without food, but you must take it the same way each time.

Take this medication every 4 to 6 hours as needed for pain relief. The maximum recommended dose for this medicine is 400 milligrams per day. For people older than 75 years, the maximum recommended dose is 300 milligrams per day.

Opioids can slow or stop your breathing, especially when you start using these medicines or whenever your dose is changed. Avoid taking this medicine in larger amounts or for longer than prescribed. Tell your doctor immediately if the medicine seems to stop working as well in relieving your pain.

Before taking tramadol, you must stop taking all other around-the-clock narcotic pain medications.

This drug may be habit-forming, even at regular doses. Do not share this medicine with another person, especially someone with a history of drug abuse or addiction. Do not misuse this drug because it can cause addiction, overdose, or death, especially in people using the medicine without a prescription. Selling or giving away this drug is against the law.

Avoid opening, crushing, or breaking an extended-release tablet or capsule. Swallow the whole tablet or capsule to avoid exposure to a potentially fatal dose.

Do not crush or break a tablet. Do not inhale the powder or mix it into a liquid to inject the drug into your vein. Doing so may lead to death.

Suddenly stopping this drug may cause unpleasant withdrawal symptoms. The withdrawal symptoms include restlessness, mental or mood changes, nausea, diarrhea, sweating, or sudden behavior changes. You must ask your doctor how to stop using this medicine safely.

You must store this drug at room temperature away from moisture and heat. Always keep track of your medicine.

What to know before taking tramadol?

You should not take this drug if you are allergic to it or if you have:

  • blockage in your stomach or bowel 
  • severe asthma or breathing problems
  • if you have recently used narcotic medications, sedatives, tranquilizers, or alcohol

Do not give tramadol to a child younger than 12 years old. Ultram ER is not for people who are less than 18 years of age. 

Do not use tramadol if you have used an MAO inhibitor in the past 14 days. The MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Never give this medicine to children between 12 to 18 years of age who have conditions that may cause breathing problems.

Tramadol may cause seizures. The risk of seizures may be higher if you have ever had a head injury, epilepsy, or other seizure disorder.

You may also have seizures if you use certain antidepressants, muscle relaxants, opioids, or other medications.

To make sure if tramadol is safe for you, tell your doctor if you have ever 


  • liver disease
  • kidney disease
  • a stomach disorder
  • urination problems
  • mental illness, or suicide attempt
  • breathing problems such as sleep apnea
  • problems with your gallbladder, pancreas, or thyroid

Do not use tramadol during pregnancy. Doing so can make your baby dependent on the drug. It can cause life-threatening withdrawal symptoms in the baby after it is born. 

Do not breastfeed while using tramadol. You must tell your doctor at once if you notice severe drowsiness or slow breathing in the nursing baby.

What are the side effects of tramadol?

The common side effects of tramadol are as follows:

  • headache
  • itching
  • stomach pain
  • constipation, nausea, vomiting
  • dizziness, drowsiness, tiredness

Serious side effects

  • breathing problems such as noisy breathing, sighing, shallow breathing, breathing that stops during sleep
  • lightheadedness
  • a slow heart rate or weak pulse
  • missed menstrual period
  • seizure or convulsions
  • sexual problems, loss of interest in sex
  • loss of appetite, nausea, vomiting, dizziness, worsening tiredness, or weakness

Narcotic medicines such as tramadol can slow your breathing which may lead to death.

This drug may cause a condition known as serotonin syndrome. You must get medical attention right away if you have symptoms of serotonin syndrome. The symptoms of serotonin syndrome include agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Older adults may experience severe side effects of this drug, especially those who are overweight, malnourished, or debilitated.

The use of opioid medication for the long-term may affect fertility (ability to have children) in men or women.

What other drugs will affect tramadol?

Some drugs can affect the removal of tramadol from your body, which may affect how tramadol works. Example of these drugs include: 

  • quinidine
  • azole antifungals such as itraconazole
  • HIV drugs such as ritonavir, macrolide antibiotics such as erythromycin, rifamycins such as rifampin
  • drugs that help treat seizures, such as carbamazepine

Drugs that may interact with tramadol include pain medications such as pentazocine, nalbuphine, butorphanol, or naltrexone.

Do not take MAO inhibitors with this medicine because it may cause a serious drug interaction. Avoid taking MAO inhibitors such as isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, and tranylcypromine during treatment with this medication. Do not take MAO inhibitors for two weeks before treatment with this medication. Do not start or stop taking this drug without asking your doctor.

Make sure to tell your doctor if you are taking other products such as:

  • other opioids such as codeine, hydrocodone
  • alcohol
  • marijuana (cannabis)
  • drugs to treat anxiety such as alprazolam, lorazepam, zolpidem
  • muscle relaxants such as carisoprodol, cyclobenzaprine
  • antihistamines such as cetirizine, diphenhydramine

Taking drugs such as MDMA and certain antidepressants with this medicine increases the risk of serotonin syndrome.

If you take these drugs with tramadol, it may increase the risk of severe side effects, including drowsiness or breathing problems.