Tramadol

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common or rare

  • Abdominal or stomach fullness
  • Abnormal or decreased touch sensation
  • Blisters under the skin
  • Bloating
  • Blood in the urine
  • Blood pressure increased
  • Blurred vision
  • Change in walking and balance
  • Chest pain or discomfort
  • Chills
  • Convulsions (seizures)
  • Darkened urine
  • Difficult urination
  • Dizziness or lightheadedness when getting up from a lying or sitting position
  • Fainting
  • Fast heartbeat
  • Frequent urge to urinate
  • Gaseous abdominal or stomach pain
  • Heart rate increased
  • Indigestion
  • Irregular heartbeat
  • Loss of memory
  • Numbness and tingling of the face, fingers, or toes
  • Numbness, tingling, pain, or weakness in the hands or feet
  • Pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion
  • Pain or discomfort in the arms, jaw, back, or neck
  • Pains in the stomach, side, or abdomen, possibly radiating to the back
  • Pale bluish-colored or cold hands or feet
  • Recurrent fever
  • Seeing, hearing, or feeling things that are not there
  • Severe cramping
  • Severe nausea
  • Severe redness, swelling, and itching of the skin
  • Shortness of breath
  • Sweats
  • Trembling and shaking of the hands or feet
  • Trouble performing routine tasks
  • Weak or absent pulses in the legs
  • Yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  • Change in consciousness
  • Decreased awareness or responsiveness
  • Difficulty with breathing
  • Lack of muscle tone
  • Lightheadedness
  • Loss of consciousness
  • Pinpointed pupils of the eyes
  • Severe sleepiness
  • Shortness of breath
  • Slow or irregular heartbeat
  • Unusual tiredness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Abdominal or stomach pain
  • Agitation
  • Anxiety
  • Constipation
  • Cough
  • Diarrhea
  • Discouragement
  • Drowsiness
  • Dry mouth
  • Feeling of warmth
  • Feeling sad or empty
  • Feeling unusually cold
  • Fever
  • General feeling of discomfort or illness
  • Headache
  • Heartburn
  • Irritability
  • Itching of the skin
  • Joint pain
  • Loss of appetite
  • Loss of interest or pleasure
  • Loss of strength or weakness
  • Muscle aches and pains
  • Nausea
  • Nervousness
  • Redness of the face, neck, arms, and occasionally, upper chest
  • Restlessness
  • Runny nose
  • Shivering
  • Skin rash
  • Sleepiness or unusual drowsiness
  • Sore throat
  • Stuffy nose
  • Sweating
  • Tiredness
  • Trouble concentrating
  • Unusual feeling of excitement
  • Weakness

Less common or rare

  • Abnormal dreams
  • Appetite decreased
  • Back pain
  • Bladder pain
  • Blistering, crusting, irritation, itching, or reddening of the skin
  • Bloody or cloudy urine
  • Body aches or pain
  • Change in hearing
  • Clamminess
  • Cold flu-like symptoms
  • Confusion
  • Cough producing mucus
  • Cracked, dry, or scaly skin
  • Decreased interest in sexual intercourse
  • Difficult, burning, or painful urination
  • Difficulty with moving
  • Disturbance in attention
  • Ear congestion
  • Ear drainage
  • Earache or pain in ear
  • Excessive gas
  • Fall
  • False or unusual sense of well-being
  • Feeling hot
  • Feeling jittery
  • Flushing or redness of the skin
  • General feeling of bodily discomfort
  • Goosebumps
  • Headache, severe and throbbing
  • Hoarseness
  • Hot flashes
  • Inability to have or keep an erection
  • Itching, pain, redness, swelling, tenderness, or warmth on the skin
  • Joint sprain
  • Joint stiffness
  • Joint swelling
  • Loss in sexual ability, desire, drive, or performance
  • Loss of voice
  • Lower back or side pain
  • Muscle aching or cramping
  • Muscle injury
  • Muscle pain or stiffness
  • Muscle spasms or twitching
  • Nasal congestion
  • Neck pain
  • Night sweats
  • Pain
  • Pain in the limbs
  • Pain or tenderness around the eyes and cheekbones
  • Pain, swelling, or redness in the joints
  • Skin discoloration
  • Swelling
  • Swelling of the hands, ankles, feet, or lower legs
  • Tightness of the chest
  • Trouble in holding or releasing urine
  • Trouble with sleeping
  • Troubled breathing
  • Weight increased or decreased

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

  • Gooseflesh
  • High blood pressure
  • Increased sweating
  • Increased yawning
  • Shivering or trembling
  • Unusually large pupils

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Precautions

It is very important that your doctor check your progress at regular visits to make sure the medicine is working properly and to check for any unwanted effects.

This medicine will add to the effects of alcohol and other CNS depressants (medicine that makes you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Do not drink alcoholic beverages, and check with your doctor or dentist before taking any of these medicines while you are using this medicine.

Make sure your doctor knows about all the other medicines you are using. This medicine may increase your risk for seizures. (convulsions) and may cause a serious condition called serotonin syndrome.

This medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed or have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or get worse quickly. Make sure your caregiver knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Tell your doctor if you have any sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let your doctor know if you or anyone in your family has bipolar disorder (manic-depressive disorder) or has tried to commit suicide.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; swelling of your hands, face, or mouth; or chest pain while you are using this medicine.

This medicine may cause some people to become drowsy, dizzy, lightheaded, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Make sure your doctor knows if you are pregnant, may be pregnant, or planning to become pregnant.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem.

Nausea or vomiting may occur, especially after the first couple of doses. This effect may go away if you lie down for awhile. However, if nausea or vomiting continues, check with your doctor. Lying down for a while may also help relieve some other side effects, such as dizziness or lightheadedness that may occur.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the doctor or dentist in charge that you are taking this medicine. Taking tramadol together with medicines that are used during surgery or dental or emergency treatments may cause increased side effects.

If you think you or someone else may have taken an overdose of tramadol, get emergency help at once. Signs of an overdose include convulsions (seizures); difficult or troubled breathing; irregular, fast or slow, or shallow breathing; pale or blue lips, fingernails, or skin; pinpoint pupils of the eyes, or shortness of breath.

Do not stop suddenly taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a possible worsening of your condition and reduce the possibility of withdrawal symptoms such as anxiety, diarrhea, headache, nausea, shivering, sweating, tremors, or trouble with sleeping.

Proper Use

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

If you think that this medicine is not working as well after you have been taking it for a few weeks, do not increase the dose. Instead, check with your doctor.

If you are using the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Do not break, crush, or chew it. Place the tablet in your mouth. It should melt quickly. After the tablet has melted, swallow or take a sip of water.

Swallow the extended-release tablets whole with liquids. Do not break, crush, or chew it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For chronic pain:
    • For oral dosage form (extended-release tablets):
      • Adults—At first, 100 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 300 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults and teenagers 16 years of age and older—At first, 50 to 100 milligrams (mg) every four to six hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day.
      • Children younger than 16 years of age—Use and dose must be determined by your doctor.
  • For moderate to severe pain:
    • For oral dosage form (disintegrating tablets):
      • Adults and teenagers 16 years of age and older—At first, 50 to 100 milligrams (mg) every four to six hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day.
      • Children younger than 16 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults and teenagers 16 years of age and older—At first, 25 milligrams (mg) per day, taken every morning. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day.
      • Children younger than 16 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Description

Tramadol is used to relieve moderate to moderately severe pain, including pain after surgery. The extended-release or long-acting tablets are used for chronic ongoing pain.

Tramadol belongs to the group of medicines called opioid analgesics. It acts in the central nervous system (CNS) to relieve pain. When tramadol is used for a long time, it may become habit-forming (causing mental or physical dependence). Physical dependence may lead to side effects when you stop taking the medicine.

This medicine is available only with your doctor’s prescription.