Key takeaways
- Tramadol oral tablets come in immediate-release (IR) and extended-release (ER) forms for moderate to severe pain. IR tablets are taken every 4 to 6 hours as needed, while ER tablets are taken once daily.
- Starting dosages are typically low and may be increased gradually based on pain level, age, and other health factors. Maximum daily dosages are 400 milligrams (mg) for IR tablets and 300 mg for ER tablets.
- Tramadol carries serious risks, including misuse, addiction, and slowed breathing. Taking the medication exactly as prescribed and talking with your doctor about any concerns can help reduce these risks.
Overview
Tramadol oral tablets are a generic medication used to manage severe pain. They’re only available with a prescription from a doctor.
This article describes tramadol oral tablets’ dosages, their strengths, and details on how to take them. You’ll also find information on cost savings and coupon options for tramadol.
If you want to know more about tramadol oral tablets, see this overview article. It covers details about the drug’s uses, side effects, and more.
Note: Tramadol also comes in a capsule that you take by mouth and as an oral solution, but those forms aren’t described in this article. To learn more about these forms, talk with your doctor.
Boxed warnings
It’s important to note that tramadol has boxed warnings about several risks. Boxed warnings are serious warnings from the Food and Drug Administration (FDA). These warnings are:
- risk of misuse and addiction
- risk of slowed or shallow breathing
- risk of accidental ingestion
- risk of life threatening side effects in children, including death in extreme cases
- risk of neonatal opioid withdrawal syndrome
- risk of use with certain medications
- risk of use with benzodiazepines or other central nervous system (CNS) depressants
- opioid Risk Evaluation and Mitigation Strategy (REMS)
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Forms and strengths of tramadol
Tramadol oral tablets come as follows:
Forms and strengths:
- Immediate-release (IR) oral tablets:
- 25 milligrams (mg)
- 50 mg
- 75 mg
- 100 mg
- Extended-release (ER) oral tablets:
- 100 mg
- 200 mg
- 300 mg
The IR tablets release the drug into the body right away after you take a dose. The ER tablets release the drug into the body slowly over time.
Dosage of tramadol
This article describes the dosages recommended by the drugmaker for tramadol oral tablets.
If your doctor prescribes this medication, you should take the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of tramadol oral tablets without your doctor’s recommendation.
Usual recommended dosage(s) of tramadol in adults
Usually, doctors start by prescribing a low dosage of tramadol oral tablets. Then, they’ll adjust it over time until the most effective dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of tramadol oral tablets that gives the desired outcome.
The list below shows recommended dosages of tramadol oral tablets for pain, including back pain.
- Immediate-release oral tablets:
- Starting dosage: 25 milligrams (mg) every 4 to 6 hours as needed
- Maintenance dosage: 100 to 200 mg every 4 to 6 hours as needed
- Maximum dosage: 400 mg per day
- Extended-release oral tablets:
- Starting dosage: 100 mg once per day
- Maintenance dosage: 100 mg to 300 mg once per day
- Maximum dosage: 300 mg per day
Will my dosage be adjusted?
Your doctor will prescribe a dosage of tramadol oral tablets based on several factors, including:
- how severe your pain is
- your age
- your other health conditions, if any
- other medications you take
- whether you’ve taken opioids in the past and what kind
- how your body responds to the drug
- your risk of misuse or addiction
Note: If you experience drug misuse or addiction, know you’re not alone. Reach out to a healthcare professional for support if this is a concern for you.
Medical perspective
How does tramadol have a risk for misuse, and what support is available?
“Tramadol can be misused because it is an opioid and can lead to dependence, even when taken as prescribed. Support is available through a doctor or pharmacist, who can help with safe use, treatment options, and referrals for substance use support if needed.”
Learn more about tramadol addiction here.
What to do if you miss a dose
Talk with your doctor or pharmacist right away if you realize you forgot to take a dose of tramadol oral tablets. They may advise you to take the missed dose. Or they may advise you to skip it and take your next dose as scheduled.
For tips on how to plan your doses of tramadol oral tablets and avoid missing a dose, read this article. You could also try:
- downloading a reminder app on your phone
- setting an alarm
- putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table
Frequently asked questions
Below are answers to some commonly asked questions about tramadol oral tablets and their dosages.
How many 50-mg tablets of tramadol are safe to take in one day?
The number of tramadol oral tablets you’ll take will depend on what your doctor prescribes.
Tramadol immediate-release (IR) oral tablets come in strengths from 25 to 100 mg. For these tablets, your doctor will usually prescribe a low dose to start. You’ll take the IR tablets every 4 to 6 hours as needed to relieve pain. If needed, your doctor may increase the dosage gradually every 3 days.
The maximum daily dosage is 400 mg, which would be equivalent to eight 50-mg tablets.
Does an older adult have to take a lower dose of tramadol?
In adults ages 65 years and older, liver and kidney function tend to slow down. This increases the risk of side effects with tramadol oral tablets. These side effects include slowed or shallow breathing. Due to this risk, doctors usually prescribe a lower dosage in older adults.
For adults ages 75 years and older, the maximum daily dosage of the drug is 300 mg.
If you have concerns pertaining to your age and taking tramadol oral tablets dosage, talk with your doctor or pharmacist.
Also, if you’re taking tramadol and having side effects or pain, let your doctor know right away. They can determine whether you need to change your dosage.
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Get free cardIs tramadol used long term?
Yes, it is in certain situations.
In most cases, doctors will prescribe tramadol for the shortest amount of time needed to treat your pain. They’ll do this to lower your risk of misuse, addiction, and slowed or shallow breathing with the drug. For details about these risks, see the “Boxed warnings for tramadol” section below.
In other cases, doctors might prescribe tramadol oral tablets as a long-term treatment for chronic pain. Chronic means continuing or repeated pain for a long time. If you and your doctor determine that it’s safe and effective for your chronic pain condition, you’ll likely take it long term.
How tramadol is taken
You’ll take tramadol oral tablets by swallowing them. Typically, you’ll take the immediate-release (IR) tablet every 4 to 6 hours and the extended-release (ER) tablet once per day.
You can take both forms of tramadol oral tablets with or without food. For the ER tablets, it’s best to be consistent. That means try to always take it with food or always take it without food.
You can crush or cut the IR tablet. But do not crush, cut, break, or chew the ER tablet.
Your doctor may advise that you take the tramadol ER oral tablet around the same time each day. This keeps a consistent amount of the drug in your body, and that can help the drug work more effectively.
Overdose of tramadol
It’s important that you do not take more tramadol oral tablets than your doctor prescribes. Doing so can lead to serious side effects.
Symptoms of an overdose can include:
- cold, clammy skin
- extreme sleepiness or drowsiness
- limp muscles
- loss of consciousness, which can progress to coma and even death in extreme cases
- seizures
- slow or shallow breathing, which can progress to stopping breathing
- very small eye pupils
What to do if you take too much tramadol
If you think you’ve taken too much tramadol, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.
Next steps
This article describes the usual recommended dosages for tramadol oral tablets. If your doctor prescribes this medication, they’ll determine the dosage that’s best for you.
Do not change your dosage of tramadol oral tablets without your doctor’s recommendation. You should take tramadol oral tablets exactly as your doctor prescribes them. Let your doctor know if you have concerns or questions about your treatment plan.
Here’s a list of some possible questions you may want to ask your doctor:
- How long can I safely take tramadol oral tablets?
- Does my dosage need to be adjusted considering other medications I take?
- Does my dose put me at risk of misuse and addiction?
- Would I get better pain relief switching from the immediate-release tablet to the extended-release tablet?
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Disclaimer: While Optum Perks strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses.