Tramadol oral tablets are a generic medication. They’re not available in a brand-name version. Tramadol also comes in a capsule that you take by mouth, but that form isn’t described in this article. To learn more about this form, talk with your 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.
Boxed warnings
This drug 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)
To learn more, see “Dosage adjustments for tramadol” in the “Dosage of tramadol” section below. Additionally, talk with your doctor and see the end of this article for more information about these warnings.
Tramadol oral tablets come as follows:
Forms and strengths:
- Immediate-release (IR) oral tablets:
- Extended-release (ER) oral tablets:
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 recommended dosages* 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.
* The drugmaker provides these recommended dosages.
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 right dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of tramadol oral tablets that gives the desired outcome.
Dosage for pain
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: 50 mg to 100 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
Dosage adjustments for tramadol
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
Missed dose of tramadol
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 50-milligram (mg) and 100-mg strengths. 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.
Tramadol extended-release oral tablets don’t come in a 50-mg strength.
You should take tramadol oral tablets exactly as your doctor prescribes. To avoid serious side effects, do not take more than your doctor recommends. If your dosage of tramadol oral tablets isn’t managing your pain, talk with your doctor. They can determine the best way for you to get better pain relief. This may include safely increasing the dosage.
Can tramadol be taken for arthritis or a toothache? If so, what is the dosage?
Doctors prescribe tramadol oral tablets for moderate to severe pain. This can include moderate to severe pain related to arthritis or a toothache. Studies of the immediate-release (IR) tablets included single doses to relieve pain after oral surgery. They also included long-term use of the IR tablets for several chronic pain conditions. Chronic means continuing or repeated pain for a long time.
Studies of the extended-release tablets included treating pain from arthritis of the knee or hip.
The recommended dosage of tramadol for arthritis or toothache is the same as its usual recommended dosage. For details, see the “Dosage of tramadol” section above.
To learn more about taking tramadol oral tablets for painful conditions, talk with your doctor. They can determine whether the drug is the right choice for pain relief.
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.
Will my dosage of tramadol be calculated by my weight in kilograms (kg)?
No, the dosage of tramadol oral tablets isn’t based on body weight. Instead, doctors usually base the dosage on your pain level and several other factors. You can read more about these factors in the “Dosage of tramadol” section above.
Doctors usually start with a low dosage and increase the dosage gradually over time. If you have questions or concerns about your dosage, talk with your doctor or pharmacist.
Is 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.
Is there a risk of misuse with tramadol?
Yes, tramadol oral tablets have a boxed warning for misuse and addiction. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).
Misuse means taking a drug in a way that’s different from how a doctor prescribes it. This includes taking tramadol oral tablets to get “high” instead of taking them to relieve pain.
Misusing the drug can lead to addiction. Addiction means you feel unable to stop taking a drug, even though it may be causing harm.
To reduce the risk of misuse and addiction, take tramadol oral tablets only as your doctor prescribes. This means taking only the dose your doctor prescribes. It also means waiting the prescribed number of hours between doses.
If you’re taking tramadol oral tablets as prescribed but still have pain, let your doctor know. Do not change your dose on your own or how often you take it.
Talk with your doctor if you have concerns about misuse or addiction while taking tramadol.
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.
If it’s hard for you to swallow tablets, view this article. It provides suggestions on how to swallow medications that come in pill form.
Also, be sure to talk with your doctor or pharmacist if you’re having difficulty taking your medication. They can offer recommendations about taking it.
Tramadol coupon
Visit this page to access Optum Perks coupons and get price estimates for tramadol when you use the coupons. These coupons can provide significant savings on your prescription costs.
Note: Optum Perks coupons cannot be used with any insurance copays or benefits.
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 tramadol overdose
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.
What to ask your doctor
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?
Boxed warnings for tramadol
This drug has boxed warnings about the following risks. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).
Risk of misuse and addiction. Taking tramadol oral tablets can lead to misuse and addiction. Misuse is using a drug in a way other than how a doctor prescribes it. Addiction is continuing to use a drug even though it causes harm. These conditions increase the risk of overdose, as well as death in extreme cases.
Risk of slowed or shallow breathing. Taking tramadol oral tablets can cause slowed or shallow breathing. This can lead to stopped breathing, as well as death in rare cases.
Risk of accidental ingestion. Accidentally taking tramadol oral tablets can cause an overdose. This can be fatal, especially in children. Tramadol oral tablets are not approved for use in children ages 17 years and younger.
Risk of life threatening side effects in children, including death in extreme cases. Children have an increased risk of slowed or shallow breathing with tramadol oral tablets. Due to this risk, tramadol oral tablets are not approved for use in children ages 17 years and younger.
Risk of neonatal opioid withdrawal syndrome. Taking this medication for an extended time while you’re pregnant can cause withdrawal in a newborn. Withdrawal refers to side effects that occur when you stop taking a drug on which your body is dependent. Dependence is when your body needs the drug to feel like you usually do. Withdrawal can lead to death in the newborn. Symptoms of withdrawal may include irritability, unusual sleep routines, being overly active, and high pitched crying. Other symptoms include vomiting, diarrhea, tremor, and no weight gain.
Risk of use with certain medications. Taking tramadol oral tablets with certain other medications can cause dangerous drug interactions. This includes drugs that affect the way your body processes or clears tramadol.
Risk of use with benzodiazepines or other central nervous system (CNS) depressants. Taking tramadol oral tablets with other CNS depressants can lead to coma, as well as death in extreme cases. CNS depressants are drugs that slow brain function. These include alcohol, benzodiazepines, and several other drugs. Examples of benzodiazepines are lorazepam (Ativan, Loreev XR) and alprazolam (Xanax, Xanax XR).
Opioid Risk Evaluation and Mitigation Strategy (REMS). With this drug’s risk of misuse and addiction, the FDA mandates that the drugmaker provide a REMS program. Under this program, the drugmaker must educate doctors about how to use opioids safely and effectively.
To learn more about these warnings, see “Dosage adjustments for tramadol” in the “Dosage of tramadol” section above. You can also talk with your doctor to learn more.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
