This article describes possible side effects of tramadol oral tablets. You’ll also find information on cost savings and coupon options for tramadol.
Tramadol oral tablets are a generic version of the brand-name drug Ultram. However, Ultram is no longer available. Tramadol oral tablets come in immediate-release and extended-release forms.* Tramadol also comes in a capsule that you swallow, but this form isn’t described in this article. To learn more about this form, talk with your doctor.
You can explore this overview article to learn more about tramadol oral tablets, including the drug’s uses, dosage, and more.
* “Immediate release” means the drug is released into your body right after you take a dose. “Extended release” means the drug is slowly released into your body over a long period of time after you take a dose.
Boxed warnings
Tramadol has boxed warnings about several risks. Boxed warnings are serious warnings from the Food and Drug Administration (FDA). Tramadol’s boxed warnings include:
For details, see the “Side effects of tramadol in detail” section below.
More common side effects of tramadol
Tramadol oral tablets may cause mild or serious side effects. Below are some of the more common side effects of this medication.
Commonly reported side effects of tramadol oral tablet and tramadol extended-release oral tablet include:
Mild side effects of tramadol
Tramadol may cause certain mild side effects. Usually, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.
Mild side effects that occurred in studies for tramadol oral tablet and tramadol extended-release oral tablet include:
Tramadol oral tablets may cause more mild side effects than those listed above. For more details, see the prescribing information for tramadol oral tablet and tramadol extended-release oral tablet.
* To learn more about this side effect, see the “Side effects of tramadol in detail” section below.
Serious side effects of tramadol
Tramadol may cause certain serious side effects. If you have any serious side effects from tramadol oral tablets, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number, or go to the nearest emergency room.
After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with tramadol oral tablets.
Serious side effects that occurred in studies for tramadol oral tablet and tramadol extended-release oral tablet include:
* Tramadol oral tablet and extended-release oral tablet have a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the “Side effects of tramadol in detail” section below.
† To learn more about this side effect, see the “Side effects of tramadol in detail” section below.
Common questions about side effects of tramadol
Here are answers to some common questions about side effects of tramadol oral tablets. If you have other questions, talk with your doctor or pharmacist.
Will tramadol 50 mg cause fewer side effects than the drug’s other strengths?
It’s possible. Opioid pain relievers, including tramadol, have side effects that are dose related. This means their side effects become more common or more serious with higher dosages.
Examples of these side effects include:
Because of this, doctors may slowly increase the dosage of tramadol oral tablets as needed over time. This can help your body tolerate the drug.
If you’re having side effects that don’t go away or become bothersome, talk with your doctor. They may suggest ways to manage your symptoms or recommend a change in dosage.
Are the side effects of tramadol in older adults different than those in younger adults?
No, older adults won’t have different side effects from tramadol than younger adults. (People ages 65 years and older are usually considered older adults.)
That said, older adults are more likely to have certain side effects with tramadol. This can occur because liver and kidney function tend to slow down with age. Your body depends on the liver and kidneys to help clear drugs from your body. If these organs don’t work as well as they should, drug levels can remain high and cause side effects.
In tramadol’s studies, adults ages 75 years and older were more likely to have side effects that caused them to stop taking the drug. The most common ones were digestive side effects, including constipation. Slowed breathing is also a serious risk for older adults. These side effects occurred in studies for tramadol oral tablet and tramadol extended-release oral tablet.
Due to these risks, doctors usually have people start taking a low dosage of tramadol. In older adults, doctors may increase the dosage more slowly than usual. They may also prescribe a lower maximum dosage.
If you have concerns about the side effects of tramadol oral tablets given your age, talk with your doctor or pharmacist.
Can tramadol cause different side effects in women versus men?
In general, side effects of tramadol oral tablets are the same in males and females.* But there is one exception.
Reports of low blood sodium levels are more common in females older than 65 years of age. This potential serious side effect tends to occur in the first week of treatment. Symptoms can include:
If you have any of these symptoms, call your doctor right away. They may recommend stopping tramadol oral tablets. If you have other questions about the differing side effects between males and females, talk with your doctor.
* Sex and gender exist on spectrums. In this article, we use the terms “male” and “female” to refer to a person’s sex assigned at birth.
How long do side effects of tramadol usually last?
It depends. Some side effects of tramadol oral tablets may be temporary and only last a few days or weeks. But other side effects may last longer.
In studies of tramadol extended-release oral tablet, people reported common side effects at 7, 30, and 90 days of treatment. But it’s unclear whether some of the side effects were related to the drug or to the underlying condition being managed. (Keep in mind that tramadol is prescribed to treat moderate to severe pain.)
In general, people can develop tolerance to mild side effects after taking a medication long term, including tramadol. This means people no longer feel the same side effects at the usual dosage they take.
Tell your doctor if you have side effects that don’t go away or become bothersome. They can evaluate your symptoms and suggest ways to manage them.
Does tramadol cause long-term side effects?
It’s possible. In some cases, tramadol oral tablets may cause long-term side effects. These can occur if you take the drug for a long time.
That said, the side effects of tramadol oral tablets tend to occur in the first few days of treatment and with dosage increases. But they may also occur later.
Studies of tramadol oral tablet and tramadol extended-release oral tablet lasted up to 90 days. Common side effects were reported throughout these studies. So, it’s possible to have side effects after taking the drug for a long time.
If you develop new side effects while taking tramadol oral tablets, tell your doctor. They can determine whether your symptoms are related to the drug. They may also recommend ways to manage your symptoms. Most side effects of tramadol should go away once treatment is stopped.
Coupon for tramadol
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Side effects of tramadol in detail
Below you’ll find details on some of the side effects of tramadol oral tablets.
Boxed warnings
Tramadol oral tablets have boxed warnings about the following risks. Boxed warnings are serious warnings from the Food and Drug Administration (FDA). These include:
Risk of misuse and addiction
Tramadol oral tablets have a risk of misuse and addiction. Misuse means a drug is taken in a way other than how it’s prescribed. Addiction means a drug is taken even though it may be causing harm.
Misuse and addiction can lead to overdose and, possibly, death.
Ways to manage
To help reduce the risk of misuse and addiction, take tramadol oral tablets exactly as your doctor prescribes. This means swallowing the tablets and waiting the recommended number of hours before taking the next dose.
If you have concerns about this risk or your use of tramadol oral tablets, talk with your doctor.
Risk of slowed or stopped breathing
Taking tramadol oral tablets can cause slowed or stopped breathing. The risk is higher when you first start taking the drug and after any dosage increases. The risk is also higher for older adults. (People ages 65 years and older are usually considered older adults.)
Ways to manage
Slowed or stopped breathing can lead to death if it’s not immediately treated. If you have any breathing problems while taking tramadol, seek medical care right away.
Risk of accidental ingestion
Accidentally taking tramadol oral tablets can lead to overdose, which can be fatal. Accidentally taking tramadol is especially dangerous in children.
Ways to manage
Store tramadol oral tablets out of the reach of children. Remember, it’s illegal to share prescription drugs, so never give this drug to anyone other than the person it’s prescribed for. It’s also illegal for anyone to take a prescription drug that isn’t theirs. So be sure to keep this drug securely stored.
Risk of life threatening side effects, including death, in children
Children have a high risk of slowed or stopped breathing from tramadol oral tablets. In some cases, this side effect can lead to death.
Certain factors increase this risk even more, including:
- being a “high metabolizer,” which means your body processes the drug too quickly, leading to very high drug levels in the body
- having a condition that affects breathing, such as sleep apnea, obesity, lung disease, or a nervous system condition
- having surgery to remove the tonsils or adenoids
- taking other medications that can slow breathing
Ways to manage
Due to this risk, tramadol oral tablets should not be taken by children under 12 years of age. Additionally, the drug should not be taken by children ages 12 to 17 years who have the risk factors listed above. Tramadol is not approved for use in people under 18 years of age.
Risk of neonatal opioid withdrawal syndrome
Taking tramadol oral tablets for a long time during pregnancy can cause problems in an infant after birth. This includes a condition called neonatal opioid withdrawal syndrome (NOWS).
With NOWS, the newborn infant may have withdrawal symptoms after birth. This is because they were exposed to the drug while in the womb and their body became dependent on it. (With dependence, your body needs the drug to function like usual.) Without proper treatment, NOWS may be life threatening for the newborn.
Ways to manage
To help reduce the risk of NOWS, tell your doctor about all the medications you take during pregnancy. If tramadol oral tablets were taken during pregnancy, doctors would closely monitor the newborn for withdrawal symptoms.
Risk of harm if taken with certain medications
Taking tramadol oral tablets with certain other drugs can cause dangerous drug interactions. This includes drugs that affect the way your body metabolizes (breaks down and clears) tramadol.
Certain kinds of drugs can cause high levels of tramadol to build up in the body. This increases the risk of serious side effects.
Some drugs could cause tramadol levels to fall too low. This could lead to withdrawal side effects and cause tramadol to not work as well as it should. Withdrawal symptoms occur when you stop taking a drug your body is dependent on. In this case, it’s a matter of tramadol levels falling too low due to an interaction. With dependence, your body needs the drug to function like usual.
Ways to manage
Tell your doctor about all medications you take. Ask whether any could interact with tramadol oral tablets.
Also, using the same pharmacy to fill all your prescriptions can help lower the risk of drug interactions. Doing so allows the pharmacist to check for possible interactions. You can also double-check at the pharmacy by asking about any possible interactions with tramadol.
Risk of harm if taken with benzodiazepines or other central nervous system depressants
Taking tramadol oral tablets in combination with other CNS depressants can be dangerous. It can lead to coma and even death. (The CNS consists of your brain and spinal cord. It regulates many functions in your body.)
CNS depressants are drugs that slow brain function. Examples include alcohol, benzodiazepines, other opioid pain relievers, and several other medications.
Ways to manage
Make sure your doctor and pharmacist know about all medications you take. Ask about possible drug interactions with tramadol. Also, ask whether any medications you take are CNS depressants. If so, your doctor may suggest other treatment options that may be safer for you.
Allergic reaction
For some people, tramadol oral tablets can cause an allergic reaction.
Symptoms can be mild or serious, and they may include:
- itchiness
- skin rash
- swelling under the skin, usually affecting eyelids, lips, hands, or feet
- swelling of the mouth, tongue, or throat, which can make it hard to breathe
- flushing (temporary warmth, redness, or deepening of skin color)
In addition, very rare but serious allergic skin reactions can occur with tramadol. These reactions are life threatening and can be fatal when they do occur. These reactions include:
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know if you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to tramadol oral tablets, your doctor may recommend taking a different medication instead.
Warnings for tramadol
Below are some factors you may want to discuss with your doctor before taking tramadol oral tablets.
Boxed warnings
Tramadol has boxed warnings about several risks. Boxed warnings are serious warnings from the Food and Drug Administration (FDA). Tramadol’s boxed warnings include:
For details, see the “Side effects of tramadol in detail” section above.
Other warnings
It may not be safe for you to take tramadol oral tablets if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether tramadol oral tablets are a safe treatment option for you.
Before taking tramadol oral tablets, tell your doctor about your health and medications you take. Things to consider include:
- past misuse, addiction, or alcohol use disorder
- past allergic reaction to tramadol
- digestive system problems, such as intestinal blockage or bile duct disease
- pancreas problems, such as pancreatitis
- performing hazardous activities that require concentration and coordination, such as driving or operating machinery
- head injury or brain tumor
- liver disease or kidney disease
- thyroid condition, such as hypothyroidism
- diabetes, which increases the risk of low blood sugar
- mental health conditions, such as depression or suicidal thoughts or behaviors
- seizures or risk factors for seizures, such as epilepsy
- drug interactions with serotonergic drugs, which may increase the risk of serotonin syndrome
- withdrawal symptoms, when suddenly stopping the drug
Tramadol and pregnancy
Tramadol oral tablets have a boxed warning about the risk of use during pregnancy. Boxed warnings are serious warnings from the FDA.
Taking tramadol oral tablets for a long time during pregnancy can cause problems in an infant after birth. This includes withdrawal symptoms that can lead to death of the infant if not treated promptly and properly.
To learn more about this side effect, see “Boxed warnings” in the “Side effects of tramadol in detail” section above.
Tramadol and breastfeeding
Taking tramadol oral tablets while breastfeeding isn’t recommended. If you’re breastfeeding or plan to do so, talk with your doctor. They’ll likely recommend you stop breastfeeding or stop taking tramadol oral tablets if you want to breastfeed.
Tramadol and alcohol
Tramadol oral tablets are known to interact with alcohol. In fact, tramadol oral tablets have a boxed warning about taking the drug with other CNS depressants, including alcohol. Boxed warnings are serious warnings from the FDA.
To learn more about this warning, see the “Risk of harm if taken with benzodiazepines or other central nervous system depressants” section above.
You should not drink alcohol while taking tramadol oral tablets.
What to ask your doctor
This article describes common and serious side effects of tramadol oral tablets. If your doctor prescribes this medication, they can discuss possible side effects with you. Talk with your doctor if you have concerns or questions about treatment with this medication.
Here’s a list of some possible questions you may want to ask your doctor:
- Is there anything in my medical history that makes me more likely to have side effects from tramadol oral tablets?
- What can I do to reduce the risk of side effects with tramadol oral tablets?
- How do side effects of tramadol oral tablets compare with those of other opioid pain relievers?
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.
