Tramadol is a prescription pain medication in the opioid class. It’s structurally similar to other opioids like codeine. But it has unique side effects, including some that are life-threatening.
Between 2002 and 2014, about 1.5% of American adults misused tramadol.[1] If you’re one of them, understanding the drug’s side effects is critical.
Your substance misuse issue could cause short-term and long-term health problems. But treatment could help you get better.
What Are Tramadol’s Common Side Effects?
Tramadol causes several unpleasant side effects, even in people who use the drug as directed by their doctors.
Common side effects include the following:[2]
- Headache
- Nausea
- Constipation
- Dry mouth
- Sedation
- Dizziness
- Vomiting
- Joint pain
- Dry mouth
Sometimes, these side effects are so unpleasant that they prompt people to stop taking tramadol. But sometimes, they fade as the body becomes accustomed to the drug and how it works. After a few weeks, you may not notice any of these side effects even if you experienced them initially.
What Are Tramadol’s Uncommon Side Effects?
Some of tramadol’s serious side effects affect less than 5% of people who use the drug. In some cases, these problems appear with the very first dose you take.[2]
Uncommon tramadol side effects include the following:[2]
- High blood pressure
- Gastrointestinal pain
- Weight loss
- Tremors
- Mental health changes, including agitation, anxiety and nervousness
- Bronchitis
- Prostate disorders
- Cardiac disorders
- Anemia
- Anorexia
- Insomnia
All of these side effects were noted in studies conducted by professionals. People who misuse tramadol may have health issues researchers never anticipated. And if the drug is misused or used in combination with other substances (like alcohol), additional symptoms could appear.
What Does Tramadol Interact With?
Like most opioids, tramadol can interact with a long list of prescription and over-the-counter medications. Before you add anything to your tramadol doses, ask your doctor.
Researchers say tramadol can interact with the following medications:[3]
- Monoamine oxidase inhibitors (MAOIs)
- Bupropion
- Duloxetine
- Nefazodone
- Selective serotonin reuptake inhibitors (SSRIs)
- Venlafaxine
- Mirtazapine
- Tricyclic antidepressants
- St. John’s wort
Since tramadol is an opioid, it can enhance the action of other central nervous system depressants, including painkillers and alcohol. Mixing substances can lead to severely slow breathing, coma, and death.[2]
Potential Risks & Warnings Regarding Tramadol
While side effects are both common and somewhat expected in people who use opioid painkillers, tramadol can cause serious health problems. Some aren’t associated with other drugs in this class. Serious risks and warnings include the following.[1]
Seizures
Tramadol and seizures are closely related. Australian experts say it’s the drug most people cite when they ask for help for medication-caused seizure activity.[4]
Some people develop seizures when taking tramadol at the proper dose, but risks rise when people take massive amounts. And those with a history of epilepsy have a greater risk of seizures, especially if they combine the drug with antidepressants.[4]
Serotonin Syndrome
Tramadol can increase how much serotonin your body releases, and it can keep cells from recycling the excess. The result is a buildup of this key chemical.
Common serotonin syndrome side effects include the following:[3]
- Tight muscles
- Rigid body
- Seizures
- Fast heart rate
- High blood pressure
- Agitation
- Confusion
Serotonin syndrome is a potentially lethal side effect that requires treatment in a hospital.[3] If anyone using tramadol develops these symptoms, call 911 and ask for an ambulance.
Opioid Use Disorder
Opioids like tramadol alter chemical signals within the brain. With repeated use, cells can’t function properly without tramadol. And they typically need larger doses to cause effects that smaller doses once delivered. This is tolerance.
Researchers say tramadol misuse is more common in people with no history of opioid use disorder (OUD).[5] And some people who develop an OUD to tramadol switch to a stronger opioid (like OxyContin or heroin) in time.
Overdose
People struggling with tramadol misuse need larger doses to get high or get pain relief. Since tramadol is a central nervous system depressant, it’s possible to take too much and overdose.
People experiencing tramadol overdose may have these symptoms:[2]
- Blue-tinged fingers and lips
- Slow or absent breathing
- Sedation or loss of consciousness
- Slow or absent heartbeat
Medications like naloxone can immediately reverse an opioid overdose. But this medication can cause seizures in tramadol users.[2]
If you think someone may be overdosing on tramadol, call 911. Tell the operator what happened and where you are. Follow instructions carefully and administer naloxone if you have it available. Stay with the person until medical professionals arrive.
Suicide
Tramadol can stop brain cells from producing feel-good chemicals. Chronic use can lead to deep depression. Sometimes, a person’s mental health deteriorates enough to spark suicidal thoughts.
Researchers say up to 80% of intense tramadol intoxication episodes are suicide attempts.[6]
If someone you love is collecting tramadol pills and expressing the intent to self-harm, call 911 and tell the operator what’s happening. Your quick action could save the person’s life.
Getting Help for Your Tramadol Addiction
Opioids like tramadol leave significant damage behind. Medication for Addiction Treatment (MAT) can help.
In MAT programs, pharmaceutical solutions Suboxone can correct chemical imbalances caused by drugs. You won’t feel intense withdrawal symptoms or cravings for tramadol. You’ll be able to participate in therapy and rebuild your life in recovery.
If you’ve tried to quit tramadol and failed, MAT is especially important for you. But anyone who misuses this drug or any opioid could benefit from a qualified treatment program. MAT can reduce your relapse risk and make recovery possible.
Reach out today to find out if this approach is right for you.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Reines SA, Goldmann B, Harnett M, Lu L. Misuse of tramadol in the United States: An analysis of the National Survey of Drug Use and Health 2002-2017. Substance Abuse: Research and Treatment. 2020;14. doi:10.1177/1178221820930006
- Tramadol prescribing information. U.S. Food and Drug Administration. Published May 2010. Accessed August 3, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022370s000lbl.pdf
- Sansone RA, Sansone LA. Tramadol: seizures, serotonin syndrome, and coadministered antidepressants. Psychiatry (Edgmont). 2009;6(4):17-21.
- Savage R. Serious reactions with tramadol: Seizures and serotonin syndrome. Medsafe. Published October 2007. Accessed August 3, 2023. https://www.medsafe.govt.nz/profs/puarticles/tramserious.htm
- Dunn KE, Bergeria CL, Huhn AS, Strain EC. A Systematic review of laboratory evidence for the abuse potential of tramadol in humans. Front Psychiatry. 2019;10:704. Published 2019 Sep 26. doi:10.3389/fpsyt.2019.00704
- Nakhaee, S., Hoyte, C., Dart, R.C. et al. A review on tramadol toxicity: mechanism of action, clinical presentation, and treatment. Forensic Toxicol 39, 293–310 (2021). https://doi.org/10.1007/s11419-020-00569-0
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