Tramadol: Uses, Side Effects & Risks
Last Updated Dec 2, 2021
Tramadol is a prescription painkiller approved by the U.S. Food and Drug Administration for moderate to severe pain in adults.
Years ago, most doctors believed that tramadol was safe for almost everyone to take. They reasoned that while tramadol is a narcotic, it didn’t work the same as medications like Vicodin, so it could be used by almost anyone.
As research on tramadol continues, the hazards have become clear. Now, researchers know that tramadol has plenty of side effects and risks. Some are so serious that you might reconsider taking the drug at all.
How to Use Tramadol
As a controlled substance, tramadol requires a prescription. You must visit a doctor, demonstrate why you need a painkiller, and head to a pharmacy to fill the prescription.
Your doctor can choose from two tramadol formulations:
- Extended-release tramadol, which offers pain release for a long time
- Immediate-release tramadol, which goes to work quickly and wears off just as fast
Both formulations come in pill form, and it’s critical that you don’t chew, crush, or dissolve the tablets. If you’re tempted to tamper with your pills to make them seem stronger or more effective, know that this is abuse and could lead to addiction. (More on this below.)
Tramadol Side Effects You Should Understand
Your prescription comes with a pamphlet packed tight with side effects and hazards. Read this document carefully, as tramadol can cause many unpleasant side effects you should know about.
More than 1 in 10 people feel sick or dizzy while taking tramadol. Less common side effects include the following:
- Dry mouth
- Mental fog
Serious side effects that merit a visit to the emergency room include the following:
- Allergic reactions, which could give you rashes, difficulty breathing, and throat/mouth swelling
- Difficulty with urination
- Low blood pressure, which can feel like dizziness and extreme fatigue
- Severe confusion
If you’re not sure if you’re sick or facing a side effect, call your doctor and ask.
Is Tramadol Risky?
Like other opioid medications, tramadol has been associated with several very serious health problems.
These are a few of the issues you could face while taking tramadol.
Do you take other prescription medications? Do you use over-the-counter drugs or herbal remedies like St. John’s wort? Tramadol could cause you problems.
Tramadol interacts with a remarkable number of prescription and over-the-counter medications. It’s critical to tell your doctor about every pill and tincture you take before you start using tramadol.
Tramadol links to receptors inside your brain and triggers a sense of euphoria. Some people lose control of their tramadol use and start taking doses in ways their doctors don’t recommend.
This can mean taking doses more frequently than prescribed, mixing tramadol with other substances like alcohol, or taking higher doses than recommended.
As you abuse tramadol, you’re engaged in a battle with your brain. You need to take more to feel normal or high. But if you take too much, you can overwhelm your body and slide into an overdose.
Tramadol overdoses typically trigger seizures, and researchers say almost 55 percent of people taking tramadol have had at least one seizure while on the drug.
As you continue to take tramadol, your brain becomes accustomed to the drug. Quit quickly, and your brain cells overreact. Withdrawal symptoms begin.
- Opioid withdrawal: Flu-like symptoms accompanied by restlessness and cravings characterize this form of withdrawal.
- Serotonin syndrome: Hallucinations, paranoia, anxiety, and confusion characterize this form of withdrawal.
Either of these forms of withdrawal can be life-threatening. Your doctor can taper your tramadol doses slowly to help you get sober instead, or you can use replacement medications from your doctor to ease into sobriety.
The choice of medicated withdrawal or a taper will depend on the level of your dependence as well as your overall health.
Tramadol vs. Opioid Pain Medications
Vicodin, OxyContin, and tramadol are all opioid pain medications. But tramadol works a little differently than classic prescription painkillers.
It attaches to brain cells in a “loose” way. At one point, doctors thought that meant it couldn’t cause addictions or other long-term problems. This proved to be incorrect.
Tramadol can cause many of the side effects we associate with opioids, including constipation and sedation. But it can cause unique problems, including nausea. And plenty of people begin using tramadol per their doctors’ orders and then begin abusing it.
Unfortunately, people who get tramadol after surgery tend to get it for longer than those who have surgery and get a different painkiller.
The longer you take these pills, the more likely it is that you’ll abuse them. Long prescriptions are incredibly dangerous, and they seem to be common.
The Bottom Line
Don’t believe that tramadol is safer than any other type of painkiller. It can be just as addictive as other drugs. It’s an opioid prescription that should be used for short periods and never abused.
If you started using tramadol and now can’t stop, it’s a sign that you need help. A treatment team can help you discover why you started misusing this drug, and you can learn how to stop taking it too.
Tramadol Information. (April 2017). U.S. Food and Drug Administration.
Tramadol. (May 2022). StatPearls.
Side Effects of Tramadol. (January 2022). NHS.
Tramadol. (January 2022). U.S. National Library of Medicine.
Tramadol Dependence in a Patient With No Previous Substance History. (2010). Primary Care Companion to the Journal of Clinical Psychiatry.
‘With Tramadol, I Ride Like a Jaguar’: A Qualitative Study of Motivations for Nonmedical Purpose Tramadol Use Among Commercial Vehicle Operators in Kumasi, Ghana. (July 2020). Substance Abuse Treatment, Prevention, and Policy.
Tramadol. (April 2009). Psychiatry.
Tramadol. (March 2020). Drug Enforcement Administration.
Is Tramadol an Opioid or a Nonopioid Analgesic? Yes! (Summer 2020). Washington Medical Commission.
Historically ‘Safer’ Tramadol More Likely Than Other Opioids to Result in Prolonged Use. (May 2019). ScienceDaily.