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Tramadol: Uses, Side Effects & Risks

Tramadol, a prescription painkiller for adults with moderate to severe pain, has known risks and serious side effects that might make one reconsider using it.

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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.

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.

Don’t believe that tramadol is safer than any other type of painkiller.

More than 1 in 10 people feel sick or dizzy while taking tramadol. Less common side effects of tramadol include the following:

  • Constipation
  • Dry mouth 
  • Fatigue
  • Headaches
  • Mental fog
  • Nausea
  • Sweating

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
  • Hallucinations
  • 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.

Even people with no history of drug abuse can become addicted to tramadol. The problem is so significant that some experts say tramadol abuse is “evolving into a health crisis.” 


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.

Tramadol withdrawal symptoms can look like this:

  • 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.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated June 12, 2023
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  10. Historically 'Safer' Tramadol More Likely Than Other Opioids to Result in Prolonged Use. (May 2019). ScienceDaily.
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