What is Tramadol: Uses, Warnings & Interactions

Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.

Tramadol in all its forms can be taken with or without food.

Always store tramadol securely. It should be out of the reach of children and in an area that can’t be accessed by others.

A Medication Guide should come with this medicine. If you don’t have one, ask the pharmacist for a copy.

How to take tramadol immediate-release tablets

• Take tablets as directed. Do not change the dose.

• Store tramadol tablets at room temperature out of the reach of children.

How to take tramadol extended-release capsules and tablets

• Take tablets as directed. Do not change the dose.

• Doses are taken once per day. Take each day’s dose at the same time each day.

• Swallow the tramadol ER tablets or capsules whole. Do not crush, break, or chew the tablets or capsules.

• Store at room temperature out of the reach of children.

How to take tramadol oral solution

• Take the dose as instructed. Do not change the dose.

• Before measuring the dose, make sure you understand the difference between milligrams (mg) and milliliters (mL). Doses will be indicated with both on the prescription, but doses are measured in milliliters.

• Use a graduated oral syringe or measuring cup with milliliter markings. If you don’t have one, the pharmacist can supply one for free. Do not use kitchen measuring tools or tableware.

• Store tramadol solution at room temperature out of the reach of children.

Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug store and clinics for take-back locations. 

For immediate-release tramadol, a missed dose can be taken when remembered. If it’s almost time for the next dose, skip the missed dose and take the next dose on time.

For extended-release tramadol, a missed dose should be skipped. Take the next dose at the regularly scheduled time.

This medicine is not right for everyone. 

Do not use tramadol if you have:

• Allergies to tramadol or other opioids

• Problems breathing (respiratory depression)

• Acute or severe asthma

• Gastrointestinal blockage

Tramadol is never prescribed to people who are suicidal or prone to drug addiction.

Tramadol should never be used along with drugs called monoamine oxidase inhibitors (MAOIs).

Tramadol should never be given to a child younger than 12 years old.

Tramadol should never be given to children immediately after they’ve had their tonsils or adenoids removed.

Tell any doctor or dentist who treats you that you are using this medicine.

Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.

Call your doctor if you think your medicine is not working.

Children have died taking opioids. Keep this medicine in a place inaccessible to children and others.

This medicine can cause serious problems including:

• Respiratory distress (insufficient breathing)

• Dependence

• Abuse

• Withdrawal

• Suicidal thoughts

• Neonatal withdrawal

• Death

Tramadol can cause other serious problems such as:

• Changes in mood and behavior

• Sleep-related breathing problems (including sleep apnea and sleep-related hypoxemia)

• Serotonin syndrome (when used with certain medicines). 

• Unusual changes in mood or behavior

• Constipation or intestinal paralysis

• Low sodium

• Low blood sugar

• Severe allergic reactions

This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up carefully.

Before taking tramadol, tell the prescriber if you have a history of:

• Head injury

• Seizures

• Asthma or breathing problems

• Liver disease

• Kidney disease

• Pancreas problems

• Gallbladder problems

• Urination problems

• Drug abuse

• Alcohol abuse

• Opioid overdose

• Depression or other mental illness

• Suicidal thoughts or behaviors

Before taking tramadol, tell the prescriber:

• If you are pregnant or have plans to get pregnant

• If you are breastfeeding

• If you live with small children

• If you live with anyone with a history of drug abuse

• If you take any prescription drugs, over-the-counter medicines, or supplements

Some medicines can affect how gabapentin works. Several medications should never be taken with tramadol because of the hazards. 

To avoid hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you are using before taking this drug.

Because of possible drug interactions, tell other healthcare providers you are using this medicine before they prescribe new medications.

Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.

Tell your doctor if you use anything else that makes you sleepy. Some examples are other opioids, antihistamines, anticonvulsants, sedatives, benzodiazepines, or muscle relaxers. 

Avoid alcohol when taking tramadol. 

Other medicines that may cause problems when taken with tramadol include:

• Antidepressants

• Migraine drugs 

• Blood thinners

• Anticholinergic drugs

• Warfarin and digoxin

Some drugs slow down the body’s metabolism of tramadol, raising the risk of serious side effects. Some drugs speed up the metabolism of tramadol, making it less effective at relieving pain.