7 things to know about Tramadol

1. About tramadol

Tramadol is a strong painkiller. It’s used to treat moderate to severe pain, for example after an operation or a serious injury, with the most common dose being the tramadol 200mg.

It’s also used to treat long-standing pain when weaker painkillers no longer work.

Tramadol is available only on prescription. It comes as tramadol tablets, tramadol capsules and tramadol liquid drops that you swallow. It can also be given by injection but this is usually only done in hospital.

2. Key facts about tramadol

  • Tramadol 200mg pill works by blocking pain signals from travelling along the nerves to the brain.
  • The most common side effects of tramadol are feeling sick and dizzy.
  • It’s possible to become addicted to tramadol, but this is rare if you’re taking it to relieve pain and your doctor is reviewing your treatment regularly.
  • It’s best not to drink alcohol with tramadol as you’re more likely to get side effects like feeling sleepy.
  • Tramadol is also called by the brand names Invodol, Larapam, Mabron, Maneo, Marol, Maxitram, Oldaram, Tilodol, Tradorec, Tramquel, Tramulief, Zamadol, Zeridame and Zydol.

3. Who can and can’t take tramadol

Tramadol can be taken by adults and children aged 12 and over.

Tramadol is not suitable for some people. Tell your doctor or pharmacist before starting the medicine if you have:

  • had an allergic reaction to tramadol or any other medicines in the past
  • an illness which causes seizures
  • a head injury
  • an addiction to alcohol, strong painkillers or recreational drugs
  • breathing difficulties
  • kidney or liver problems
  • had a reaction to other strong painkillers in the past

4. How and when to take tramadol

It’s important to take tramadol as your doctor has asked you to.

The dose can vary but you should not normally take more than 400mg a day.

Tramadol 200mg tablets doesn’t usually upset your stomach, so you can take it with or without food.

Different types of tramadol

Tramadol comes as:

  • fast-acting tablets – these contain 50mg of tramadol
  • slow-acting tablets – these contain 50mg, 75mg, 100mg, 150mg, 200mg, 300mg or 400mg of tramadol
  • fast-acting capsules – these contain 50mg of tramadol
  • slow-acting capsules – these contain 50mg, 100mg, 150mg or 200mg of tramadol
  • drops that you swallow – these contain 100mg of tramadol in 1ml of liquid
  • an injection (usually given in hospital)
  • soluble tablets – these contain 50mg of tramadol
  • tablets that dissolve in the mouth – these contain 50mg of tramadol
  • an injection (usually given in hospital)

Tramadol drops, injections and some tablets and capsules are fast-acting. They start to work within 30 to 60 minutes. They’re used for pain that is expected to last for only a short time. You may be told to take fast-acting tramadol only when you need it for pain or on a regular basis. Always follow the instructions given to you by your doctor.

Some tramadol tablets and capsules are slow-release. This means the tramadol is gradually released into your body over either 12 or 24 hours. This type of tramadol takes longer to start working but lasts longer. It’s used for long-term pain.

Your doctor will decide the right dose for you, depending on how sensitive you are to pain and how bad your pain is. Your dose may need to be changed several times to find what works best for you. In general, you will be prescribed the lowest dose that relieves your pain.

How much to take of tramadol

Dosages vary from person to person. Your dose will depend on how bad your pain is, how you’ve responded to previous painkillers and if you get any side effects.

How to take tramadol

Fast-acting tramadol comes as capsules, drops and 2 different tablets – soluble and dissolve-in-the-mouth tablets:

  • capsules: swallow each capsule whole with plenty of water
  • drops: mix the drops into a glass of water then drink the whole contents of the glass
  • soluble tablets: dissolve each tablet in 50ml (1/2 cup) of water and drink
  • dissolve-in-the-mouth tablets: make sure your hands are dry before handling the tablet. Take the tablet out of the blister pack and put it on your tongue. Suck the tablet, do not chew it. After it has melted, swallow or have a drink of water. You can also dissolve the tablet in a glass of water if you prefer.

Slow-release tramadol comes as tablets and capsules. It’s important to swallow slow-release tramadol tablets and capsules whole with a drink of water.

When to take tramadol

When to take it depends on the type of tramadol that you have been prescribed:

  • fast-acting tablets and capsules – usually 3 to 4 times a day
  • drops – usually 3 to 4 times a day
  • slow-release tablets and capsules – usually 1 or 2 times a day

If you’re 65 and over, or you have liver or kidney problems, you may be asked by your doctor to take tramadol less often.

You can take your tramadol at any time of day but try to take it at the same time every day and space your doses evenly. For example, if you take tramadol twice a day and have your first dose at 8am, take your second dose at 8pm.

What if I forget to take it?

This will vary depending on which type of tramadol you are taking.

If you forget to take a dose, check the information on the patient information leaflet inside the packaging or ask your pharmacist or doctor for advice on what to do.

Never take 2 doses at the same time to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

5. Taking tramadol with other painkillers

It’s safe to take tramadol with paracetamol, ibuprofen or aspirin (aspirin is suitable for most people aged 16 years and over).

Do not take tramadol with codeine-containing painkillers you can buy from a pharmacy. You’ll be more likely to get side effects.

Some everyday painkillers that you can buy from pharmacies contain codeine, which is a similar medicine to tramadol. Codeine-containing painkillers that you can buy from pharmacies include co-codamolNurofen Plus and Solpadeine.

6. Side effects

Like all medicines, tramadol can cause side effects although not everyone gets them. Talk to your doctor or pharmacist if the side effects listed below bother you or don’t go away.

Very common side effects

Very common side effects of tramadol happen in more than 1 in 10 people and include:

  • feeling sick
  • feeling dizzy

Common side effects

Common side effects of tramadol happen in more than 1 in 100 people. They include:

  • headaches
  • feeling sleepy, tired, dizzy or “spaced out”
  • feeling or being sick (vomiting)
  • constipation
  • dry mouth
  • sweating
  • low energy

Serious side effects

Serious side effects are rare. Call your doctor straight away if you get:

  • breathing difficulty or short shallow breathing
  • dizzy, tired and have low energy – these can be a sign of low blood pressure
  • hallucinations (seeing or hearing things that are not there)
  • confusion
  • very sleepy
  • trouble peeing or you can’t pee at all
  • seizures (fits)

7. Common questions

How does tramadol work?

When will I feel better?

How long will I take tramadol for?

Can I become addicted to tramadol?

How will I know if I’m addicted?

Are there other painkillers I can try?

Will it affect my contraception?

Will it affect my fertility?

Can I drink alcohol with it?

Can I drive or ride a bike with it?

Will recreational drugs affect it?

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