Tramadol Side Effects, Interactions, & Warnings

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on February 21, 2023
Fikret Terzic

Written by: Fikret Terzic MD, MS

Tramadol is an opioid pain medication that causes side effects such as sedation and constipation. Additionally, dangerous drug interactions may occur while taking tramadol, particularly when antidepressants are combined with the drug.

Tramadol (brand names Ultram and Conzip) is an opioid pain medication prescribed for those suffering from moderate to severe pain. As stated by the United States Drug Enforcement Administration (DEA), tramadol is a Schedule IV controlled substance.

The drug has potential for abuse which may lead to physical dependence or psychological dependence. Before taking tramadol, consult the medical advice of your healthcare provider as numerous side effects may occur.

Side Effects Of Tramadol

Tramadol works by binding to opioid receptors in the brain. This depresses the central nervous system (CNS), resulting in sedation and pain relief.

Tramadol is offered in immediate-release and extended-release (Ultram ER) tablets. Although this opioid medication can be used for pain management, it may create side effects.

Tramadol may include common side effects such as:

  • constipation
  • drowsiness
  • changes in mood
  • headache
  • sedation
  • dry mouth
  • indigestion
  • loss of appetite

Men, women, and the elderly can all experience these common side effects of tramadol.

Side Effects In Men

The use of tramadol in men can result in sexual dysfunction. Those who participate in tramadol abuse may struggle with erectile dysfunction, premature ejaculation, or other ejaculation disorders.

Men may also have difficulty maintaining an erection, and testosterone levels can be lowered and affected as well.

Side Effects In Women

Women may experience sexual side effects as well, with the tramadol creating a decreased libido. Additionally, women who are pregnant or breastfeeding should avoid tramadol, as side effects can harm the child.

If you are pregnant or nursing, speak with your doctor before taking tramadol. Those taking tramadol who become pregnant should contact their primary doctor immediately.

Side Effects In The Elderly

The elderly who suffer from chronic pain and require medication may experience an increase in side effects of tramadol. It may be necessary for older adults with liver or kidney disease to consider another opioid drug instead.

According to the United States Food and Drug Administration (FDA), elderly patients over the age of 75 years old should not take a larger dose than 300 mg per day. 

Older patients prescribed tramadol may have their medication changed and adjusted over time depending on how the drug affects the person.

Tramadol Drug Interactions

Combining illicit or prescription drugs may create a number of drug interactions that can lead to serious side effects. Some of the substances to avoid while taking tramadol include:

  • certain antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • benzodiazepines such as Ativan and Xanax
  • over-the-counter medications such as acetaminophen
  • painkillers including oxycodone, codeine, and other opiates
  • supplements and certain vitamins
  • alcohol
  • phenelzine (Nardil)
  • selegiline (Eldepryl)
  • duloxetine (Cymbalta)

Adverse effects may take place including allergic reactions which may result in hives or swelling of the face.

Serotonin Syndrome

A serious and life-threatening condition known as serotonin syndrome can occur when someone combines antidepressants with tramadol. This can lead to tramadol toxicity, and occurs when a large increase of serotonin is released, resulting in possible seizures or mental health concerns.

Tramadol Warnings

Those who take tramadol should be aware of adverse events that may take place, including opioid withdrawal and overdose.

Tramadol Withdrawal

Those who abruptly stop taking tramadol may experience serious withdrawal symptoms. According to the FDA, opioid withdrawal symptoms may include:

  • panic attacks
  • breathing problems
  • tremors
  • sleeping problems
  • runny nose
  • nausea
  • nervousness
  • diarrhea
  • sweating
  • hallucinations

Tramadol Overdose

Some of the symptoms of a tramadol overdose may include:

  • trouble breathing or respiratory depression
  • loss of consciousness
  • extreme sleepiness
  • heart rate fluctuations
  • increase in blood pressure

If an overdose is suspected, contact 911 immediately. A person may have Narcan (naloxone) administered to them, which helps reverse the effects of opioid overdose.

If you or a loved one live with tramadol addiction, contact us today to learn how our healthcare professionals can help.

  1. Drug Enforcement Administration — Tramadol
  2. Food and Drug Administration — Ultram
  3. Food and Drug Administration — Ultram ER
  4. Interdisciplinary Toxiolcoy — Effect of tramadol dependence on male sexual dysfunction
  5. National Institute on Drug Abuse — What are Prescription Opioids?
  6. National Library of Medicine: MedlinePlus — Tramadol

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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