Tramadol Side Effects


Tramadol is a commonly prescribed opioid painkiller to treat acute and chronic pain ranging from moderate to moderately severe. Compared to other opioids, such as OxyContin, morphine, Vicodin, and fentanyl, tramadol produces milder opioid effects—this makes it a safer alternative to these drugs. Tramadol’s potency is about one-tenth that of morphine, and at therapeutic doses, it doesn’t produce dangerous side effects like profound respiratory depression. However, tramadol still has several unpleasant side effects, such as vomiting, nausea, and dizziness.1 

Short-Term Effects of Tramadol Use

If you are prescribed tramadol for pain, make sure you follow your doctor’s instructions very closely, being careful not to take your doses too frequently or to mix them with other substances, such as alcohol. Taking tramadol as directed will reduce the risk of experiencing unwanted side effects. Conversely, abusing or misusing tramadol increases the chance you’ll experience harmful and dangerous short-term effects.

Common short-term tramadol side effects include:2,3

  • Dry mouth
  • Heartburn or indigestion
  • Muscle tightness
  • Mood changes
  • Shakiness
  • Headache
  • Sleepiness
  • Anxiety or restlessness
  • Sleep disturbances
  • Constipation

These tramadol side effects may interfere with your daily life if they are severe enough. Make sure to talk to your doctor about any side effects so they can adjust your dose.

Some severe and potentially fatal short-term effects of tramadol include:2

  • Loss of consciousness
  • Confusion
  • Agitation
  • Hallucinations
  • Difficulty swallowing or breathing
  • Seizures

Stop taking your tramadol and call 911 immediately if you experience any of these dangerous tramadol side effects.

How Long Do the Effects Last?

How long tramadol effects last depends on whether you are taking an immediate-release or extended-release formulation.

Tramadol comes in several fast-acting formulations, such as:3

  • 50mg tramadol tablets
  • 50mg tramadol capsules
  • 100mg tramadol drops
  • Tramadol injection (administered in a hospital)

The effects of a fast-acting tramadol tablet or capsule can be felt within 30-60 minutes and last about 4-6 hours.3

Long-acting versions of tramadol include:3

  • 50mg-400mg tramadol tablets
  • 50mg-200mg tramadol capsules

In the case of long-acting tramadol, the opioid medication is gradually released into your body over a 12–24-hour period. The effects take longer to feel but last much longer than fast-acting versions. Typically, these are used to manage chronic pain that requires around-the-clock relief.

Are Tramadol Side Effects Dangerous?

Some side effects of tramadol can be dangerous, such as seizures, trouble breathing, or hallucinations.2 Another life-threatening side effect of tramadol use is the risk of anaphylaxis or a severe allergic reaction. Signs of a serious allergic reaction to tramadol include:3

  • Wheezing
  • Tightening in the throat or chest
  • Swollen throat, tongue, lips, face, or mouth
  • Problems talking or breathing
  • Itchy, red, swollen rash
  • Peeling or blistered skin

Another potentially fatal side effect of tramadol use is overdose. At therapeutic doses, the risk of tramadol overdose is extremely low, but if you misuse tramadol or mix it with other central nervous system (CNS) depressants like alcohol or benzodiazepines then you could experience severe respiratory depression, overdose, and death.

Signs and symptoms of a tramadol overdose include:2,4

  • Slowed heartbeat
  • Shallow or slowed breathing
  • Cold, clammy skin
  • Blue or purple lips or fingernails
  • Muscle weakness
  • Body goes limp
  • Unresponsiveness
  • Unable to wake the person
  • Extreme sleepiness or drowsiness
  • Pinpoint pupils
  • Vomiting or making gurgling noises

If you suspect you or someone else has overdosed on tramadol, call 911 immediately. Stay with the person until first responders arrive. Administer naloxone (Narcan), the opioid overdose reversal medication, if you have it available.4

Long-Term Effects of Tramadol

As with the short-term side effects of tramadol, the risk of experiencing harmful long-term effects increases if you misuse or abuse tramadol. Prolonged use of an opioid like tramadol can affect both your mental and physical health. Possible long-term side effects of tramadol use include:5

  • Increased risk of heart failure and heart attack
  • Chronic constipation
  • Sexual dysfunction
  • Infertility
  • Sleep-disordered breathing
  • Increased sensitivity to pain
  • Weakened immune system
  • Increased risk of depression
  • Tolerance, which can lead to overdose
  • Dependence, which can cause tramadol withdrawal symptoms when you quit
  • Addiction

Injecting Tramadol

Other potential long-term effects are specific to how you misuse or abuse tramadol. For example, if you dissolve this opioid in liquid and inject it, you may experience the following effects:6

  • Scars
  • Abscesses
  • Cellulitis
  • Peripheral edema
  • Puncture marks
  • Track lines
  • Infection of the heart lining
  • Tuberculosis
  • Increased risk of contracting HIV and hepatitis C

Snorting Tramadol

If you crush and snort tramadol, some long-term side effects may include:6

  • Chronic nose bleeds
  • Irritation of nasal lining
  • Perforated nasal septum

The Risk of Dependence, Withdrawal, & Addiction

One of the most hazardous long-term effects of tramadol abuse is the risk of dependence, withdrawal, and tramadol addiction. Misusing tramadol can lead to the rapid development of physiological dependence, which means you need tramadol or another opioid to avoid distressing withdrawal symptoms.

Tramadol withdrawal symptoms may include:1,2,6

  • Agitation
  • Anxiety
  • Restlessness
  • Depressed mood
  • Excessive sweating
  • Fever
  • Shakiness/tremors
  • Burning or prickling sensation in limbs
  • Goosebumps
  • Runny nose and watery eyes
  • Nausea and vomiting
  • Diarrhea
  • Muscle/bone pain
  • Severe tramadol cravings
  • Excessive yawning

These tramadol withdrawal symptoms are typically severe enough to require professional detox services. Without a tramadol detox program, you may return to tramadol use to relieve these painful symptoms. This cycle of quitting and relapsing can contribute to the development of tramadol addiction. Once you’re addicted to tramadol, you will compulsively use this opioid regardless of how it interferes with your life or daily functioning. Tramadol addiction may be challenging to overcome on your own, which is why it’s important to find a tramadol addiction treatment program that can help you obtain and maintain sobriety in the long run.

Find a Tramadol Addiction Treatment Program

If you’re struggling with an addiction to tramadol, a rehab program can help. A professional tramadol recovery program can help you build the foundation for a life of sobriety by teaching you healthy coping skills, drug-refusal strategies, impulse-control skills, and more. Individual, group and family therapy will help you make positive changes in your life and repair relationships that were damaged by addiction. Ready to begin on the road to recovery? Give a call at 1-800-429-7690. One of our rehab support specialists can help you find the right program for you.

Frequently Asked Questions About Tramadol Side Effects

What are the Tramadol Side Effects in Elderly?

Patients 65 and older may experience an increased risk of adverse effects, such as falls, fractures, emergency room visits, and cardiovascular hospitalizations. Elderly patients may also have an increased risk of side effects like insomnia, pneumonia, serotonin syndrome, and respiratory problems.7

What are the Side Effects of Tramadol and Alcohol?

Tramadol and alcohol are both CNS depressants, which means they slow your breathing and heart rate. When mixing tramadol and alcohol, you have a much higher risk of experiencing dangerous side effects, such as slowed or stopped breathing, unconsciousness, drowsiness, coma, overdose, and death.1

What are the Bad Side Effects of Tramadol?

The negative side effects of tramadol include mood swings, tremors, headaches, sleepiness, anxiety, heartburn, sleep problems, constipation, and dry mouth. More severe tramadol side effects include seizures, trouble breathing and swallowing, and hallucinations.2,3

Can I Become Addicted to Tramadol?

If you are taking your tramadol exactly as indicated, you have a very low risk of becoming addicted. However, if you misuse tramadol by taking higher or more frequent doses than prescribed, mixing it with substances like alcohol or sedatives, or injecting or snorting it, you can become addicted to tramadol.

Tramadol Resources

  1. World Health Organization. (2014). Tramadol.
  2. U.S. National Library of Medicine. (2020). Tramadol.
  3. National Health Service. (2018). Tramadol.
  4. Substance Abuse and Mental Health Services Administration. (2020). Opioid Overdose.
  5. Baldini, A., Von Korff, M., & Lin, E. H. (2012). A Review of Potential Adverse Effects of Long-Term Opioid Therapy: A Practitioner’s GuideThe primary care companion for CNS disorders14(3).
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  7. Musich, S., Wang, S.S., Schaeffer, J.A., Slindee, L., Kraemer, S., Yeh, C.S. (2021). Safety Events Associated with Tramadol Use Among Older Adults with Osteoarthritis. Population Health Management 24(1), 122-132.
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