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What is Tramadol?

Tramadol belongs to the group of medicines called opiates, others include codeine and dihydrocodeine. Tramadol is used to make moderate to moderately severe pain better. It works by changing the way the body senses pain and can then give pain relief. It can be used to treat different types of pain.

What dose should I take?

Your pain specialist will tell you what dose to take. Tramadol comes as 50mg ordinary capsules. These are taken 1-2 tablets up to four times a day. Tramadol is also available in slow-release form capsules or tablets. These are taken once or twice a day. The most you can take of both types is 400mg in 24hours. Often we start with a low dose to see how effective it is and avoid side effects.

How quickly will it work?

You should start to feel it working within 30 minutes to 1 hour and it will last for 4-6 hours if using the ordinary capsules or 8-12 hours if using the slow release.

How long will I have to take them for?

This is different for different people. In general, they will have to be taken for as long as you are requiring pain relief for moderate to moderately severe pain.

How will the dose be increased?

Doses of Tramadol vary from person to person. The dose of your Tramadol may be put up slowly depending on your response, how sore you are and any side effects you have tramadol give the best pain relief if used with regular paracetamol. Using regular paracetamol, allows you to put up your Tramadol when your pain is at its worst and put down your dose when it improves. This stops your body ‘getting used’ to a dose (sometimes known as tolerance).

When should I use slow-release tramadol?

Most people use ordinary tramadol capsules so they can change the dose when their pain changes. For some people who are wakened by their pain, or who need regular doses at the same level for a longer time then slow-release versions may be used.

Are there any side effects?

Yes, as with all medicines, side effects may happen but hopefully, these can be made less or stopped from happening. Not everyone will get side effects.

Common side effects include 

  • feeling sick,
  • constipation,
  • dizziness,
  • sleepiness, and sickness.

Less common side effects include 

  • itching,
  • sweating,
  • dry mouth,
  • diarrhea, or rash.

Some of the side effects may be short-lived and pass after the first few doses.

If affected by sleepiness you should avoid driving or operating machinery. Alcohol may make the sleepiness worse and should be avoided where possible. Starting on a low dose of 50mg and slowly putting the dose up can help stop side effects.

Although we have mentioned the most common side effects in this leaflet, there is a full list in the patient information sheet with your prescription. If you have any other side effects not listed in the information sheet please tell your doctor or pain specialist.

If you are breastfeeding, pregnant, or likely to become pregnant, you should let your pain specialist know.

If side effects go on and become a problem then speak to your pain specialist who will monitor you carefully and change your medication if needed.

Does Tramadol interact with other medicines?

Tramadol can act together with a few other medicines including some antidepressants. The main effect is more sleepiness.

You should never buy other medicines over the counter without telling the pharmacist that you are taking Tramadol.

How you could begin to reduce your Tramadol?

  • It is important not to stop taking your Tramadol suddenly as this may cause withdrawal symptoms for a few days. It is best to begin to reduce your Tramadol slowly then you are unlikely to get withdrawal symptoms.
  • It is important to choose a time to begin reducing your medication. This should be when you do not have stress in your life and when your pain is stable.
  • If you are taking Tramadol 50mg capsules you could reduce as follows: If you take Tramadol 50mg two-four times a day you could try reducing to Tramadol 50mg two-three times a day and just one 50mg capsule at one dose.
  • If you take Tramadol capsules 50mg one four times a day, you could try reducing to Tramadol capsules 50mg one three times a day.
  • Only you know when your pain tends to be worse so it would be best to reduce the first dose at the time of day when your pain is usually at it’s best.
  • You can discuss your pain medication with your GP, pharmacist, or pain specialist. They can give you advice on which painkillers may help and they can help you find the best way to take your medicines. They can advise you on putting your dose up safely if your pain is worse.

What should you avoid while taking Tramadol?

  • Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor.
  • Severe side effects have happened when this drug is used with benzodiazepines or other drugs that may make you drowsy or slow your actions. This includes slow or troubled breathing and death. Benzodiazepines include drugs like alprazolam, diazepam, and lorazepam. Benzodiazepines may be used to treat many health problems like anxiety, trouble sleeping, or seizures. If you have any questions, talk with your doctor.
  • Many drugs interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs.
  • Do not take with alcohol or products that have alcohol. Unsafe and sometimes deadly effects may happen.
  • Get medical help right away if you feel very sleepy, very dizzy, or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up.
  • This drug is not approved for use in children. Do not give to a child younger than 12 years of age. Children between 12 and 18 years of age who are very overweight or have certain other health problems like sleep apnea or other lung or breathing problems must not use this drug. If your child has been given this drug, ask the doctor for information about the benefits and risks.
  • Some children have had very bad and sometimes deadly breathing problems when using codeine after surgery to remove tonsils or adenoids. Do not give to a child younger than 18 years of age who has had surgery to remove tonsils or adenoids. Talk with your child’s doctor.