Tramadol – Uses, Dosage, and Potential Risks

To control medium to severe pain, there is no better option than taking tramadol. Being an opioid agonist, it works on the opioid receptors in the brain & body. When other painkillers do not relieve, tramadol dosage works well. To control pain, it works on the central nervous system. If you use it with other medicines like aspirin, ibuprofen, etc., you will get fast relief. It also relieves you when you use it alone.

Like other opioid medicines, tramadol also has higher risks of developing dependence, tolerance, and abuse. If used with other opioids or in higher amounts than recommended, it can create big damage, sometimes leading to death. Hence, we are here to tell you all the information about tramadol—uses, dosages, and potential risks.

What is Tramadol? Brief Overview

Tramadol is a prescribed medicine that is present in two forms.

• Immediate-release: After using, it starts working in the body right away. It is recommended for pain that lasts at least one week.
• Extended-release: These forms of medicine take little time to show their response. It is recommended for pain beyond the week.

Many people ask is tramadol an NSAID. NSAID medicines are used to treat the allergy-related disease. While tramadol does not control any allergy problems when you use it alone. So it is not NSAID.

The following are the tramadol brand and street names:

• ConZip
• Ultram ER
• Ultram
• Qdolo
• Chill Pills, Trammies, Ultras

The other most common question that is asked about this medicine is: is tramadol a controlled substance? It is a class IV controlled substance that the US Food & Drug Administration has cleared since July 2024. This organization has also approved tramadol as a painkiller. Tramadol control substance classification is due to its addiction and misuse nature. Therefore, its uses are limited to cases of pain (refractory pain) with other medicines.

Form of Tramadol

Tramadol is available in the following dosage forms:

• Tablet: Extended & Immediate Release Formulations
• Capsules: Extended & Immediate Release Formulations
• Liquid Solution (drops, injections)

What Does Tramadol Look Like?

Tramadol looks like a round pill or oblong pill, a colored capsule, or a liquid. It also may have printed letters or numbers on one side. Usually, the shape of tramadol depends on the brand. A few are described in the below table:

Uses of Tramadol

• Acute pain: Tramadol controls pain from moderate to severe, like pain after surgery.
• Chronic non-cancer pain: It can be used for chronic pain, like osteoarthritis. However, according to CDC guidelines, tramadol should be recommended after a deep, careful risk-benefit analysis.
• Premature ejaculation: Tramadol is also for off-level (it means it can be used to treat other diseases than what the FDA approved) to treat premature ejaculation. How strong is 50 mg of tramadol for this goal? According to a recent meta-analysis, using 25 to 50 mg of tramadol is best before intercourse for premature ejaculation.
• As an Alternative: Tramadol is the best alternative for other painkillers that are not tolerated or do not control pain properly.

What is the Working Process of Tramadol?

For controlling pain, tramadol controls opioid receptors. They play a big role in sending pain messages to the brain. However, tramadol stops these receptors from doing their work, and because your brain is not receiving the pain signal, you feel relieved.

Tramadol works as a dual mechanism of action.

1. Act as a weak opioid to get control of opioid receptors.
2. Stop to reach the chemical messengers (pain messengers) to the brain.

How long does tramadol take to work? If one uses its fast-acting form (injections, some formulas of capsules, and tablets) that are used to control short-term pain, it takes one hour to start its work. It may take a longer time to start with its slow-release/extended-form over 12 to 24 hours, but the patient feels relief for a longer time.

How long does tramadol stay in your system? Tramadol fast-acting form reaches its highest stages of relief within 2 to 3 hours and stays for 6 hours. Patients have to use it after every 6 hours. While tramadol’s extended-release form takes 10 to 12 hours to show complete relief that lasts for up to one day. Patients have to consume it once a day. Due to its multiple mechanisms of action and good tolerance ability, tramadol is considered a low-risk opioid choice to manage moderate to severe pain.

Tramadol Dosage

For consuming tramadol, you must follow the instructions of your doctor. For every patient, its dosage will be different. How long does tramadol last in your body? It depends on its medicine strength, the number of dosages you take per day, the time limit between dosages, etc. The following details are related to tramadol average dosage:

For Chronic Pain

Extended-release capsules and tablets for adults: It may start from 100 mg once a day. Its dosage may increase to 300 mg per day.

For Moderate to Severe Pain

Special Instructions for People with Kidney and Liver Disease

Kidney Patients

• Immediate-release tablet: Every 12 hours, you may take 50 mg to 100 mg of tramadol if you have serious kidney problems. 200 mg is the highest dosage.
• Extended-release tablet: This form is not for patients with severe kidney pain.

Liver Patient

• Immediate-release tablet: It may be prescribed by a doctor, 50 mg every 12 hours.
• Extended-release tablet: Never use tramadol extended-release tablet with severe liver problems.

Every person has their own system to respond to any drugs.  All this tramadol dosage information may not be effective for everyone. So we want to clear it up again; it is better to get advice from a doctor before consuming.

Side Effects of Using Tramadol

What are the Common Side Effects of Tramadol?

Does tramadol cause constipation? Yes, of course. This is one of the main effects of using the medicine. Below, you can find more information about some other common sides of using tramadol:

• Constipation
• Headache
• Stomach pain
• Vomiting
• Itching
• Daziness
• Tiredness

What are the Worst Side Effects of Tramadol?

An Allergic Reaction

• Fever
• Swelling of face, tongue, mouth, and lips
• Throat swelling or tightness
• Skin rash
• Stomach pain
• Vomiting

Breathing Problems

A patient with breathing problems may face big damage. The following are some side effects that you can face in such a case:

• Does tramadol make you sleepy? Yes, of course. Misusing tramadol or using it with other breathing problems (slowed breathing, etc.) may cause a high desire to sleep in the affected person.
• The color of your skin may change, especially your lips and fingernails may turn blue
• Higher heartbeat rate
• Confusion
• Shortness of breath

Serotonin Syndrome

Serotonin is a necessary chemical for nerve cells and the brain to function. The human body can produce it naturally, but the serotonin level increases more than normal by regularly using medications that cause its syndrome. Tramadol is one of them if you consume it in a huge amount. The following are some symptoms that you may face:

• Confusion
• Sweating
• Irritation
• Fast heartbeat
• Muscle stiffness
• Diarrhea
• Vomiting

Seizure

A seizure is an uncontrolled movement (shaking) in the body that may happen due to abnormal electrical activities in the brain. Contact your physician if you face the following signs:

• Shaking of the entire body that may last for two minutes, muscle twitching, spasms
• Losing consciousness
• Feeling nervous
• Tightness of legs and arms

The following are also some of the worst side effects of tramadol:

• Suicidal thoughts
• Low blood pressure, low sodium, and low blood sugar level
• Allodynia (a condition in which you may feel pain even doing little things like brushing your hair, wearing glasses, etc.)
• Tramadol can slow brain activities. It may cause sleepiness, sedation (relaxation), and even impair cognitive activities.

What Are Tramadol’s Side Effects on the Elderly?

The older kidneys and liver work slowly. So, their organs cannot work effectively as they used tramadol. Due to the slow mechanism, the drug stays in the body for a long time, which leads to harm and can cause an increased effect of the effects described above.

Tramadol Addiction & Dependence

Is tramadol addictive?  If you take tramadol regularly, you may start depending on this medicine. It has opioids that have a habit-forming quality and cause physical and mental dependence. You may have to consume its heavy dose after getting tolerance for it. Tramadol also has withdrawal signs like other Opioid Withdrawal feelings that may last for 5-7 days. These signs include:

• Irritation
• Vomiting
• Diarrhea
• Watery eyes
• Nausea
• Lack of appetite
• Running nose
• Sweating

Signs of Tramadol Overdoses

When starting, the doctor recommends taking

• 50 mg of short-acting tramadol every 6 hours
• 100 mg of long-acting tramadol once a day

According to patient tolerance, the amount may increase. You cannot increase or decrease the strength of the dosage by yourself. What do the tramadol overdoses mean? The overdose dosage includes when you take

• 400 mg strength (long-lasting) every day or
• 300 mg strength (short-acting) every 6 hours.

Overdosing side effects may reach a dangerous level. These are:

• Breathing that may be slow or swallow
• Confusion
• Muscle weakness
• Seizures
• Coma
• Trouble speaking
• Extreme tiredness
• Low blood pressure
• Cold Skin
• Dangerous heart problems, including slow heartbeat rate, cardiac arrest

If you think you or someone from your loved one has taken too much tramadol, call your doctor as soon as possible. You can also contact the American Association of Poison Control Center through its online tool or at 800-222-1222. But if the situation becomes serious, get immediate help from the nearest emergency room. Call 911 is also the best.

Tramadol Addiction and Abuse: Treatment

If you handle the situation on time, treatment is available and recovery is possible. The following are some treatment options for tramadol addiction:

Detoxification

Due to withdrawal symptoms, the detoxification method may be uncomfortable. It is better to do it under medical supervision. Under medical facilities, doctors can control conditions in their own way. To minimize the patient’s withdrawal pain, the doctors can also recommend some prescribed medicines (medication-assisted treatment or MAT) or over-the-counter medications.

Therapy

If you get therapy from an addiction counselor or licensed behavioral health professionals, it may leave many positive effects on your mental and physical health.

• Biofeedback Therapy: In this therapy, the therapist helps patients understand the importance of recovery of their involuntary processes (breathing, heart rate, etc.) by applying many electronic sensors to their bodies. By getting reviews from patients after biofeedback therapy, the therapist recommends the limit of this treatment till complete recovery.
• Cognitive Behavioral Therapy: CBD therapy is applied to patients to get rid of problematic thoughts. This type of therapy also relieves affected persons of anxiety and depression.

Support Groups

After finishing treatment, you can join the support group to stay on your recovery path. Here, you will get encouraging thoughts from members of the group. The following are a few groups that you can join:

• 12-Step Programs
• SMART Recovery
• Addiction Counselors

Precautions and Safety Measures

• Tramadol should not be taken with other certain medications like MAOIs (monoamine oxidase inhibitors). Which drug supplements you are taking, you must tell your doctor.
• Tramadol may cause harm to unborn babies. It also penetrates breast milk. Hence, consult your doctor if you are
  • Pregnant
  • Plan of pregnancy
  • Breastfeeding your baby.
• Tramadol is not effective for patients with allergy issues, asthma, etc.
• If you have serious liver and kidney problems, you should also avoid taking tramadol.
• It is strictly prohibited for children younger than 12 years. Children who are older than 12 years but have had surgery (tonsil removal, etc.) also cannot take it.
• People, especially those over 70, should make sure to use tramadol as their doctors prescribe.
• Never use tramadol and alcohol with each other. This combination can make the condition more serious.

Alternatives to Tramadol

Every human system responds differently to every pain relief medication. Some people may get relief by using non-opioid medicine (acetaminophen, etc.) that has low side effects. Others feel better when using tramadol and ibuprofen together.

Some non-pharmacological options are also useful to get pain relief without any side effects. These include:

• Physical therapy
• Heat/cold therapy
• Exercise
• Relaxation techniques
• Pain relief creams

Tramadol Vs Hydrocodone and Other Alternatives

Instead of using tramadol, you can use other prescription medicines like hydrocodone, oxycodone, and others. Let’s compare them:

Conclusion

Tramadol is the best option to treat the pain (moderate to severe) with a lower level of side effects. If you use it according to your doctor’s instructions, you may get little withdrawal symptoms that can be managed. But always remember what its precautions are for you. It is best to consult your doctor if you are using medication for any disorder. You can use tramadol with a combination of other medicines, like non-opioid but avoid taking it with opioid medication. Its overdose side effects may be life-threatening. Never ignore if you have taken its overdose mistakenly, and make sure to get help as soon as possible. Visit your doctor or rehab center for quick help and take care.