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Tramadol
Tramadol hydrochloride ( Ultram®) is a prescription medication approved to treat moderate to moderately severe pain in adults. Currently, tramadol is not considered a controlled substance or a narcotic by the United States Drug Enforcement Administration (DEA). However, this medication has significant potential for abuse and is classified as a controlled substance in certain states.
Just like any medicine, tramadol can cause side effects. However, not everyone who takes the drug will experience problems. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or are easily treated by you or your healthcare provider. Serious side effects are less common.
(Click Tramadol Side Effects to learn more, including potentially serious side effects you should report immediately to your healthcare provider.)
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking tramadol if you have:
- Seizures or epilepsy
- Liver disease, such as cirrhosis, liver failure, or hepatitis
- Kidney disease, such as kidney failure (renal failure)
- A head injury or high intercranial pressure
- Severe abdominal (stomach) pain
- Lung disease of any sort
- A history of drug or alcohol dependence
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
The dose of tramadol your healthcare provider recommends will vary, depending on a number of factors, including:
- How you respond to tramadol
- Other medications you are taking
- Your age
- Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
What If I Take an Overdose of Tramadol?
An overdose with tramadol can be dangerous. If you happen to take too much, seek immediate medical attention.
What Should I Do If I Miss a Dose?
Tramadol is often prescribed "as needed," which means that you do not need to take a dose if you do not feel pain. If you forget to take a dose, however, and notice significant pain, take your missed dose right away. However, make sure to wait the recommended time before the next dose.
Tramadol is classified as a "centrally acting opioid analgesic." This means that it works in the central nervous system (the brain and spinal cord), acts much like morphine in the body, and relieves pain. Much like morphine, tramadol binds to certain opioid receptors in the body known as μ ("mu") receptors.
Tramadol also works in a similar manner as some antidepressant medications by inhibiting the reuptake of certain brain chemicals (serotonin and norepinephrine). These are two of several chemicals used to send messages from one nerve cell to another. As a message travels down a nerve, it causes the end of the cell to release serotonin or norepinephrine. The serotonin or norepinephrine enters the gap between the first nerve cell and the one next to it. When enough serotonin or norepinephrine reaches the second nerve cell, it activates receptors on the cell and the message continues on its way. The first cell then quickly absorbs any serotonin or norepinephrine that remains in the gap between cells. This is called "reuptake."
Tramadol has a significant potential for both psychological and physical dependence and abuse, similar to morphine. Initially, this drug was marketed as a pain medication with little potential for abuse. However, healthcare providers quickly recognized that many of their patients had become addicted to tramadol. Now, the prescribing information contains numerous warnings about the potential for tramadol abuse.
Because tramadol can be a desirable drug of abuse, people often try to buy it through illegal means, such as from foreign countries or online sources that do not require a prescription.
For more information, visit the following eMedTV articles:
When and How to Take Tramadol
Some general considerations for those taking tramadol include the following:
- This medication comes in tablet form. It is taken by mouth, typically every four to six hours as needed for pain.
- In many cases, your healthcare provider may recommend that you start with a low dose and slowly work up to a higher dose.
- You can take this medication with or without food. If tramadol bothers your stomach, try taking it with a little food.
- Do not drink alcohol while taking this medication (see Tramadol and Alcohol).
- For tramadol to work properly, it must be taken as prescribed. Do not increase your dose without your healthcare provider's approval. Also, do not suddenly stop taking it, especially if you have taken the drug regularly for more than several weeks (see Tramadol Withdrawal).
Who Makes This Medication?
Brand-name tramadol is sold under the name Ultram and is made by Janssen Ortho, LLC, and is marketed by Ortho-McNeil Pharmaceutical, Inc. Generic versions are made by various manufacturers.
How Should Tramadol Be Stored?
Tramadol tablets should be stored at room temperature, away from moisture and heat. Keep this and all other medications out of the reach of children. Because it can be a desirable drug of abuse, make sure to keep it in a safe place.
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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