Important Things to Know About Tramadol

Tramadol Is Not an NSAID

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The painkiller tramadol, the generic version of Ultram, is a synthetic, narcotic-like analgesic medication. It acts similar to morphine but at about 1/10 of its potency. Tramadol binds to opioid receptors, which decreases the body's ability to feel pain. It is used commonly prescribed to treat arthritis.

U.S. Drug Enforcement Administration listed tramadol as a Schedule IV Controlled Substance in August 2014.

Examples of other Schedule IV drugs include diazepam (Valium), alprazolam (Xanax), and zolpidem (Ambien).

There are 10 things you should know about tramadol to ensure its appropriate and safe use.

Not an NSAID

Tramadol belongs to the class of drugs known as opiate agonists. What that means is tramadol binds to opioid receptors in the brain and provides pain relief. Some people mistakenly believe that tramadol is a NSAID (nonsteroidal anti-inflammatory drug), but it is not.

Immediate Release and Extended Release

Tramadol may be prescribed as an immediate release 50 mg tablet or as an extended-release 100, 200, or 300 mg tablet. The extended-release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment. Follow your doctor's appropriate dosage schedule for you.

Do Not Split, Chew, or Crush the Tablets

It is important to swallow tramadol pills whole.

Do not split, chew, or crush tramadol extended-release tablets. Breaking the pill may cause too much of the drug to be released at one time. Take your medication as directed and follow prescribing instructions. If taken improperly or in a way that is not recommended, serious side effects, including death can result.

Can Be Habit-Forming for Some People.

You should not take more tramadol than has been prescribed for you. Taking more tramadol or taking it more often can cause dependency. Also, you should not stop tramadol without first consulting your doctor. You may experience withdrawal symptoms if you stop the drug suddenly. Your doctor will likely advise you to decrease the dose of tramadol gradually.

Other Drug Interactions Are Possible

Be sure to tell your doctor about all of the medications and supplements you take. Tramadol strength can be affected if taken with other medications.

Other MedicationsPotential Interaction
CarbamazepineCan reduce the effect of tramadol
QuinidineCan increase tramadol concentration by 50 percent to 60 percent
MAOIs (monoamine oxidase inhibitor) or SSRIs (selective serotonin reuptake inhibitors)Can lead to seizures or other side effects

Can Cause Respiratory Distress if Combined with Recreational Substances

If taken with recreational or non-prescribed substances, like alcohol, narcotics, anesthetics, tranquilizers, and sedatives, tramadol can affect breathing, even causing breathing to stop. 

Not Approved for Pregnant and Breastfeeding Women and Children 

Since tramadol can carry serious risks, including slowed or difficult breathing and death, which appears to be at a greater risk in children younger than 12 years, tramadol is not FDA-approved for children under 18 years of age.

It is also not recommending for breastfeeding mothers due to possible harm to their infants. Because the safety of tramadol use during pregnancy has not been established, the medication should not be used during pregnancy. 

Tramadol Side Effects Are Usually Temporary.

There are some common side effects associated with tramadol. However, it is usually well tolerated. Symptoms may include:

  • nausea
  • constipation
  • dizziness
  • headache
  • drowsiness
  • vomiting

There are a few less common side effects including itching, sweating, diarrhea, rash, dry mouth, vertigo, and seizures. 

Potential Benefit for Treatment of Osteoarthritis

A Cochrane Review of scientific evidence by a group of researchers and medical professionals found that if tramadol is taken for up to 3 months for osteoarthritis, there may be decreased pain, as well as improvements in function, stiffness, and overall well-being.

However, the review also found that tramadol can cause side effects, which are significant enough to require that the patient stops taking the medication. In some cases, risks can outweigh the benefits for people taking tramadol.

In Case of Overdose Call 911 Immediately

Symptoms of an overdose include decreased pupil size, difficulty breathing, problems staying awake, unconsciousness, coma, heart attack, or seizure. Call for help, even if you are unsure whether you should.

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