What People Should Know about Tramadol

What People Should Know about Tramadol

In 1995, the US FDA approved the use of Tramadol. Originally, the agency approved the drug as a non-controlled analgesic. That non-controlled status was later changed to “controlled” due to reports of abuse, diversion, and misuse. The TV Star Ant McPartlin confessed to “getting addicted” to Tramadol after his knee surgery.
Many people are still curious about what this drug exactly is and what its side effects are. It also includes questions on whether or not it is addictive or if it can be taken by people who have just drunk alcoholic beverages.

What is Tramadol?

Tramadol is a pain reliever medication. Its molecular formula is C16H25NO2 and is sold under brand names such as Ultram, Tramal, and Ralivia. The drug’s main ingredient is called Tramadol Hydrochloride.
The German pharmaceutical company was the first to launch Tramadol. In 1977, the company marketed it under the brand name Tramal. Twenty years later, the drug was marketed in several countries like the US, UK, and Australia.


Tramadol works by stopping pain signals between the brain and the nerves. The process involves two mechanisms. Number one, Tramadol binds to the µ-opioid receptor. Number two, it acts as a reuptake inhibitor for the stress hormone norepinephrine and the neurotransmitter serotonin.

Tramadol is an opioid belonging to the benzenoid class. When absorbed by the body, it is changed to desmetramadol, a more powerful opioid.


Tramadol is used in treating moderate to severe pain and is considered for patients with respiratory depression. It is also used to treat cancer, dental, postoperative, and acute musculoskeletal pain. The drug is also prescribed as an adjuvant for osteoarthritis patients undergoing NSAID therapy.

The drug can be used in dogs and cats and can be potentially used in other animals. In animals, it is used as a treatment for chronic and postoperative pain and for a cough.
Tramadol’s usefulness in chronic pain conditions in animals is under investigation. In particular, experts are currently studying its potency when combined with NSAID drugs and other analgesics.

Side Effects

Reported side effects include:

• Constipation
• Nausea
• Drowsiness
• Vomiting
• Dizziness
• Dryness in the mouth

Serious side effects include:

• Difficulty in breathing (people with asthma reported about worsening of their condition)
• Increased heart rate and heart palpitation
• Anxiety
• Muscular spasm
• Swelling of throat, tongue, and face
• Seizures
• Decreased alertness
• Increased risk of serotonin syndrome
• Drug addiction

Changes in dosage may be advised for people with liver or kidney conditions. People with suicidal tendencies should not be given Tramadol.
In nursing women, the drug is not recommended.

Questions You Might Be Asking

Here are questions you might want to be clarified:

Is Tramadol controlled in all US states?

Yes, in all 50 states. The drug has been put under schedule IV in 2014, which means refilling prescriptions for the drug is restricted. Users may get refills but only up to five times and within six months from the date the prescription for which it is written. After that period or after five refills have been made, another prescription is required.

What must I do in case of seizures or withdrawal symptoms?

Seizures happen, but more often with overdose and with people who abuse the drug. It is not recommended not to stop using the drug abruptly when withdrawal symptoms occur. If experiencing tremors, anxiety, nausea or diarrhea, talk with your doctor before stopping treatment.

What are possible drug interactions for Tramadol?

You may have heard of serotonin syndrome. Those using serotonergic drugs are particularly prone to it. Drugs like those belonging to the triptan group are serotonergic drugs. If you are taking medications for migraine, for example, it is highly likely that your drugs are seronotergic. Brands include Relpax, Axert, and Imitrex.

Tramadol should not be taken together with narcotics, tranquilizers, and sedatives. Alcohol should be avoided.

Driving must be avoided until you are sure of the effect of Tramadol in your body. The same goes for other activities that necessitate mental alertness.

Is it habit-forming?

If you or your loved one has a history of “drug-seeking”, think twice about using Tramadol. The drug is closely related to morphine and codeine in chemical structure. That means those who take it may develop addiction, withdrawal and dependence. However, cases of illicit acts were also committed by users with no prior addiction or dependence on drugs.

Are there support groups for Tramadol addiction?

If you are already struggling with Tramadol abuse, it is important to talk to your doctor and seek help from support groups. The first step to take is to detoxification until no trace of the drug is left in your body.
Group counseling sessions are particularly helpful. Take note however that Tramadol is not really addictive. It is wrong to use that leads to it. Follow the recommended dosage and don’t buy it from illegal sources.

What forms are available?

There are two. First is the immediate-release formulation. Immediate administration is applied. After an hour, pain is significantly reduced. The second form is the extended-release. It is designed for round-the-clock treatment and not for “as-needed” basis. Extended-release Tramadol tablets are to be taken whole not cut or crushed.
Both forms are sold in generic stores. If the budget is tight, ask your doctor to prescribe to you the generic form of Tramadol.

Are there adjustments for special patients?

If this question is about doses, yes we have adjustments for that. For people with liver and kidney problems, we have recommended dosages, and that goes as well for the elderly. People over 65 years old but below 75 should start from the lower end of the dose range. The dose is gradually increased based on effectiveness and tolerance. Those who are over the age of 75 can take 300 mg daily but divided into smaller doses. For kidney patients, the maximum daily dose is 200 mg, but if one’s creatinine clearance is below 30, the extended-release form should not be used.

Liver disease patients must use the regular-release form. Fifty (50) mg can be given two times per day. Patients with severe liver disease should also not receive the extended-release form.