Tramadol
Also sold as: Tramal, Ultram
Usual adult dose
Dose is set by your doctor. Usual adult dose: 50 to 100 mg every 4 to 6 hours when needed; no more than 400 mg in 24 hours. Use for the shortest time possible.
Your doctor may give you a different dose. Children's doses depend on weight.
Side effects
Common
- nausea
- dizziness
- drowsiness
- constipation
- sweating
Serious — get help
Stop taking it and see a doctor straight away if you notice:
- slow or shallow breathing
- seizures
- extreme sleepiness
- dependence and withdrawal when stopped suddenly
Do not take it, or take care, if
- Children under 12
- Epilepsy or history of seizures
- Severe breathing problems
- Taking antidepressants or other strong sedatives (use with caution)
- Pregnancy and breastfeeding (only if your doctor advises)
- History of drug or alcohol addiction
Interactions
Medicines that can react with this one.
Serious11 medicinesDo not take these together unless your doctor says so.
- Alprazolam
Together they can cause deep sedation and slowed breathing.
- Amitriptyline
Together they raise the risk of seizures and serotonin syndrome.
- Citalopram
Together they raise the risk of serotonin syndrome and seizures.
- Clonazepam
Together they can cause deep sedation and slowed breathing.
- Diazepam
Together they can cause deep sleepiness and dangerously slow breathing.
- Escitalopram
Together they raise the risk of serotonin syndrome and seizures.
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- Fluoxetine
Risk of serotonin syndrome and seizures; tramadol may also work less well.
- Imipramine
Together they raise the risk of seizures and serotonin syndrome.
- Lorazepam
Together they can cause deep sedation and slowed breathing.
- Paroxetine
Together they raise the risk of serotonin syndrome and seizures, and tramadol works less well.
- Sertraline
Risk of serotonin syndrome and seizures.
Moderate12 medicinesTake together only with care. Ask your doctor or pharmacist.
- Baclofen
Together they increase drowsiness and dizziness.
- Carbamazepine
Carbamazepine lowers tramadol levels and both affect seizure risk; avoid together.
- Chlorphenamine
Combined use increases drowsiness and the risk of slowed breathing.
- Chlorpromazine
The combination increases the risk of seizures and drowsiness.