Tramadol
(tra’ ma dole)
Why is this medication prescribed?
Tramadol is used to relieve moderate to moderately severe pain. It may be used to treat pain caused by surgery and chronic conditions such as cancer or joint pain. Tramadol is in a class of medications called opiate (narcotic) analgesics. It works by decreasing the body’s sense of pain.
How should this medicine be used?
Tramadol comes as a tablet to take by mouth. It may be taken with or without food. Your doctor may start you on a low dose of tramadol and gradually increase your dose not more often than every 3 days. Tramadol may be taken every 4-6 hours as needed. If you take too much tramadol, you may experience serious side effects.Ask your doctor about the maximum number of tablets that you may take for each dose or for a 24-hour period.Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tramadol exactly as directed.
Tramadol can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor. Call your doctor if you find that you want to take extra medication or notice any other unusual changes in your behavior or mood.
Do not stop taking tramadol suddenly without talking to your doctor. If you suddenly stop taking tramadol, you may experience side effects. Your doctor will probably decrease your dose gradually.If you suddenly stop taking tramadol you may experience withdrawal symptoms such as nervousness; panic; sweating; difficulty falling asleep or staying asleep; runny nose, sneezing, or cough; numbness, pain, burning, or tingling in your hands or feet; hair standing on end; or rarely, hallucinations (seeing things or hearing voices that do not exist).
Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking tramadol,
- tell your doctor and pharmacist if you are allergic to tramadol or other narcotic pain medications such as meperidine (Demerol), morphine, codeine (or medications that contain codeine such as Tylenol with Codeine), hydrocodone (e.g., Vicodin), hydromorphone (e.g., Dilaudid), oxycodone (e.g., Percocet), propoxyphene (e.g., Darvon, Darvon N), any other medications, or corn.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); antihistamines; bupropion (Wellbutrin);celecoxib (Celebrex); cimetidine (Tagamet);cyclobenzaprine (Flexeril); digoxin (lanoxin); doxorubincin (Adriamycin);haloperidol (Haldol); imipenem and cilastatin (Primaxin); methadone (Dolophine, Methadose); monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate); medications for anxiety, mental illness, nausea, pain; medications for seizures, such as carbamazepine (Tegretol); metoclopramide (Reglan); nefazodone; promethazine (Phenergan); quinidine (Quinaglute; Quinidex); ranitidine (Zantac); ritonavir (Norvir, in Kaletra); sedatives; sleeping pills; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); ticlopidine (Ticlid); tranquilizers; tricylic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil);venlafaxine (Effexor);warfarin (Coumadin). Many other medications may also interact with tramadol, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had seizures, head injury, infection in your brain or nervous system, increased intracranial pressure (increased pressure within the skull), diabetes, breathing problems or lung disease, or kidney or liver disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tramadol, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol.
- you should know that this drug may make you drowsy and may affect your coordination. Do not drive a car or operate machinery until you know how this drug affects you.
- remember that alcohol can add to the drowsiness caused by this drug. The manufacturer states that tramadol should not be taken with alcohol containing beverages.
- you should know that tramadol may cause dizziness, lightheadedness, and fainting when you get up from a lying position. To avoid this, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
Tramadol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- dizziness
- weakness
- headache
- nervousness or anxiety
- agitation
- shaking hands that you cannot control
- increased muscle tightness
- changes in mood
- drowsiness
- blurred vision
- heartburn or indigestion
- upset stomach
- vomiting
- diarrhea
- constipation
- itching
- sweating
- flushing
- dry mouth
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
- hives
- rash
- sores on the inside of your mouth, nose, eyes, or throat
- flu-like symptoms
- itching
- difficulty swallowing or breathing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- fast heartbeat
- hoarseness
- difficulty swallowing or breathing
- changes in urination
- seeing things or hearing voices that do not exist (hallucinating)
- seizures
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- confusion
- vomiting
- decreased size of the pupil (the black circle in the center of the eye)
- difficulty breathing
- extreme drowsiness
- unconciousness
- coma
- seizure
- heart attack
What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Brand names
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Last Revised - 07/01/2005