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Tramadol

Sounds like 'tra-ma-doll'

Key points about tramadol

Tramadol is used for the relief of moderate to severe pain such as after an injury, or operation or pain caused by a terminal illness such as cancer.
Follow the instructions on the label of your medicine, for how much to take and how often.
Tramadol is also known as Tramal.
Find out how to take it safely and possible side effects.

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Tramadol is a medicine used for the relief of moderate to severe pain. This may be after a serious injury or operation, or for pain caused by a terminal illness such as cancer. It's usually used when other milder pain medicines, such as paracetamol or non-steroidal anti-inflammatories (NSAIDs), don’t work well enough.

Tramadol belongs to a group of medicines called opioids. They act on your brain and nervous system to reduce pain.
Other types of pain relievers such as paracetamol and NSAIDs (ibuprofen, diclofenac, naproxen) may also be used with tramadol.
Read more about pain, pain-relief medication and opioids.

Some types of tramadol are immediate release (or short-acting) and others are slow release (or long-acting)

Immediate release: These start working quickly to ease pain and are usually taken every 4 to 6 hours.
Slow release: These work slowly over several hours to give a constant and more even pain control. They are usually taken twice daily (12 hours apart) at about the same time each day.
Follow the instructions on the label of your medicine, for how much to take and how often.

The dose of tramadol will be different for different people.

Some types of tramadol are short-acting or immediate release (eg, tramadol capsules and liquid) – they work quickly to ease your symptoms.
Long-acting or slow release tramadol tablets work slowly over several hours to give a constant and more even pain control.
Always take your tramadol exactly as your doctor has told you. Depending on the cause of your pain, your doctor may advise you to take regular doses or yo take tramadol only when you need it for pain relief. Make sure you know which is right for you.
The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions.
If you’re drowsy or sleepy, don’t take your next dose until you’re wide awake. Ask your healthcare provider for advice.

Follow the instructions on the label of your medicine, for how much to take and how often.
You can take tramadol with or without food.
Some types of tramadol are immediate release or short-acting and others are slow release or long-acting. Ask your pharmacist if you're not sure about the type you're taking.
If you're taking it regularly and forget to take your dose, take it as soon as you remember that day. But if it's nearly time for your next dose, just take the next dose at the right time. Do not take double the amount.

Formulation (type)	How to take
Immediate release – examples are tramadol capsules or tramadol liquid	These are usually taken every 4 to 6 hours. They start working quickly to ease pain.
Slow release – examples are tramadol tablets	The tablets work slowly over several hours to give a constant and more even pain control. These are usually taken twice daily (12 hours apart). Swallow the tablets whole – don't break or chew them, otherwise, they may release the medicine too quickly and cause side-effects.

Here are some things to know when you're taking tramadol. Other things may be important as well, so ask your healthcare provider what you should know about.

Eat plenty of fibre and drink more water while you are taking tramadol

Tramadol can affect your bowel movements – it might be hard or painful to poo (constipation).
If this happens, ask your healthcare provider for a laxative, to soften your poo.
Eating foods with fibre, drinking plenty of water and keeping active can help.

Tramadol can make you sleepy, drowsy, dizzy or affect your concentration

If you’re drowsy or sleepy, don’t take your next dose until you’re wide awake. Ask your healthcare provider for advice.
Limit or avoid alcohol as it can make these effects worse.
Don’t drive a vehicle, ride a bike or operate machinery (including power tools) and don’t make important personal or business decisions or sign legal papers if you are feeling sleepy, drowsy or have trouble concentrating.

Taking other medicines

Your doctor may recommend taking other pain relievers such as paracetamol and NSAIDs (ibuprofen, diclofenac, naproxen) as well. If taken regularly, they can reduce how much tramadol you need to take.
If you're taking any other medicines, or starting a new medicine, check with your doctor or pharmacist to make sure they're safe to take with tramadol. This includes any medicines you buy without a prescription (over the counter), such as herbal and complementary medicines or recreational drugs.
If you're taking the anticoagulant warfarin, tramadol may affect your INR results. More frequent testing of your INR is recommended when these 2 medicines are taken together.

Tramadol reduces severe pain but won’t take all of your pain away

If your pain isn’t improving:

Don’t take extra doses.
Try other ways to manage your pain such as relaxation techniques, gentle exercises and stretches.

Tramadol is addictive

If you're addicted to tramadol, you may find it difficult to stop taking it or feel you need to take it more often than necessary.
It's unusual for people who are prescribed tramadol for a short time or for a terminal illness to become addicted to it.
Some people are more likely to develop addiction than others and seem to be very sensitive to the cravings. You may be at risk for addiction if you have mental health problems, such as depression, or a history of substance abuse, including alcohol and recreational drugs.
To reduce your risk of addiction when using tramadol for short-term pain relief, use it for the shortest possible time, at the lowest effective dose.
Have a plan in place for how and when to reduce and stop taking it.
Talk to your doctor if you're worried about addiction or if you want to know more about how to prevent withdrawal symptoms.

Like all medicines, tramadol can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Feeling sleepy, dizzy or tired Vertigo Problems with concentration	This is common when starting tramadol or after increasing the dose. If you’re drowsy or sleepy, don’t take your next dose until you’re wide awake, and ask your healthcare provider for advice. Be careful when driving or using tools until you know how this medicine affects you. Don't drink alcohol.
Feeling sick (nausea) or being sick (vomiting)	This is common when you first start taking tramadol. Mostly this settles and goes away. Tell your doctor if this is bothering you. You may need an anti-sickness tablet.
Constipation	Constipation is very common and can be quite severe. Ask your doctor to prescribe a laxative, which you will need to take regularly. You also need to eat more fibre (such as fresh fruit, vegetables, brown bread, bran-based breakfast cereals) and drink plenty of water. Read more about how to ease and prevent constipation.
Headache, dry mouth, changes in your eyesight or vision Flushing, sweating	Tell your doctor if they bother you.
Mood changes, sleep problems, hallucinations, confusion, nightmares Palpitations or feeling like your heart is racing	Tell your doctor if they bother you.
Changes in breathing (slow or shallow), hard to wake up, seizures Difficulty urinating (passing pee)	Tell your doctor immediately or ring Healthline 0800 611 116.
Signs of an allergic reaction such as skin rashes, itches, swelling of the face, lips, mouth, or difficulty breathing	Tell your doctor immediately or ring Healthline 0800 611 116.
Signs of serotonin syndrome such as feeling agitated and restless, heavy sweating, shivering, fast heart rate or irregular heartbeat, headache, diarrhoea (runny poo) and rigid or twitching muscles	You are at increased risk of serotonin syndrome if you recently started taking tramadol, or recently increased the dose. You also have an increased risk if you are taking it with another medicine that increases serotonin. Tell your doctor immediately or ring Healthline 0800 611 116.