Tramadol: Uses, How to Use, Forms & Side Effects

Updated in December 2023

Tramadol is an opioid analgesic that acts on the nervous system to treat moderate to intense pain. It is usually prescribed for cases of back pain, neuralgia and osteoarthritis, as it works specifically on the nerve cells in the spinal cord and brain. 

This medication is available in several forms, such as drops, pills, capsules and injections

Tramadol should be used cautiously under medical supervision. A prescription is necessary for it to be obtained. Common side effects, like physical dependence, psychological dependence, or addiction, can emerge in some patients if this medication is used on a chronic basis.

Imagem ilustrativa número 1

Common uses

Tramadol is a medication prescribed for cases of back pain, neuralgia or osteoarthritis. IT relieve moderate to intense pain due to its central nervous system action. 

How to use it

Dosing should be prescribed by a doctor, as the right dose can depend on the patient’s symptoms and the form used. 

1. Tramadol 50 mg pill

The recommended dose for adults and teens over 12 years old is 50 to 100 mg, or 1 to 2 pills every 4 to 8 hours, depending on how intense the pain is. Generally, you should not take more than 400 mg (or eight 50 mg pills) in one day. 

Pills should be taken whole and swollen with water. Avoid chewing tramadol pills. 

Long-acting tramadol pills should be taken every 12 to 24 hours, as prescribed by a doctor. 

2. Tramadol oral solution/drops (100 mg/mL)

Normally, the initial dose for adults or teens over 12 years old is 20 to 40 drops of tramadol, which is equivalent to 50 to 100 mg, every 6 to 8 hours. You should not consume more than 160 drops of tramadol per day, unless prescribed by a doctor. 

3. Tramadol injectable (100 mg/ 2mL)

Tramadol injectable is prescribed for the treatment of intense pain in adults and teens over 12 years old. The initial dose is 100 mg, although complementary 50 mg doses can be administered every 10 to 20 minutes to achieve pain relief, for a total maximum of 250 mg.  The doctor can also opt to prescribed 50 to 100 mg every 4 to 6 hours. 

This medication should be injected by a healthcare professional, and dosing should be calculated based on weight and pain intensity. 

Possible side effects 

Some of the more common side effects that can occur with tramadol treatment are nausea, dizziness, headache, vomiting, constipation, dry mouth, excessive sweating and fatigue. 

In addition, it can also trigger sleep disturbances, like sleep apnea and low oxygen levels while sleeping (which can cause cardiac arrest), night wakes due to difficulty breathing, difficulty staying asleep or drowsiness during the day. 

Long-term tramadol treatment can lead to physical and psychological dependence or addiction in some people. 

Is tramadol the same as morphine? 

No. Tramadol contains a substance extracted from opium, like morphine, and are both analgesics. However, they have different compositions and varying uses. Morphine is typically prescribed for more extreme cases of pain. 

Contraindications for use

Tramadol should not be used by people with a hypersensitivity or allergy to tramadol or any of its components. 

In addition, it should not be taken with alcohol, sleep medication, other analgesics or tranquilizer. Use is also prohibited by people who are on MAO inhibitors or have been on them in the last 14 days. It should not be used by patients with uncontrolled epilepsy or by patients being treated for narcotic withdrawal. This medication should also not be used by patients with an acute overdose of alcohol, hypnotics, opioids or other psychotropics. 

This medication should not be used by pregnant or breastfeeding women, or by children with respiratory problems without a prescription from the doctor. It should also be avoided by people with kidney or liver disease.