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Tramadol Interactions, Types, Risk Factors & Side Effects

Tramadol interactions: What is Tramadol?

Tramadol is an opioid pain reliever that is typically used after surgery to alleviate pain. It is sometimes used to reduce dental pain. Aside from its analgesic properties, tramadol also prevents the reuptake of norepinephrine and serotonin, resulting in mood changes. Using tramadol for more prolonged periods can change your brain chemistry, and make tramadol detox more challenging. This is the result of having chemical dependence on tramadol.

There are a large number of other drugs that may interact with tramadol, that is why it is important to always tell your doctor about other medicines you are taking and avoid developing a dependence on tramadol. 

As you become more dependent on tramadol, your body behaves like it needs tramadol to thrive. Hence, when you suddenly stop using it, you’ll experience physical and psychological effects such as intense cravings and irritability. Experiencing tramadol detox can make it complicated for you to think well and makes you tempted to use tramadol excessively. If you want to heal yourself from this, you need to eliminate tramadol’s dependence on your mind and body. Tramadol detox is the only process to do it.

Tramadol interactions
Tramadol interactions: There are a large number of other drugs that may interact with tramadol, that is why it is important to always tell your doctor about other medicines you are taking.

According to, tramadol comes as a tablet, a solution (liquid), an extended-release (long-acting) tablet, and an extended-release (long-acting) capsule to take by mouth. The regular tablet and solution are taken usually with or without food every 4 to 6 hours as needed. The extended-release tablet and extended-release capsule should be taken once a day. Take the extended-release tablet and the extended-release capsule at about the same time of day every day. [1]

If you are taking the extended-release capsule, you may take it with or without food. If you are taking the extended-release tablet, you should either always take it with food or always take it without food. Take tramadol exactly as directed. Do not take more medication as a single dose or take more doses per day than prescribed by your doctor. Taking more tramadol than prescribed by your doctor or in a way that is not recommended may cause serious side effects or death. [1]

Tramadol Interactions: Different types of tramadol

Tramadol comes as:

  • Fast-acting tablets: these contain 50mg of tramadol
  • Slow-acting tablets: these contain 50mg, 75mg, 100mg, 150mg, 200mg, 300mg or 400mg of tramadol
  • Fast-acting capsules: these contain 50mg of tramadol
  • Slow-acting capsules: these contain 50mg, 100mg, 150mg or 200mg of tramadol
  • Drops that you swallow: these contain 100mg of tramadol in 1ml of liquid
  • An injection (usually given in hospital)
  • Soluble tablets: these contain 50mg of tramadol
  • Tablets that dissolve in the mouth: these contain 50mg of tramadol

Tramadol drops, injections, and some tablets and capsules are fast-acting. They start to work within 30 to 60 minutes. They’re used for pain that is expected to last for only a short time. You may be told to take fast-acting tramadol only when you need it for pain or regularly. Always follow the instructions given to you by your doctor.

Some tramadol tablets and capsules are slow-release. This means the tramadol is gradually released into your body over either 12 or 24 hours. This type of tramadol takes longer to start working but lasts longer. It’s used for long-term pain.

Tramadol interactions
Tramadol interactions: Tramadol drops, injections, and some tablets and capsules are fast-acting. They start to work within 30 to 60 minutes. They’re used for pain that is expected to last for only a short time.

Your doctor will decide the right dose for you, depending on how sensitive you are to pain and how bad your pain is. Your dose may need to be changed several times to find what works best for you. In general, you will be prescribed the lowest dose that relieves your pain

Tramadol Interactions

If your doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible tramadol interactions and must be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

A total of 545 drugs are known to interact with tramadol categorized as 294 major, 248 moderate, and 3 minor tramadol interactions.

Most frequently checked interactions:

  • Ambien (zolpidem)
  • Aspirin Low Strength (aspirin)
  • Benadryl (diphenhydramine)
  • Celebrex (celecoxib)
  • Cymbalta (duloxetine)
  • Fish Oil (omega-3 polyunsaturated fatty acids)
  • Flexeril (cyclobenzaprine)
  • Lipitor (atorvastatin)
  • Lyrica (pregabalin)
  • Nexium (esomeprazole)

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.

Tramadol Interactions: alcohol

Do not drink alcohol. Dangerous side effects or death could occur. Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Tramadol and alcohol could be a fatal mix.

Tramadol interactions: diseases

There are 10 disease interactions with tramadol which include:

  • Gastrointestinal obstruction
  • Acute alcohol intoxication
  • Drug dependence
  • Liver disease
  • Renal dysfunction
  • Seizure disorders
  • Acute abdominal conditions
  • Intracranial pressure
  • Respiratory depression
  • Suicidal

Tramadol Interactions: Side Effects

Commonly reported side effects of tramadol include: pruritus, agitation, anxiety, constipation, diarrhea, hallucination, nausea, tremor, vomiting, and diaphoresis. Other side effects include insomnia. 

Tramadol Interactions: Addiction, Abuse, and Misuse

Tramadol hydrochloride exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. It is necessary to assess each patient’s risk before prescribing tramadol hydrochloride and monitor all patients regularly for the development of these behaviors or conditions.

Tramadol Interactions: Life-Threatening Respiratory Depression

Serious, life-threatening, or fatal respiratory depression may occur with the use of tramadol hydrochloride. The health care provider must monitor for respiratory depression, especially during initiation of tramadol hydrochloride or following a dose increase. 

Tramadol interactions
Tramadol interactions: A total of 545 drugs are known to interact with tramadol categorized as 294 major, 248 moderate, and 3 minor tramadol interactions.

Tramadol Interactions: Accidental Ingestion

Accidental ingestion of even one dose of tramadol hydrochloride, especially by children, can result in a fatal overdose of the drug.

Tramadol Interactions: Life-Threatening Respiratory Depression in Children

Life-threatening respiratory depression and death have occurred in children who received tramadol. Most of the reported cases occurred following tonsillectomy and/or adenoidectomy, and many of the children had evidence of being an ultra-rapid metabolizer of tramadol.

Tramadol Interactions: Neonatal Opioid Withdrawal Syndrome

Prolonged use of tramadol hydrochloride during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. If opioid use is required for a prolonged period in a pregnant woman, the doctor must advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available.

Tramadol Interactions: Risks from Concomitant Use with Benzodiazepines or Other Central Nervous System (CNS) Depressants

Concomitant use of opioids with benzodiazepines or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. 

Tramadol Interactions: Side effects requiring immediate medical attention

Along with its needed effects, tramadol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking tramadol:

Most common:

  • Agitation
  • confusion
  • cough
  • darkening of the skin
  • diarrhea
  • difficulty swallowing
  • dizziness
  • fever
  • hives, itching, skin rash
  • loss of appetite
  • mental depression
  • nausea
  • overactive reflexes
  • poor coordination
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • restlessness
  • shivering
  • talking or acting with excitement you cannot control
  • tightness in the chest
  • twitching
  • unusual tiredness or weakness
  • Vomiting

Tramadol Interactions: How to cope with side effects

  • Constipation: try to get more fibre into your diet such as fresh fruit and vegetables and cereals. Also try to drink several glasses of water or another non-alcoholic drink every day. If you can, it may also help to do some gentle exercise like swimming or going for a short walk. Speak to your doctor about medicine to help prevent or treat constipation caused by tramadol if your symptoms don’t go away.
  • Dry mouth: try chewing sugar-free gum or sucking sugar-free sweets. Your doctor may also prescribe an artificial saliva substitute to keep your mouth moist. This comes as a spray, gel or lozenge.
  • Sweating: try wearing loose clothing, using a strong anti-perspirant and keeping cool using a fan if that is possible. If this doesn’t help and you find it unbearable, speak to your doctor as you may need to be treated with a different type of painkiller.
  • Low energy: speak to your doctor as they may be able to adjust your dose or give you a different painkiller.
  • Headaches: make sure you rest and drink plenty of fluids. It’s best not to drink alcohol with tramadol as you’re more likely to get side effects like feeling sleepy. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking tramadol. Talk to your doctor if they last longer than a week or are severe.
  • Feeling sleepy, tired, dizzy or “spaced out”: these side effects should wear off within a week or two as your body gets used to tramadol. Talk to your doctor if they carry on for longer. Do not drink any alcohol as this will make you feel more tired.
  • Feeling or being sick (vomiting): stick to simple meals and do not eat rich or spicy food. It might help to take your tramadol after you’ve eaten a meal or snack. If you’re sick, try small frequent sips of water. If it carries on, tell your doctor. They may be able to prescribe an extra medicine to protect your stomach.

Reclaim your life from tramadol dependence 

Tramadol dependence is a serious condition that can cause major health problems that should not be taken lightly. We Level Up CA Treatment Center can provide you, or someone you love, the tools to recover from this by detoxification with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can give you further information about issues such as tramadol interactions. Our specialists know what you are going through. Please know that each call is private and confidential.