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Tramadol in pregnancy, Side Effects, Risks, Effects on Fertility, Neonatal Withdrawal Syndrome, Breastfeeding, Withdrawal & Addiction Treatment

Taking Tramadol in pregnancy

Due to possible safety concerns in a fetus, people should avoid using opioids like tramadol in pregnancy. These concerns involve both the possibility of birth defects as well as neonatal opioid withdrawal syndrome if the opioid is taken close to the baby’s birth.

Tramadol is an opioid pain-reliever prescribed to people who suffer from moderate to severe pain, typically from a surgery or injury. Though it contains less opioid content than other prescription drugs — such as oxycodone, hydrocodone, and morphine — Tramadol is still addictive and should be used with caution, especially during pregnancy.

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.

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.

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.

Tramadol in pregnancy
Due to possible safety concerns in a fetus, people should avoid using opioids like tramadol in pregnancy.

What Are the Side Effects of Taking Tramadol in Pregnancy?

Tramadol’s side effects in a pregnant person are similar to side effects in nonpregnant people. These include:

  • Constipation
  • Nausea and vomiting
  • Dry mouth
  • Indigestion
  • Dizziness
  • Vertigo
  • Headache
  • Drowsiness

However, tramadol crosses the placenta and can cause additional, possibly serious, side effects in your baby.

Can Tramadol Affect Fertility?

Evidence suggests that long-term tramadol use can reduce male fertility. Although some data suggest that female fertility can also be reduced by tramadol, the overall evidence remains unclear.

Tramadol in pregnancy: How Can Tramadol Affect Your Baby?

Because tramadol crosses the placenta, the risks of taking tramadol in pregnancy include exposing an unborn baby to the drug. Like other opioids, tramadol carries an FDA Black Box Warning for causing neonatal abstinence syndrome (NAS) in a newborn baby.

Because opioids have been linked to birth defects, doctors will often avoid prescribing tramadol to pregnant women. These include neural tube defects, heart defects, intestinal abnormalities, poor fetal growth, stillbirth, and preterm birth.

Does Use of Tramadol in Pregnancy Lead to NAS?

Taking tramadol in pregnancy can lead to the development of NAS. This condition can occur when an expectant mother consumes opioids, like tramadol, especially in the final months of her pregnancy.

NAS can develop in babies whose mothers took large amounts of tramadol to ease prenatal pain or who were addicted to opioids during their pregnancy. In either scenario, prenatal opioid use can cause a baby to be born addicted to drugs and experience severe withdrawal symptoms upon birth. As they can be severe, NAS symptoms often require immediate medical attention and can include:

Tramadol in pregnancy
Because tramadol crosses the placenta, the risks of taking tramadol in pregnancy include exposing an unborn baby to the drug.
  • High-pitched crying
  • Excessive sweating
  • Irritability
  • Jitteriness
  • Abnormal muscular activity
  • Seizures

In addition to these painful symptoms, NAS may be responsible for low birth weight, heart defects, and various developmental challenges.

Is Tramadol Safe To Use While Breastfeeding?

The FDA states that tramadol is not safe to use during breastfeeding. This is because of the risk of side effects in a nursing baby, including:

  • Excessive sleepiness
  • Problems breastfeeding
  • Slow or shallow breathing
  • Limpness
  • Death

What Are the Risks of Taking Opioids While Pregnant?

Taking opioids while pregnant impacts the mother and fetus together and can put the pregnancy itself at risk. In general, opioid use during pregnancy may increase the risk of:

  • Preeclampsia
  • Premature rupture of membranes
  • Spontaneous abortion
  • Low birth weight

Weighing the Benefits and Risks of Taking Tramadol in Pregnancy

Expectant mothers and their doctors must carefully weigh the benefits against the risks of taking opioids like tramadol in pregnancy. Although experts recommend avoiding opioids if possible during pregnancy, they recognize that some people may need opioids to control pain. Ultimately, before a woman chooses to take opioid pain-relievers like tramadol during pregnancy, the mother’s health must be considered alongside the potential risks to her unborn baby.

What Are Some Alternatives for Pain to Tramadol in Pregnancy?

Experts recommend that pregnant women should seek out non-pharmacological remedies for pain while pregnant if possible. These can include:

  • Using a heating pad
  • Taking warm baths
  • Eating a balanced diet
  • Engaging in light exercise
  • Investing in massage therapy
  • Attending prenatal yoga classes

Signs and Symptoms of Tramadol Withdrawal

An important study published in 2011 established, for the first time, that humans can become physically dependent on tramadol. This is true even when taking it as directed by a doctor. When someone is physically dependent on a drug, it means they will experience withdrawal symptoms when they stop or reduce their dose.

Tramadol works like an opioid, which means that many of its withdrawal symptoms resemble those of other opioid withdrawal syndromes. But unlike traditional opioids, tramadol has a significant effect on several of the brain’s other neurotransmitters, including serotonin.

Because of this, you may experience additional withdrawal symptoms, including those more commonly associated with antidepressant withdrawal.

When withdrawing from tramadol, you may experience any of the following symptoms:

  • Sweating
  • Chills
  • Irritability
  • Anxiety
  • Diarrhea
  • Nausea or vomiting
  • Loss of appetite
  • Panic, paranoia, or panic attacks
  • Aches and pains in the muscles or joints
  • Trouble falling or staying asleep
  • Runny nose, sneezing, or coughing
  • Gooseflesh
  • Abdominal cramps
  • Restless leg syndrome
  • Confusion or delirium
  • Agitation
  • Increased blood pressure or heart rate
  • Fast breathing

Everyone’s withdrawal and tramadol detox experience is different. It is impossible to predict exactly when your symptoms will start, how long they will last, or how severe they will be.

Things that can influence your withdrawal and tramadol detox experience include the duration of your drug use, how much you use, and how often you use. Other factors that can influence your withdrawal include:

  • Your mental health
  • Your other drug use
  • Your history with substance abuse
  • Your health
  • Your age
  • Genetics

In a typical healthy adult, tramadol withdrawal begins one to two days after the last dose, peaks after day three, and subsides within one to two weeks.

Long-Term Treatment for Tramadol Addiction

If you developed a physical dependence on tramadol because you spent several months or years taking a therapeutic dose for your pain, then you probably won’t need any additional treatment. A taper during a tramadol detox should be enough to help you quit, as long as you have a plan to handle your pain in the future.

But if you are among the many people who misuse or abuse tramadol, then you have a long road ahead of you. Tramadol misuse means taking it in any way other than prescribed by your doctor, including taking larger or more frequent doses than you’re supposed to or mixing it with other medications. Tramadol abuse is when you use it to get high, use it to intensify the high of another drug, or use it to treat opioid withdrawal symptoms.

A substance use disorder (addiction) is a complex disease that has both physical and psychological symptoms. The physical symptoms are your withdrawal symptoms, while the psychological symptoms are the thoughts, feelings, and behaviors surrounding your drug use.

Research shows that a combination of medication and counseling is the best approach to opioid addiction. Depending on your circumstances, medication may mean a slow tramadol taper or the addition of opioid maintenance medications like buprenorphine or methadone.

Some people choose to work one-on-one with a drug counselor or psychiatrist who can prescribe medication. Whereas others prefer the abstinence-based 12-step model. All of these methods have been shown to encourage long-term sobriety.

In the long-term, many people chose the convenience of a free 12-step group, like Narcotics Anonymous. These social support groups are offered every day around the country. At meetings, you swap stories with people who have been where you are. Through a process of acceptance and participation, these groups give you the strength to stay clean and rebuild your life after addiction.

Tramadol in pregnancy
Taking tramadol in pregnancy can lead to the development of NAS. This condition can occur when an expectant mother consumes opioids, like tramadol, especially in the final months of her pregnancy.

Reclaim Your Life From Tramadol Addiction

Tramadol addiction is a condition that can cause major health, social and economic problems that should not be taken lightly. We Level Up California can provide you, or someone you love, the tools to recover from addiction with professional and safe tramadol detox. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.


[1] Compound Summary: Tramadol. Pub Chem. National Library of Medicine.

[2] Bush DM. Emergency Department Visits for Drug Misuse or Abuse Involving the Pain Mediation Tramadol. The CBHSQ Report. Substance Abuse and Mental Health Services Administration. Published May 14, 2015.

[3] Opiate and opioid withdrawal. U.S. National Library of Medicine.

[4] Food and Drug Administration. “FDA Drug Safety Communication: FDA restricts use of prescription codeine pain and cough medicines and tramadol pain medicines in children; recommends against use in breastfeeding women.