Tramadol should be used with caution in: patients who have taken tramadol or any other medicine containing tramadol for a long time, addiction to morphine or other painkillers, patients who have had an allergic reaction to any other morphine-like medicine, liver or kidney problems, patients who have recently had a head injury or have a very bad headache that makes them feel sick, patients who have ever had fits (convulsions) or suffer from epilepsy, asthma or breathing difficulties, patients taking medicines for depression, fits (convulsions) or psychosis, patients who feel as though they are going to faint, patients who have or had in the past low blood levels of sodium.
It should not be used in: children aged under 12 years, patients who have ever experienced a reaction to tramadol or any of the other ingredients in the medicine, patients with severe liver or kidney problems, patients who are taking or have taken in the last 2 weeks monoamine oxidase inhibitor drugs (MAOIs) which are used to treat depression, patients who suffer from uncontrolled epilepsy (fits), those who have drunk enough alcohol to make them feel even slightly drunk or have taken several sleeping tablets, other pain killers or any other medicines that slow down thinking or breathing rate.
Also see list of precautions and interactions
Do not store above 30ºC (Zydol capsules). Do not store above 25ºC (Zamadol capsules)
Tramadol is used to relieve pain. By acting on nerve cells in the spinal cord and brain, tramadol interrupts the pain messages travelling to your brain and stops you from feeling the pain.
It is an opioid, sometimes known as a painkiller or analgesic.
In general this drug is used to prevent or relieve moderate or severe pain after an operation or an injury.
Benefits of being on this drug can include feeling less or no pain (analgesic effect).
Listed below are the typical uses of tramadol.
- Relief of moderate to severe pain
HOW TO USE/TAKE
How often do I take it?
- Tramadol is available as tablets, capsules and as an injection.
- Tramadol tablets and capsules should be taken orally usually every 4-6 hours swallowed whole with a glass of water, with or without food. Some tramadol tables are soluble and should be dissolved in water before taking. Other tablets are modified release which means they release tramadol more slowly into your body and do not need to be taken as often. Make sure you check the label of your medicine so that you know exactly how many tramadol tablets or capsules to take, how to take them and how often to take them. If you are unsure about this ask you doctor or pharmacist. If you have been prescribed tramadol injection it may be injected into a vein (intravenously) or a muscle (intramuscularly). The dose and frequency of injection will depend on how much pain you are experiencing.
- Use this medication regularly in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
- It may take up to 30 minutes before the full benefit of this drug takes effect.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- Tramadol can cause drowsiness, dizziness and blurred vision and this can be increased by alcohol or by taking drugs used to treat depression. If affected do not drive or operate machinery. Consult your doctor or pharmacist for more details. Do not drink alcohol during treatment with tramadol.
When can I stop?
- It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.
TRAMADOL SIDE EFFECTS
- Feeling sick (nausea)
- Being sick (vomiting)
- Dry mouth
- Feeling drowsy or tired
- Feeling dizzy (especially after standing up suddenly from a sitting position)
- Shortness of breath
- Lack of energy
Only the most common side effects are listed here. Further information on side effects can be found in the patient information leaflet for this medicine.
If any of these persist or you consider them severe then inform your doctor or pharmacist.
Tell your doctor immediately if you develop any of the following symptoms: worsening of asthma if you already have severe asthma, difficulty breathing, wheezing, skin swelling, swelling of the face, tongue or throat, itching, skin rash, shock or sudden circulatory failure.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website
Before taking tramadol, tell your doctor or pharmacist if you are allergic to it; or to other opioids; or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: ever experienced a reaction to tramadol or any of the other ingredients in the medicine, severe liver or kidney problems, are pregnant or breastfeeding, are taking or have taken in the last 2 weeks monoamine oxidase inhibitor drugs (MAOIs) which are used to treat depression, suffer from uncontrolled epilepsy (fits), have drunk enough alcohol to make you feel even slightly drunk or have taken several sleeping tablets, other pain killers or any other medicines that slow down thinking or breathing rate.
Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following: you have taken tramadol or any other medicine containing tramadol for a long time, have an addiction to morphine or other painkillers, have had an allergic reaction to any other morphine-like medicine, liver or kidney problems, recently had a head injury or have a very bad headache that makes you feel sick, have ever had fits (convulsions) or suffer from epilepsy, asthma or breathing difficulties, are taking medicines for depression, fits (convulsions) or psychosis, feel as though you are going to faint, have or ever had low blood levels of sodium.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- You should not drink alcohol whilst taking this medicine.
The elderly: tramadol should be used with caution in the elderly as it may take longer for the drug to leave (be excreted) from the body of an elderly patient (aged over 75 years) than a younger patient. It may be necessary to use a lower dose of tramadol or to leave a longer gap between doses.
Pregnancy and breastfeeding - please ensure you read the detailed information below
Tramadol is not safe to take if you are, or are planning to become, pregnant.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Tramadol is not safe to take if you are breastfeeding.
Ask your doctor or pharmacist if you have any doubts or questions about this.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:
- Monoamine oxidase inhibitors (MAOIs) used to treat depression or if you have taken them in the past two weeks
If you are currently using any of these medications, tell your doctor or pharmacist before starting tramadol.
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- Medicines for depression including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and other antidepressants such as duloxetine, mirtazapine and venlafaxine
- Medicines for psychosis (antipsychotics)
- Medicines for convulsions or fits (anticonvulsants such as carbamazepine)
- Other painkillers (such as buprenorphine, pentazocine, nalbuphine, morphine, codeine [also in cough medicines])
- Blood thinning drugs (anticoagulants) such as warfarin
- Ondansetron (used to prevent nausea)
This information does not contain all possible interactions. Therefore, before using tramadol, tell your doctor or pharmacist of all the products you use.
Symptoms of overdose include sickness, reduction (constriction) in the size of the pupil of the eye (miosis), extreme sleepiness (sedation), fits (seizures), decreased breathing (respiratory depression), low blood pressure (hypotension), failure of the heart and blood vessels to pump blood around the body (circulatory failure), coma. If you ever take too much tramadol or if a child accidentally takes tramadol then contact your nearest hospital casualty department or tell your doctor immediately.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of tramadol or intentional overdose is suspected, contact your local hospital, GP or if in England call 111 or NHS Direct. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.