What is tramadol?
This combination product contains both tramadol and acetaminophen. Opioid analgesics belong to a class of drugs called opioids, and anesthetics belong to a category of drugs called painkillers. This combination medication is prescribed for managing moderate to moderately severe pain. It reduces pain by working on the brain.
This medication may be marketed under various brand names; however, any specific brand name of this drug may not be available in every form or approved for every condition discussed here. Some forms of this medication may be used for some but not all of the conditions discussed above.
You should always discuss any changes in your medications with your doctor. Don’t stop taking this medication without first talking to your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can harm people to take this medication if their doctor has not prescribed it.
Which forms of this medication come in?
Mylan has stopped manufacturing Tramadol/Acetaminophen (Mylan-Tramadol) tablets in Canada. If you’re looking for these products, look for them under Tramadol – Acetaminophen. This article is not intended for use as medical advice, diagnosis, or treatment. Please consult a physician if you need help with any aspect of your health.
What should I do when taking this medicine?
The usual recommended dose for tramadol (taken alone) is one tablet every four to six hours as needed for pain management, up to eight daily.
Several factors can affect the dose of medication someone needs, including their body weight, other medical conditions, and any medications they may be taking. If your doctor has prescribed a dose different than those mentioned here, don’t change how you take the drug without first talking to them.
Acetaminophen (Tylenol) – tramadol (Ultram) can be taken with or without whole pills. It would help if you never cut, break, chew, crush, or dissolve the tablets. Doing so could be harmful. Stop taking this medicine if you feel any of these symptoms. If you stop taking this medicine abruptly, you may experience withdrawal effects such as anxiety, sweating (especially at night), trouble sleeping, shaking, nausea, vomiting, diarrhea, or hallucinations (seeing things that aren’t there). If you’re planning on stopping taking your medication, your doctor might suggest reducing the dose gradually so that you don’t experience severe withdrawal symptoms.
You must take this medicine exactly as directed by your doctor. If your doctor tells you to take this medicine regularly and you miss a dose (or forget), assume it as soon as you remember and continue with your regular dosing schedule. If it is almost your next dose, skip your missed dose and continue with the rest of your regular dosing schedule. Don’t take a double amount to replace a skipped one. If you’re unsure what to do if you miss a dose, ask your doctor or pharmacist.
Keep this medication away from kids and pets.
Do not throw out medications in wastewater (e.g., down the sink), household trash, or sewage. Talk to your pharmacist about properly disposing of drugs that are not needed anymore or have expired.
Do not use this medicine if you:
If you’re taking one of these medications, don’t take them if you:
- Are you allergic to tramadol or acetaminophen or any ingredients of the medication?
- Are allergic to other opioid medications such as codeine, morphine, etc.
- are experiencing acute alcohol poisoning or delirium tremensus
- Are you experiencing acute asthma or other respiratory diseases
- Are you experiencing acute respiratory depression
- Have mild pain, which can usually be treated with other pain medication.
- Has or may have an abdominal problem that requires surgery (appendicitis, pancreatitis).
- are intoxicated with alcohol, other drugs, or psychotropic medications such as sedatives, antidepressants, antipsychotics, anxiolytics, or antihistamines.
- Are you pregnant, in labor, giving birth, or breastfeeding
- Are/have been taking MAO inhibitors (e. g, phenelzine, transylpramine, moclobemide) within the last 14 d e ers
- Have a blockage of the GI tract, especially paralytic ileus.
- Have epilepsy
- Have a head injury, a tumor, or increased pressure inside your skull or spine.
- Have severe CNS depression (e.g., slowed nervous system).
- Have severe kidney failure
- Have severe liver damage
- are under 18 years of age and have undergone surgical treatment for obstructive sleep apnea (OSA)
Do not give this medication to children less than 12 years old.
What side might effects be associated with this medication?
Medications may sometimes cause side effects. Side effects are unwanted responses to taking drugs. Side effects can range from mild to severe, temporary to permanent.
These side effects may occur for some people taking this medication, but they’re unlikely to happen to most people. If you experience any of these side effects, talk to your doctor.
There may be some side effects associated with this medication. If any occur, talk to your doctor. Some of these side effects can usually be managed, and some might disappear on their own over time.
If you experience any of these symptoms, contact your doctor immediately. You might want to ask your pharmacist for advice on dealing with any side effects you experience.
- decreased appetite
- decreased interest in sexual activity
- decreased sexual ability
- dry mouth
- trouble sleeping
- vision problems
Most of the side effects listed here may not occur very often but could cause serious health issues if left untreated.
Talk to your doctor immediately if one or more of these side effects occurs:
- fast, slow, irregular heartbeat
- low blood pressure (such as dizziness, fainting, light-headedness
- poor muscle coordination
- Contact your doctor immediately if you notice any symptoms of liver problems (such as nausea, vomiting, or diarrhea).
- Symptoms of low blood sugar include cold sweats, cool pale skin, headaches, rapid heart rate, and weakness.
- Symptoms of low sodium include tiredness, weakness, dizziness, muscle aches, stiffness, and incoordination.
- Withdrawal symptoms include nausea, vomiting, diarrhea, and anxiety. They may be accompanied by shivering, cold and sweaty skin, body aches, and loss of appetite.
If any of these symptoms occur, stop taking the medication immediately and go see a doctor.
Signs of taking too much medication, e.g.,:
- cold, clammy skin
- Hallucinations (hearing or seeing things that aren’t there)
- shallow, rapid breathing
- severe drowsiness
- decreased coordination
- floppy muscles
Signs of a severe allergic reaction, e.g.:
- difficulty breathing
- swelling of the lips, mouth, throat, or tongue
Signs of a severe skin reaction, e.g.:
- high fever
- painful blisters on the skin, mouth, or eyes
- skin peeling off
- slow or weak breathing
- symptoms of a bowel blockage (e.g., abdominal pain, severe constipation, nausea)
- symptoms of serotonin syndrome (e.g., confusion, fast heartbeat, hallucinations, high blood pressure, restlessness, shaking, shivering, sudden jerking of muscles, sweating)
You might experience some side effects not mentioned here. If you notice anything unusual, check with your doctor.
What other precautions or warnings should I be aware of when taking this medication?
Before taking a medication for a condition, tell your doctor if you have any medical conditions or allergies, medications you’re currently taking, whether you’re pregnant or breastfeeding, and anything else important about your health. Some of these factors may affect how you use this medication.
If you’re taking tramadol for pain relief, acetaminophen might make diagnosing an abdominal condition more difficult or worse. If you have an intestinal disorder such as inflammatory or obstructing bowel disease, acute cholecystitis, or pancreatitis, discuss with your physician how this medication may affect these conditions, how they might affect the dose and effectiveness of this medicine, and whether any special tests are necessary.
If tramadol-acetaminophen is taken by someone other than the person for whose benefit it was prescribed, the results could be fatal. Store this medicine where children cannot get at it.
Acetaminophen (Tylenol) is usually considered a safe drug; however, overuse of acetaminophen can cause liver damage leading to liver failure and death or requiring a liver transplant. You must be careful not to exceed the recommended dosage of Tramadol – Acetaminophen. Acetaminophen (Tylenol) can be found in many over-the-counter medications without prescriptions. Make sure you read the labels carefully before considering whether you’re taking too much acetaminophen when taking into account the different medications you’re taking. If you have questions about the amount of acetaminophen you take, talk to your pharmacist or doctor first.
If you experience liver problems such as fatigue, unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Adrenal gland problems:
Your adrenal glands produce chemicals called hormones which help regulate the functions of your body’s organs, including your response to injury or stress. Tramadol may occasionally cause your adrenal glands to malfunction. If you experience any symptoms related to an underactive adrenal gland, your doctor may monitor you for these conditions.
Alcohol and other medications that cause drowsiness:
People who take this medication should avoid drinking alcohol or taking drugs that cause drowsiness, such as sedatives or certain antidepressants. It is important to note that doing so may cause serious health risks, including breathing problems, seizures, and drowsiness.
Acetaminophen (Tramadol) – acetaminophen can If you have asthma or COPD, talk to your doctor before taking this medicine if you’re pregnant, planning pregnancy, breastfeeding, or unsure whether you’re pregnant. You should also tell your doctor if you’re allergic to any ingredient in this product; take precautions when handling your medications; and inform your doctor immediately if you experience symptoms of an allergic reaction (such as difficulty breathing, swelling of your face, lips, tongue, or throat).
Dependence and withdrawal:
Tramadol may cause physical dependence, psychological dependency, and addiction. People with past or present substance use problems may be more likely to develop a habit while using this drug. If you stop taking this medication abruptly, you might experience withdrawal symptoms such as nervousness, insomnia, shivering, trembling, headache, stomach cramps, vomiting, diarrhea, and dizziness. Stop taking this medicine if you’ve been using it for some time now. Your doctor may direct you to stop gradually. Don’t stop taking this medicine without first talking to your doctor or healthcare provider.
This medication may cause some side effects, including dizziness or drowsiness. It may also affect your ability to drive safely or perform other dangerous activities. It’s important to avoid combining this medication with alcohol or any other medicines that may cause drowsiness (for example, antidepressants, sleeping pills, anxiolytics). Other drowsiness and dizziness can occur and be dangerous and potentially fatal. Do not drive, use machinery, or perform hazardous activities until you know how this medicine affects you.
If you have head injuries or increased pressure inside your head, you might experience breathing problems or a worsening condition when taking this medicine. If you recently suffered a head injury, discuss with the doctor how this medication may impact your medical condition, how that condition may affect the dosing and effectiveness, and if there are any special monitoring requirements.
Tramadol may cause changes to the normal rhythms of the heart, including a prolonged QT interval. The long QT interval is a severe life-threatening condition that can cause faints, seizures, and sudden deaths. If you’re concerned about side effects from tramadol, talk to your doctor before using it. You might be able to lower your dose without having severe side effects. Your doctor might want to monitor your heartbeat closely during the treatment.
Tramadol passes through the liver before entering the bloodstream. If you’re taking this medicine for high blood pressure, you might experience some unwanted side effects if you don’t take it properly. If you have kidney damage or decreased kidney function, talk to your doctor before taking this medicine. Your doctor might want to adjust your dose or monitor you for side effects. This medication is not suitable for people with severely reduced kidney function.
The liver is partially involved in removing both tramadol and acetaminophen from the body. Taking medications for high blood pressure, diabetes, or heart conditions might risk developing an adverse reaction if you take certain drugs together. If you have liver damage or reduced liver function, talk to your doctor before taking this medicine. Your doctor might want to adjust your dose or monitor you closely for side effects. People with severe liver disease should not usually use this medication.
If you experience any symptoms of liver problems such as fatigue, feeling unwell or loss of appetite, nausea or vomiting, yellowing of the body or whites of the eyes (jaundice), dark urine, pale stool, abdominal pain or swelling or itching, contact your doctor immediately for advice.
Low blood pressure:
Sometimes, blood pressure drops too far after taking tramadol – acetaminophen. Those who take diuretics, eat low-salt foods, are on hemodialysis, experience diarrhea or vomiting, sweat excessively, and don’t drink enough fluids may be at risk. When rising from a sitting or laying down position, get up slowly if low blood pressure makes you faint or feels lightheaded, call your doctor immediately.
When taking tramadol, avoid using alcohol or other drugs that might increase its effects.
- monoamine oxidase inhibitors (MAOIs; e.g., phenelzine, tranylcypromine)
- neuroleptics (e.g., haloperidol, quetiapine, olanzapine, risperidone)
- other opioids (e.g., morphine, codeine, oxycodone)
- serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
- selective serotonin reuptake inhibitors (SSRIs; e.g., paroxetine, fluoxetine)
- tricyclic antidepressants (TCAs; e.g., amitriptyline)
People with epilepsy are also at greater risk of having seizures if they take certain medications. If you have epilepsy or are at risk of having seizures, talk to your doctor before taking this medicine. You might need to adjust your dosage or stop using this drug if you experience side effects. Your doctor can tell you whether special monitoring is necessary to take this medicine safely.
Tramadol may cause severe side effects if taken with certain antidepressants. Combining tramadol and MAOs must be avoided. Symptoms may include muscle rigidity, difficulty moving, and mental changes, including delirium and agitation. You could die from m coma or even death.
Sleep apnea is when you stop breathing for short intervals during sleep. It may be caused or worsened by certain medications such as tramadol-acetaminophen. If you have sleep apnea or if people notice you stop breathing from time to time when you’re asleep, contact your doctor immediately.
Tramadol interacts with some medications used during surgery. You might need to take these medications to Let your doctor know if you take any medicines before surgery.
Pregnant women taking this drug during pregnancy may experience dangerous withdrawal symptoms if they stop using it after giving birth. This drug should not be taken during pregnancy unless the benefits outweigh the risks. Call your doctor immediately if you get pregnant while taking this medicine.
This medicine passes into breast milk. If you’re breastfeeding and are taking tramadol – acetaminophen, it might affect your baby. If breastfeeding, talk to your doctor about whether continuing is right for you.
Because there has not been enough research on this drug, its use in children is not recommended. This medication should not be used by anyone younger than 18 years old.
Seniors: Seniors may be more likely to experience side effects from this medication. Lower doses may be required.
What other medications might interact with this drug?
It’s important to note that there could be interactions between tramadol -acetaminophen and any of these drugs:
- abiraterone acetate
- amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
- antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, rupatadine)
- antipsychotics (e.g., haloperidol, chlorpromazine, clozapine, quetiapine, olanzapine, risperidone)
- antiseizure medications (e.g., carbamazepine, clobazam, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
- “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
- beta 2 agonists (e.g., salbutamol, formoterol, terbutaline)
- benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
- calcium channel blocker (e.g., amlodipine, diltiazem, verapamil)
- chloral hydrate
- diabetes medications (e.g., canagliflozin, glyburide, insulin, linagliptin, lixisenatide, metformin, rosiglitazone,)
- diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
- ergot alkaloids (e.g., ergotamine, dihydroergotamine)
- grapefruit juice
- HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
- HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
- lumacaftor and ivacaftor
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, phenelzine, selegiline, tranylcypromine)
- muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine)
- narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
- protein kinase inhibitors (e.g., ceritinib, dasatinib, idelalisib, imatinib, nilotinib, sunitinib)
- quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
- St. John’s wort
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
- serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
- serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
- tricyclic antidepressants (TCAs; e.g., amitriptyline, clomipramine, desipramine, imipramine)
- “triptan” migraine medications (e.g., eletriptan, sumatriptan)
Speak with your doctor if you’re taking any of these medications. Depending on your specific situation, he/she may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
Interactions between drugs don’t necessarily mean that you need to stop taking one; talk to your doctor about how they’re being managed or should be handled.
You need to tell your doctor or prescriber if you’re taking other medicines besides those listed above. You might not be able to take some or all of these medications together because they could cause serious side effects. Tell them about any supplements you’re taking. Because caffeine, alcohol, cigarette smoke, or street drugs can affect the action of many medicines, you should let your doctor know if you use them.
Tramadol Frequently Asked Questions
What does tramadol pill do for you?
The painkiller tramadol is used to treat mild to moderately severe pain. Only those who anticipate a constant need for pain relief should use the extended-release tablets and capsules of tramadol. The group of drugs known as opiate (narcotic) analgesics includes tramadol.
Is tramadol a strong painkiller?
Tramadol is a potent analgesic that belongs to the class of drugs known as opiates or narcotics. It is utilized to treat moderate to severe pain, such as that which follows surgery or a traumatic injury. If fewer medicines stop working for your chronic pain, your doctor may prescribe this medication.
Is tramadol stronger than codeine?
The official answer: Tramadol and codeine are opioid prescription medications that appear equally effective at reducing pain.
Is tramadol a narcotic?
Tramadol is a specific type of narcotic medicine called an opioid that is approved to treat moderate to moderately severe pain in adults. It is available under the brand names Ultram, Ultram ER, Conzip, and also as generics.
- Rybix® ODT¶
- Ultram® ER¶
- Tramadol Injection
- Tramadol STADA 100mg Long release Tablets
Brand names of combination products
- Ultracet® (containing Acetaminophen, Tramadol)
Protopic topical: Uses, Side Effects, Interactions, Pictures … – WebMD. https://www.webmd.com/drugs/2/drug-20335/protopic-topical/details
Co-codamol 30/500 Tablets – Patient Information Leaflet (PIL) – (EMC). https://www.medicines.org.uk/emc/product/4457/pil