How Can You Ease Constipation From Tramadol and Other Opioid Pain Medications?

If you’re taking tramadol and notice that it’s becoming harder to have a bowel movement, you’re not alone. Constipation is a common side effect of tramadol and other opioid pain medications. And sometimes it can be difficult to manage. We’re here with some helpful tips on how to manage opioid-related constipation, so you can get your bowels moving again. 

How does tramadol cause constipation?

Tramadol and other opioids cause the digestive system to slow down its normal function. And this causes stool to become dry and hard. These medications can also affect the muscles of the anus — making it hard for them to relax. These factors can make it hard for stool to pass, leading to constipation. 

This process happens because of special opioid receptors that are found on cells throughout the body. Tramadol works to decrease your sense of pain by binding to these receptors in the brain. But these receptors are also found throughout the digestive system. And when the medication binds to the receptors in the bowel, it isn’t able to function as well.  

How long does constipation from tramadol last?

The symptoms of constipation will last as long as you continue to take the tramadol or until you start treatment. Constipation from tramadol won’t typically resolve on its own. 

And while your body may get used to the medication the more you take it, constipation is one side effect that doesn’t get better with time. Even after you stop the medication, it may take some time to resolve. 

Does tramadol cause less constipation than oxycodone or hydrocodone?

Tramadol may cause less constipation than other medications, like oxycodone or hydrocodone. This might be due to the fact that it weakly attaches to the opioid receptors in the bowel. Tramadol is generally considered a milder opioid than oxycodone or hydrocodone.

Which opioid medication is the least constipating?

All opioids have the potential to cause constipation. But there are some that may cause less constipation than others. In some small studies, tapentadol (Nucynta) and oxycodone were shown to cause less constipation than other opioids. 

Research also shows that fentanyl patches may not cause constipation at the same rates as other opioid medications. This may have something to do with the way the medication is given. There are ongoing studies to look at whether how you receive an opioid affects your risk of constipation. Receiving opioid pain medication through the skin may decrease the effect on the bowels. 

How can you relieve constipation from tramadol?

There are several different treatments for constipation from opioids like tramadol. Your healthcare provider will develop a treatment plan for you based on your symptoms and medical history. 

Here are some common treatments for opioid-related constipation.

Dietary and lifestyle changes

Adding more water and fiber to the diet are often the first options to relieve constipation symptoms. Because stool tends to be dry from opioid use, increasing water intake may offer some relief. 

You can get more fiber each day from your diet or supplements. Fruits, vegetables, and whole grains are a great natural source of fiber. 

Increasing your physical activity is another way to stimulate your digestive system. Exercise can also have the added benefit of improving pain — leading to less tramadol use. 

Laxatives

Laxatives are often one of the first treatments for constipation due to opioids like tramadol. But there is increasing evidence that they’re not very effective in treating this type of constipation.  

Over-the-counter laxatives are more likely to help if you had a history of constipation before taking opioids. Laxatives may also be more effective when taken together. A common combination is to use a stool softener, like docusate, along with a stimulant laxative, like senna.

Approved opioid-induced constipation (OIC) treatments

There are several prescription medications that are approved for treating opioid-related constipation. These medications prevent the effect of tramadol and other opioids on the bowels — without affecting their effect on pain. These treatments include:

• Methylnaltrexone (Relistor)

• Lubiprostone (Amitiza)

• Naldemedine (Symproic)

• Naloxegol (Movantik)

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Written by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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