11 Tramadol Side Effects You Should Know About

Tramadol (ConZip, Qdolo) is an opioid medication that treats pain. It’s generally reserved for pain that isn’t effectively treated by non-opioid medications. Tramadol isn’t as potent as other opioids, such as oxycodone (Roxicodone, OxyContin) and hydrocodone / acetaminophen (Norco). But it still has side effects to know about if you’re taking it.

Here we’ll cover common and serious tramadol side effects you should know about.

1. Dizziness and drowsiness

Dizziness is one of the most common tramadol side effects reported in clinical studies. And feeling drowsy isn’t far behind. Both of these side effects are likely related to tramadol’s sedative effects on the brain. Tramadol can also lower blood pressure, which can cause these effects — more on that later.

These side effects can make falls more likely. And feeling dizzy or drowsy can also make driving unsafe. Take your time when walking or performing your normal daily activities, especially when you first start taking tramadol. And use caution when driving until you know how it affects you. It’s also best to avoid drinking alcohol while taking tramadol. It can make dizziness and drowsiness worse.

You may feel less dizzy or drowsy as your body adjusts to taking tramadol. But if these side effects become bothersome or won’t go away, let your healthcare provider know.

2. Constipation

Constipation is a common side effect of opioids, and tramadol is no exception. In many cases, you can manage it yourself at home, especially if you’re only taking tramadol for a short time.

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Getting regular exercise, drinking plenty of water, and eating a high-fiber diet are all helpful for managing constipation from tramadol. You can also try an over-the counter (OTC) laxative such as bisacodyl (Dulcolax). But OTC treatments aren’t very effective for this type of constipation.

If your constipation becomes bothersome or you’re taking tramadol long term, talk to your healthcare provider. There are prescription medications for constipation caused by opioids that may be helpful for you.

If you have severe constipation, you may need medical help. Symptoms of severe constipation include severe stomach pain, trouble eating, and vomiting.

3. Nausea and vomiting

Nausea and vomiting are also common tramadol side effects. This is because opioids may trigger areas in the brain that cause vomiting.

Nausea tends to get better on its own after a few days. In the meantime, if you’re taking tramadol on an empty stomach, try taking it with food. If nausea doesn’t improve or gets worse, let your healthcare provider know. There could be something more serious going on.

4. Headache

Headaches are a common side effect of many medications, including tramadol. Mild headaches tend to resolve on their own. If needed, you can talk to your healthcare provider about OTC medications, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

If your headaches become severe or won’t go away, let your healthcare provider know. They can make sure there isn’t a more serious issue causing them.

5. Itching

Taking tramadol can make your skin feel itchy. But it tends to be less common than other tramadol side effects. It was reported by 5% to 10% of people taking tramadol in clinical studies.

If your symptoms are mild, you may be able to handle this side effect at home. Try to avoid harsh soap, keep skin moisturized, and avoid irritants like fragrances. If this doesn’t help, your healthcare provider may suggest an OTC medication like hydrocortisone cream or an oral antihistamine to help.

If your itching is severe or won’t go away, your healthcare provider may suggest stopping tramadol. And if itching comes with a rash or shortness of breath, get medical care right away. You could be having an allergic reaction to tramadol.

6. Serotonin syndrome

Serotonin syndrome is a rare, but serious condition that can happen while taking tramadol. It happens when serotonin levels in your body are too high. Symptoms include sweating, confusion, and agitation.

This tramadol side effect is more common if you’re also taking other medications that raise serotonin levels. These include antidepressants, certain anti-nausea medications, and some migraine medications.

Your healthcare provider and pharmacist will likely review your medication list to see if any medications you’re taking put you at risk for this side effect. But if you develop any symptoms of serotonin syndrome, get medical care as soon as possible.

7. Seizures

Tramadol may raise the risk of seizures, especially for those with epilepsy. This risk is greater with high doses of tramadol, or if you’re taking other medications that also raise the risk of seizures. These include antidepressants or other opioids.

If you have a seizure while you’re taking tramadol, contact your healthcare provider. They’ll likely want you to stop taking tramadol. If you have a seizure along with other symptoms, such as confusion or vomiting, get medical help right away. This could be a sign of serotonin syndrome.

8. Opioid misuse or dependence

Tramadol is an opioid, which means that misuse and dependence are possible side effects of taking it. This can happen even when you’re taking tramadol at the recommended dose. But it’s more likely if you’re taking more than you should. The risk of misuse and dependence is also greater if you have a personal or family history of substance use disorder.

You can help avoid this side effect by taking tramadol as prescribed. And don’t take it for a longer period of time than necessary. It’s also best to avoid stopping tramadol suddenly, especially if you’ve been taking it for a while. This could cause unpleasant withdrawal symptoms.

If you’re concerned about misuse or dependence, talk with your healthcare provider. They can help assess your risk and find other treatment options if needed. They can also help you stop taking tramadol safely over time to help avoid withdrawal symptoms.

If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) to learn about resources in your area.

9. Trouble breathing

Tramadol, like other opioids, can cause respiratory depression. This means they can slow down your breathing, or make it hard for you to breathe normally. This tramadol side effect is more common if you take too much medication (overdose). But it can also happen at recommended doses, and if you combine tramadol with other medications that have this effect.

This side effect can be dangerous, and can cause death in severe cases. If you notice your breathing is slower than it should be, or you start feeling lightheaded and have trouble catching your breath, call 911 right away.

If you take tramadol, consider asking your healthcare provider for a prescription for naloxone (Narcan). You can use it if you or someone you know takes too much tramadol. It helps reverse respiratory depression. In some states, you can find Narcan for free and without a prescription.

Can tramadol affect your blood pressure?

Tramadol can raise or lower your blood pressure. But even though high blood pressure (hypertension) and low blood pressure (hypotension) are possible, they’re not common tramadol side effects.

Your blood pressure might also go up if you stop taking tramadol suddenly. This is more likely if you’ve been taking it for a long time. Talk to your healthcare provider before you stop taking tramadol. They can help you lower your dose slowly to avoid a spike in your blood pressure.

Tramadol can cause low blood pressure when standing up (orthostatic hypotension). This can make you feel faint or dizzy when you sit up or stand too quickly. This side effect is more likely if you already have low blood pressure or take other medications that cause hypotension.

What are the side effects of tramadol in older people?

It’s common to be more sensitive to medications as you age. In clinical trials, people who were 75 years of age and older were more likely to experience tramadol side effects when taking tramadol in clinical trials. They were also more likely to stop taking tramadol due to constipation, nausea, and vomiting.

Older adults also have a higher risk of respiratory depression, or slowed breathing from tramadol. The manufacturer suggests lower starting doses and slow dose increases for people ages 65 and older.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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