Tramadol

generic for Ultram

Tramadol Side Effects

See also Warning section.

Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, or headache may occur. Some of these side effects may decrease after you have been using this medication for a while. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

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.

Tell your doctor right away if you have any serious side effects, including: interrupted breathing during sleep (sleep apnea), mental/mood changes (such as agitation, hallucinations), severe stomach/abdominal pain, difficulty urinating, signs of your adrenal glands not working well (such as loss of appetite, unusual tiredness, weight loss).

Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, severe dizziness, fainting, seizure.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

Tramadol is changed into a strong opioid drug in your body. In some people, this change happens faster and more completely than usual, which increases the risk of very serious side effects. Get medical help right away if you notice any of the following: slow/shallow breathing, severe drowsiness/difficulty waking up, confusion.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any of the following symptoms: rash, itching/swelling (especially of the face/tongue/throat), severe 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.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
  • hypoglycemic disorder
  • adrenocortical insufficiency
  • androgen deficiency
  • anemia
  • acute confusion
  • mood changes
  • depersonalization
  • suicidal
  • libido changes
  • drug dependence
  • agitation
  • euphoria
  • depression
  • hyperkinesis
  • serotonin syndrome
  • cataracts
  • blurred vision
  • visual changes
  • miosis
  • tinnitus
  • hearing loss
  • hypertension
  • myocardial ischemia
  • pulmonary thromboembolism
  • abnormal ECG
  • prolonged QT interval
  • orthostatic hypotension
  • hypotension
  • ecchymosis
  • vasodilation of blood vessels
  • peripheral ischemia
  • pharyngitis
  • sinusitis
  • pulmonary edema
  • respiratory depression
  • bronchospastic pulmonary disease
  • xerostomia
  • stomatitis
  • dyspepsia
  • gastroenteritis
  • constipation
  • hepatic failure
  • hepatitis
  • urinary tract infection
  • hematuria
  • erectile dysfunction
  • menstrual disorder
  • toxic epidermal necrolysis
  • Stevens-Johnson syndrome
  • pruritus of skin
  • urticaria
  • arthralgia
  • neck stiffness
  • hypertonia
  • myalgia
  • cramps in legs
  • drowsy
  • delirium
  • hallucinations
  • syncope
  • seizure disorder
  • vertigo
  • dizziness
  • sleep disorder
  • insomnia
  • fever
  • flu-like symptoms
  • hyperhidrosis
  • chills
  • tremor
  • muscle fasciculation
  • dysgeusia
  • skin rash
  • peripheral edema
  • flushing
  • anorexia
  • weight loss
  • headache disorder
  • palpitations
  • dyspnea
  • yawning
  • nausea
  • vomiting
  • flatulence
  • diarrhea
  • dysuria
  • urinary retention
  • increased urinary frequency
  • hyperglycemia
  • nervousness
  • bruising
  • anaphylaxis
  • angioedema
  • infertility
  • paresthesia
  • general weakness
  • acute abdominal pain
  • indifference
  • dream disorder
  • night sweats

Drug Interactions

See also Warning section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: certain pain medications (mixed opioid agonist-antagonists such as pentazocine, nalbuphine, butorphanol), naltrexone.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Other medications can affect the removal of tramadol from your body, which may affect how tramadol works. Examples include quinidine, azole antifungals (such as itraconazole), HIV drugs (such as ritonavir), macrolide antibiotics (such as erythromycin), rifamycins (such as rifampin), drugs used to treat seizures (such as carbamazepine), among others.

The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as other opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

This medication may interfere with certain laboratory tests (including amylase/lipase levels), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.