What Does Tramadol Do? – All You Need to Know

Tramadol is a prescription pain medication that works in the brain and nervous system to reduce feelings of pain. Chemically, it is similar to opioid drugs like morphine, but it also shares some properties with antidepressants. Tramadol tablets and injections are used to help relieve moderate to moderately severe pain in adults.

Tramadol purchase, when taken as prescribed by a doctor, tramadol can safely and effectively treat many types of acute and chronic pain. However, it does come with some risks if misused or abused. Read on to learn exactly how tramadol works in the body, what conditions it treats, its risks and side effects, and how it compares to other pain medications.

Chemical structure

The chemical name for tramadol is (±)cis-2-[(dimethylamino)methyl]-1-(3-methoxyphenyl) cyclohexanol hydrochloride. Despite its long, complex name, it can simply be understood as a synthetic agent that impacts pain signals through opioid and non-opioid mechanisms.

Mechanism of action

Tramadol works in two main ways. First, it binds to μ-opioid receptors similarly to drugs like morphine, dampening pain signals. Second, it inhibits reuptake of the neurotransmitters serotonin and norepinephrine, like some antidepressants. The dual opioid and non-opioid pain-relieving effects provide effective analgesic properties.

What Does Tramadol Treat?

Moderate to moderately severe pain

Tramadol is primarily used to treat moderate to moderately severe pain following surgery, from conditions like osteoarthritis, fibromyalgia, and other painful disorders. By dampening pain signals in the central nervous system, it can provide significant pain relief.

Chronic pain

In addition to acute pain, tramadol is also used off-label to control chronic pain conditions like neuropathy, back pain, severe arthritis, etc. For chronic pain, it may be used long-term if benefits continue to outweigh risks and side effects.

Other off-label uses

Besides pain relief, some doctors may prescribe tramadol off-label to treat depression, anxiety, or even in opioid withdrawal protocols. More research is still needed to confirm efficacy and safety for these off-label uses.

How Should Tramadol Be Taken?

Forms of tramadol

Tramadol is available under the brand names Ultram, Ultram ER, Conzip, and Ryzolt in immediate and extended-release oral tablets. It also comes as an injectable solution under the name Zaldiar when combined with acetaminophen for postoperative pain.


The recommended dosage is 50-100mg every 4-6 hours as needed for pain relief, up to 400mg per day. Extended release tablets allow longer 12-hour dosing. Dosage may be adjusted based on pain severity, patient factors, and risk of side effects.

Special considerations

Tramadol dosage adjustments may be required for elderly patients, people with liver/kidney disease or impairment, and those taking interacting medications. Discontinuing tramadol requires tapering under a doctor’s guidance to prevent withdrawal side effects.

How Does Tramadol Make You Feel?

Pain relief

The primary effect of tramadol is pain relief similar to weak opioid medications. Patients report comparable analgesic effects to codeine-level opioids, allowing improved function with less pain impairment. Onset of pain relief occurs within about an hour.

Side effects

Common side effects of tramadol include dizziness, drowsiness, headaches, nausea, vomiting, constipation, and fatigue. More serious side effects involve seizures, serotonin syndrome, respiratory depression, and suicidal thinking.

Risk of dependence

Due to its opioid mechanism of action, tramadol carries a risk of both psychological and physical dependence. Withdrawal side effects like anxiety, sweating, insomnia, and pain can occur if tramadol is stopped abruptly after regular long-term use.

Is Tramadol Safe?


The FDA requires tramadol to carry black box warnings for addiction, misuse, life-threatening respiratory depression, and suicidal thoughts and behaviors. It should be used cautiously and only as directed.

Risk of overdose

Overdose symptoms like extreme drowsiness, confusion, and slowed breathing occur at high doses of tramadol. Seek immediate medical care if you suspect tramadol overdose as it can lead to respiratory failure and death without swift intervention.

Drug interactions

Serious drug interactions with tramadol involve serotonin-modifying drugs like SSRIs, MAOIs, TCAs, other opioids, sedatives, stimulants and more. These combinations can cause toxicity or life-threatening serotonin syndrome.

Tramadol vs. Other Pain Medications

Tramadol vs. NSAIDS

Compared to non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, tramadol can provide more potent pain relief, but with a higher risk of side effects and dependence. NSAIDs treat inflammatory pain while tramadol impacts the nervous system.

Tramadol vs. codeine

Codeine and tramadol offer comparable pain relief, but tramadol has a lower dependence profile. With codeine’s greater conversion to morphine, more side effects and risks of respiratory depression occur. Tramadol may cause less constipation and appetite changes.

Tramadol vs. morphine

As an opioid agonist, tramadol is less potent than true opioids like morphine or oxycodone. But increased tramadol dosages come with similar risks for side effects, overdose potential, misuse, tolerance and addiction as potent opioids.

Getting Help for Addiction

Signs of addiction

Some signs of tramadol addiction involve constantly thinking about the drug, taking higher doses, inability to control use, spending significant time and money obtaining tramadol, failed quit attempts, and continuing use despite harm.

Withdrawal risks

Suddenly stopping tramadol after regular extended use can cause severely unpleasant withdrawal symptoms. Seeking medical support can ease the detox process through careful medication tapering. Unmanaged withdrawal carries health risks.

Treatment options

A combination of detox support, behavioral therapies, peer support groups, and relapse prevention education can help in overcoming tramadol addiction. Trained chemical dependency professionals create customized treatment plans.


While tramadol can effectively treat moderate to moderately severe pain, its opioid effects come with very real risks when misused or abused. Working closely with your doctor mitigates serious side effects and dangers if taken as prescribed strictly for pain management. Seek help immediately if you suspect dependency or addiction. Ongoing research aims to develop safer alternatives without the high addiction and overdose profile seen with opioid medications.


Is tramadol an opioid?

Yes, tramadol is considered an atypical opioid. While not derived from opium directly, it activates opioid receptors similarly to classic opioids while also inhibiting reuptake of serotonin and norepinephrine neurotransmitters.

Can you take tramadol long-term?

Tramadol may be used long-term under medical supervision if benefits continue to outweigh risks of side effects or addiction. Dosages are usually tapered to the lowest effective amount and enforced breaks from tramadol may help reduce tolerance.

What should you not take with tramadol?

Dangerous drug interactions with tramadol involve other CNS depressants, serotonergic drugs, and MAO inhibitors. Never mix tramadol with alcohol, benzodiazepines, sleeping aids, antidepressants, other opioids, or illicit drugs due to overdose risks.

Can tramadol cause seizures?

Yes, tramadol increases seizure risk especially in people with a history of seizures, head injury, metabolic disorder, alcohol/drug withdrawal, or taking other drugs that lower seizure threshold. Higher doses also increase seizures.

How long does tramadol withdrawal last?

Acute tramadol withdrawal peaks within the first few days but some psychological and physical symptoms can persist for weeks or months after stopping. Each person’s experience varies widely. Medical support can ease the process.

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