From the Guidelines
Tramadol commonly causes several side effects that patients should be aware of, including nausea, vomiting, constipation, dizziness, headache, drowsiness, and dry mouth, as reported in a study published in the Journal of the National Comprehensive Cancer Network in 2019 1. The most frequent side effects of tramadol include:
- Nausea
- Vomiting
- Constipation
- Dizziness
- Headache
- Drowsiness
- Dry mouth Some patients may also experience sweating, itching, or feelings of weakness. More serious but less common side effects include serotonin syndrome (especially when combined with other serotonergic medications), seizures (particularly at higher doses or in those with seizure disorders), respiratory depression, and the potential for physical dependence with prolonged use. Tramadol works by binding to opioid receptors and inhibiting the reuptake of serotonin and norepinephrine, which explains many of its side effects, as described in a study published in the Journal of the National Comprehensive Cancer Network in 2019 1. The risk of side effects may increase with higher doses, in elderly patients, those with kidney or liver problems, or when combined with other central nervous system depressants like alcohol or benzodiazepines. If you experience severe side effects, difficulty breathing, or signs of an allergic reaction while taking tramadol, seek medical attention immediately. Always take tramadol exactly as prescribed by your healthcare provider to minimize adverse effects, as recommended in a study published in the Mayo Clinic Proceedings in 2010 1.
From the FDA Drug Label
Withdrawal symptoms may occur if tramadol hydrochloride is discontinued abruptly ... Reported symptoms have included anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, piloerection, and rarely hallucinations.
Some deaths have occurred as a consequence of the accidental ingestion of excessive quantities of tramadol alone or in combination with other drugs
In treating an overdose, primary attention should be given to maintaining adequate ventilation along with general supportive treatment
Acute overdosage with tramadol can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, seizures, bradycardia, hypotension, cardiac arrest, and death.
The common side effects of tramadol include:
- Anxiety
- Sweating
- Insomnia
- Rigors
- Pain
- Nausea
- Tremors
- Diarrhea
- Upper respiratory symptoms
- Piloerection
- Hallucinations (rarely)
- Respiratory depression
- Somnolence
- Skeletal muscle flaccidity
- Cold and clammy skin
- Constricted pupils
- Seizures
- Bradycardia
- Hypotension
- Cardiac arrest
- Death 2 2
From the Research
Common Side Effects of Tramadol
- Nausea
- Dizziness
- Drowsiness
- Tiredness
- Sweating
- Vomiting
- Dry mouth 3
Less Common Side Effects
- Diarrhoea
- Pruritus
- Gastrointestinal disorder (except nausea and vomiting) 3
Rare Side Effects
- Seizures, which can occur even at low doses 4
Side Effects in Specific Populations
- In elderly patients with chronic low back pain, common side effects include nausea and floating sensation, with 12.5% of patients discontinuing treatment due to these side effects 5
Comparison of Side Effects with Other Medications
- Tramadol has a lower incidence of adverse events compared to immediate-release tramadol and nonsteroidal anti-inflammatory drugs (NSAIDs) 6