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Common questions about tramadol

How does tramadol work?

Tramadol is from a group of medicines called opiates, or narcotics.

It acts on pain receptors in the central nervous system and the brain to block pain signals to the rest of the body. It also works in your brain to stop you feeling pain messages.

When will I feel better?

You will feel less pain around 30 to 60 minutes after taking standard tramadol. The pain relief wears off after 4 to 6 hours.

Slow-release tramadol tablets and capsules can take a day or two to start working but the pain relief will last for longer.

Are there other painkillers I can try?

The best type of painkiller depends on what type of pain you have and the cause of your pain.

If tramadol does not get rid of your pain, or starts to work less well, talk to your doctor.

Can I become addicted to tramadol?

Yes, tramadol is addictive. For this reason, your dose will be reviewed to make sure you are only taking the amount you need to control your pain.

Your treatment plan may include details of how and when you will stop taking tramadol.

If you need to take it for a long time your body can become used to it. That means you need higher doses to control your pain over time.

Some people can become more sensitive to pain (hyperalgesia). If this happens, your doctor will reduce your dose gradually to help these symptoms.

Speak to your doctor if you are worried about tolerance, hyperalgesia or becoming addicted.

How will I know if I'm addicted?

If you're addicted to tramadol, you may find it difficult to stop taking it or feel you need to take it more often than necessary.

And if you stop taking tramadol suddenly you may suffer from withdrawal reactions. These include: agitation, anxiety, nervousness, panic attacks, difficulty sleeping, shaking, over-activity, pins and needles or ringing in the ears.

Talk to your doctor if you're worried about addiction or if you want to know more about how to prevent withdrawal symptoms.

Will it affect my contraception?

Tramadol does not affect any type of contraception, including the combined pill and emergency contraception.

However, if tramadol makes you (sick) vomit or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Check the pill packet to find out what to do.

Find out more about what to do if you're on the pill and you're being sick or have diarrhoea.

Can I drink alcohol while taking tramadol?

Drinking alcohol while you're taking tramadol can make you feel more sleepy or increase the risk of serious side effects. Try to not have any alcohol during the first few days of treatment until you see how the medicine affects you.

If you feel sleepy with tramadol, it may be best to stop drinking alcohol while you're taking it.

Can I drive or ride a bike?

Do not drive a car, ride a bike or use heavy tools or machinery if tramadol makes you sleepy, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions. This may be more likely when you first start taking tramadol but could happen at any time, for example when starting another medicine.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

GOV.UK has more information on the law on drugs and driving. Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking tramadol.

Will recreational drugs affect taking tramadol?

If you take recreational drugs, such as cannabis, cocaine and heroin, while you are taking tramadol, you're more likely to get serious side effects. These include:

  • breathing difficulties
  • heart problems
  • having a fit or seizure

Some recreational drugs, such as cannabis, will also increase tramadol side effects such as feeling sleepy and dizzy.

If you take MDMA (ecstasy), cocaine, amphetamines or LSD while taking tramadol, you may develop a condition called serotonin syndrome. Serotonin syndrome occurs when the levels of a chemical in your brain called serotonin become too high.

Symptoms of severe serotonin syndrome can include:

  • a very high temperature
  • a seizure or fit
  • an irregular heartbeat
  • losing consciousness

Tell your doctor if you think you may take recreational drugs while you're on tramadol.

Find out more about the side effects of recreational drugs and how they can affect you, on the Frank website.

Page last reviewed: 19 January 2022
Next review due: 19 January 2025