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Tramadol is a strong painkiller. It's used to treat moderate to severe pain, for example after an operation or a serious injury.

It's also used to treat long-standing pain when weaker painkillers no longer work.

Tramadol is available only on prescription. It comes as tablets, capsules and liquid drops that you swallow. It can also be given by injection but this is usually only done in hospital.

Key facts

  • Tramadol works by blocking pain signals from travelling along the nerves to the brain.
  • The most common side effects of tramadol are feeling sick and dizzy.
  • It's possible to become addicted to tramadol, but this is rare if you're taking it to relieve pain and your doctor is reviewing your treatment regularly.
  • It's best not to drink alcohol with tramadol as you're more likely to get side effects like feeling sleepy.
  • Tramadol is also called by the brand names Invodol, Larapam, Mabron, Maneo, Marol, Maxitram, Oldaram, Tilodol, Tradorec, Tramquel, Tramulief, Zamadol, Zeridame and Zydol.

Who can and can't take tramadol

Tramadol can be taken by adults and children aged 12 and over.

Tramadol is not suitable for some people. Tell your doctor or pharmacist before starting the medicine if you have:

  • had an allergic reaction to tramadol or any other medicines in the past
  • an illness which causes seizures
  • a head injury
  • an addiction to alcohol, strong painkillers or recreational drugs
  • breathing difficulties
  • kidney or liver problems
  • had a reaction to other strong painkillers in the past

How and when to take it

It's important to take tramadol as your doctor has asked you to.

The dose can vary but you should not normally take more than 400mg a day.

Tramadol doesn't usually upset your stomach, so you can take it with or without food.

Different types of tramadol

Tramadol comes as:

  • fast-acting tablets - these contain 50mg of tramadol
  • slow-acting tablets - these contain 50mg, 75mg, 100mg, 150mg, 200mg, 300mg or 400mg of tramadol
  • drops that you swallow - these contain 100mg of tramadol in 1ml of liquid
  • an injection (usually given in hospital)
  • soluble tablets – these contain 50mg of tramadol
  • tablets that dissolve in the mouth – these contain 50mg of tramadol
  • an injection (usually given in hospital)

Tramadol drops, injections and some tablets and capsules are fast-acting. They start to work within 30 to 60 minutes. They're used for pain that is expected to last for only a short time. You may be told to take fast-acting tramadol only when you need it for pain or on a regular basis. Always follow the instructions given to you by your doctor.

Some tramadol tablets and capsules are slow-release. This means the tramadol is gradually released into your body over either 12 or 24 hours. This type of tramadol takes longer to start working but lasts longer. It's used for long-term pain.

Your doctor will decide the right dose for you, depending on how sensitive you are to pain and how bad your pain is. Your dose may need to be changed several times to find what works best for you. In general, you will be prescribed the lowest dose that relieves your pain.

How much to take

Dosages vary from person to person. Your dose will depend on how bad your pain is, how you've responded to previous painkillers and if you get any side effects.

How to take it

Fast-acting tramadol comes as capsules, drops and 2 different tablets - soluble and dissolve-in-the-mouth tablets:

  • capsules: swallow each capsule whole with plenty of water
  • drops: mix the drops into a glass of water then drink the whole contents of the glass
  • soluble tablets: dissolve each tablet in 50ml (1/2 cup) of water and drink
  • dissolve-in-the-mouth tablets: make sure your hands are dry before handling the tablet. Take the tablet out of the blister pack and put it on your tongue. Suck the tablet, do not chew it. After it has melted, swallow or have a drink of water. You can also dissolve the tablet in a glass of water if you prefer.