Tramadol Side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

The most commonly reported adverse drug reactions are nausea, vomiting, sweating and constipation. Drowsiness is reported, although it is less of an issue than for non-synthetic opioids. Patients prescribed tramadol for general pain relief with or without other agents have reported withdrawal symptoms including uncontrollable nervous tremors, muscle contracture, and ‘thrashing’ in bed (similar to restless leg syndrome) if weaning off the medication happens too quickly. Anxiety, ‘buzzing’, ‘electrical shock’ and other sensations may also be present, similar to those noted in Effexor withdrawal. Anecdotally, tramadol is widely regarded by chronic pain sufferers as being among the most difficult of the pain medications to stop after prolonged administration, as withdrawal from both the serotonergic/noradrenergic and the mu-opioid effects is present. Respiratory depression, a common side-effect of most opioids, is not clinically significant in normal doses. By itself, it can decrease the seizure threshold. When combined with SSRIs, tricyclic antidepressants, or in patients with epilepsy, the seizure threshold is further decreased. Seizures have been reported in humans receiving excessive single oral doses (700 mg) or large intravenous doses (300 mg). However, there have been several rare cases of people having grand-mal seizures at doses as low as 100–400 mg orally

Get emergency help immediately if any of the following symptoms of overdose occur:

Change in consciousness
Chest pain or discomfort
Convulsions (seizures)
Decreased awareness or responsiveness
Difficulty in breathing
Dizziness or fainting
Lack of muscle tone
Lightheadedness
Loss of consciousness
Pinpointed pupils of the eyes
Severe sleepiness
Shortness of breath
Slow or irregular heartbeat
Unusual tiredness
Check with your doctor as soon as possible if any of the following side effects occur:

Less common or rare
Abdominal fullness
Abnormal or decreased touch sensation
Blisters under the skin
Bloating
Blood in urine
Blood pressure increased
Blurred vision
Change in walking and balance
Chest pain or discomfort
Chills
Convulsions (seizures)
Darkened urine
Difficult urination
Dizziness or lightheadedness when getting up from a lying or sitting position
Fainting
Fast heartbeat
Frequent urge to urinate
Gaseous abdominal pain
Heart rate increased
Indigestion
Irregular heartbeat
Loss of memory
Numbness and tingling of face, fingers, or toes
Numbness, tingling, pain, or weakness in hands or feet
Pain in arms, legs, or lower back, especially pain in calves and/or heels upon exertion
Pain or discomfort in arms, jaw, back or neck
Pains in stomach, side, or abdomen, possibly radiating to the back
Pale bluish-colored or cold hands or feet
Recurrent fever
Seeing, hearing, or feeling things that are not there
Severe cramping
Severe nausea
Severe redness, swelling, and itching of the skin
Shortness of breath
Sweats
Trembling and shaking of hands or feet
Trouble performing routine tasks
Weak or absent pulses in legs
Yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Abdominal or stomach pain
Agitation
Anxiety
Constipation
Cough
Diarrhea
Discouragement
Dizziness
Drowsiness
Dry mouth
Feeling of warmth
Feeling sad or empty
Feeling unusually cold
Fever
General feeling of discomfort or illness
Headache
Heartburn
Irritability
Itching of the skin
Joint pain
Loss of appetite
Loss of interest or pleasure
Loss of strength or weakness
Muscle aches and pains
Nausea
Nervousness
Redness of the face, neck, arms and occasionally, upper chest
Restlessness
Runny nose
Shivering
Skin rash
Sleepiness or unusual drowsiness
Sore throat
Stuffy nose
Sweating
Tiredness
Trouble concentrating
Unusual feeling of excitement
Unusual tiredness or weakness
Vomiting
Weakness
Less common or rare
Abnormal dreams
Appetite decreased
Back pain
Bladder pain
Blistering, crusting, irritation, itching, or reddening of skin
Bloody or cloudy urine
Body aches or pain
Change in hearing
Clamminess
Cold flu-like symptoms
Confusion
Cough producing mucus
Cracked, dry, scaly skin
Decreased interest in sexual intercourse
Difficult, burning, or painful urination
Difficulty breathing
Difficulty in moving
Disturbance in attention
Ear congestion
Ear drainage
Earache or pain in ear
Excessive gas
Fall
False or unusual sense of well-being
Feeling hot
Feeling jittery
Flushing or redness of the skin
General feeling of bodily discomfort
Goosebumps
Headache, severe and throbbing
Hoarseness
Hot flashes
Inability to have or keep an erection
Itching, pain, redness, swelling, tenderness, warmth on skin
Joint sprain
Joint stiffness
Joint swelling
Loss in sexual ability, desire, drive, or performance
Loss of voice
Lower back or side pain
Muscle aching or cramping
Muscle injury
Muscle pain or stiffness
Muscle spasms or twitching
Nasal congestion
Neck pain
Night sweats
Pain
Pain in limb
Pain or tenderness around eyes and cheekbones
Pain, swelling, or redness in joints
Skin discoloration
Swelling
Swelling of hands, ankles, feet, or lower legs
Tightness of chest
Trouble in holding or releasing urine
Trouble in sleeping
Troubled breathing
Weight increased or decreased
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Anxiety
Body aches
Diarrhea
Fast heartbeat
Fever, runny nose, or sneezing
Gooseflesh
High blood pressure
Increased sweating
Increased yawning
Loss of appetite
Nausea or vomiting
Nervousness, restlessness or irritability
Shivering or trembling
Stomach cramps
Trouble in sleeping
Unusually large pupils
Weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

What special precautions should I follow?

Before taking tramadol,

• tell your doctor and pharmacist if you are allergic to tramadol or other opiate pain or cough medications such as meperidine (Demerol), morphine (Avinza, Kadian, MS Contin), codeine (in some pain medications and cough syrups), hydrocodone (in Vicodin), hydromorphone (Dilaudid), oxycodone (OxyContin, in Percocet), propoxyphene (Darvon, Darvon N, in Darvocet), any other medications, or any of the ingredients in tramadol tablets or extended-release tablets. Ask your pharmacist for a list of ingredients in tramadol tablets or extended release tablets.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking. Be sure to mention any of the following: antifungal medications such as ketoconazole (Nizoral); digoxin (Lanoxin); erythromycin (E.E.S., E-Mycin, Erythrocin); monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); medications for anxiety, mental illness, nausea, and pain; medications for seizures, such as carbamazepine (Tegretol); muscle relaxants such as cyclobenzaprine (Flexeril); promethazine (Phenergan); quinidine; rifampin (Rifadin, Rifamate, Rimactane, others); sedatives; sleeping pills; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); tranquilizers; tricyclic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil);and warfarin (Coumadin). Many other medications may also interact with tramadol, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor what herbal products you are taking, especially St. John’s wort.
• tell your doctor if you have or have ever had seizures; an infection in your brain or spine; a head injury, a brain tumor, a stroke, or any other condition that caused high pressure inside your skull; depression or thoughts about harming or killing yourself or planning or trying to do so; diabetes; breathing problems or lung disease; or kidney or liver disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tramadol, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol.
• you should know that this medication may make you drowsy and may affect your coordination. Do not drive a car or operate machinery until you know how this medication affects you.
• talk to your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects from tramadol worse.
• you should know that tramadol may cause dizziness, lightheadedness, and fainting when you get up from a lying position. To avoid this, get out of bed slowly, resting your feet on the floor for a few minutes before standing up

What other drugs will affect tramadol?

You may be more likely to have a seizure (convulsions) if you take tramadol while you are using certain other medicines. Do not take tramadol without telling your doctor if you also use any of the following medications:

• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or
• an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).

Cold or allergy medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by tramadol. Tell your doctor if you regularly use any of these medicines, or any other pain medication.

Tell your doctor about all other medicines you use, especially:

• carbamazepine (Tegretol);
• warfarin (Coumadin);
• digoxin (Lanoxin, Lanoxicaps);
• ketoconazole (Extina, Ketozole, Nizoral, Xolegel);
• erythromycin (E-Mycin, E.E.S., Ery-Tab);
• migraine headache medicine such as sumatriptan (Imitrex, Treximet);
• rifampin (Rifadin, Rimactane, Rifater);
• St. John’s wort;
• quinidine (Quin-G); or
• drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety).

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