Like all medicines, tramadol can cause side effects, although not everyone gets them. Talk to your doctor or pharmacist if the side effects listed below bother you or do not go away.
Very common side effects
Very common side effects of tramadol happen in more than 1 in 10 people and include:
- feeling sick
- feeling dizzy
Common side effects
These common side effects of tramadol happen in more than 1 in 100 people. There are things you can do to help cope with them.
Headaches
Make sure you rest, and drink plenty of fluids. It's best not to drink alcohol with tramadol as you're more likely to get side effects, like feeling sleepy. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking tramadol. Talk to your doctor if they last longer than a week or are severe.
Feeling sleepy, tired, dizzy or "spaced out"
These side effects should wear off within a week or two as your body gets used to tramadol. Talk to your doctor if they carry on for longer. Do not drink any alcohol as this will make you feel more tired.
Feeling or being sick (nausea or vomiting)
Stick to simple meals and do not eat rich or spicy food. It might help to take your tramadol after you've eaten a meal or snack. If you're being sick, try small frequent sips of water. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.
If tramadol continues to make you sick, or feel sick, tell your doctor. They may be able to prescribe a medicine which can also protect your stomach. If you take the combined pill or the progestogen-only pill and tramadol makes you vomit or have severe diarrhoea for more than 24 hours, it may not protect you from pregnancy. Check the pill packet to find out what to do.
Constipation
Try to get more fibre into your diet such as fresh fruit and vegetables and cereals. Also try to drink several glasses of water, or another non-alcoholic drink, every day. If you can, it may also help to do some gentle exercise like swimming or going for a short walk.
Speak to your doctor about medicine to help prevent or treat constipation caused by tramadol if your symptoms do not go away.
Dry mouth
Try chewing sugar-free gum or sucking sugar-free sweets. Your doctor may also prescribe an artificial saliva substitute to keep your mouth moist. This comes as a spray, gel or lozenge.
Sweating
Try wearing loose clothing, using a strong anti-perspirant and using a fan, if possible. If this does not help and you find it unbearable, speak to your doctor as you may need to be treated with a different type of painkiller.
Low energy
Speak to your doctor as they may be able to adjust your dose or give you a different painkiller.
Serious side effects
Serious side effects happen in less than 1 in 100 people.
Call your doctor or call 111 now if you:
- feel dizzy, tired and have low energy – these can be a sign of low blood pressure
- have hallucinations (seeing or hearing things that are not there)
- feel confused
- feel very sleepy
- have trouble peeing or you cannot pee at all
Immediate action required: Call 999 or go to A&E now if you or your child:
- have a seizure or fit
- have breathing difficulties or short shallow breathing
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to tramadol.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Long-term side effects
Some people with conditions that need long-term pain relief may need to take tramadol for a long time.
If you need to take it for a long time your body can become used to it (known as tolerance). 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.
It's possible to become addicted to tramadol. For this reason, your dose will be reviewed to make sure you're only having the amount you need to control your pain.
Your treatment plan may include details of how and when to stop taking tramadol.
If you're having treatment for cancer pain or other severe pain, your pain control will be carefully monitored. Speak to your doctor if you're worried about tolerance, hyperalgesia or becoming addicted.
Other side effects
These are not all the side effects of tramadol. For a full list, see the leaflet inside your medicine packet.
Reporting side effects
You can report any suspected side effect using the Yellow Card safety scheme.
Visit the Yellow Card website for more information about reporting side effects.