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Does tramadol raise or lower blood pressure?

Medically reviewed by Sally Chao, MD. Last updated on Oct 24, 2022.

Official answer


Tramadol is a synthetic opioid pain reliever that has been linked to both high blood pressure and low blood pressure. But, neither adverse reaction is common when the medicine is taken as directed.

  • Studies on tramadol have reported that between 1% and 5% of people taking the extended-release version and a very small number of people taking the fast-acting version developed high blood pressure (hypertension).
  • Less than 1% of people taking tramadol developed low blood pressure (hypotension) in studies.

Those who had low blood pressure in the studies sometimes had what’s called postural or orthostatic hypotension. Postural hypotension occurs when blood pressure drops when someone stands up from sitting or lying down. Whether it was caused by tramadol is unclear.

Tramadol doesn’t seem to interact with high blood pressure medications, but other interactions are possible.

Taking other drugs can interfere with the way your body processes tramadol or cause other interactions. For instance, tramadol is not a blood thinner, but there are some reports that it may interact with blood thinners, like warfarin.

Many drugs may interact with tramadol, including:

  • Certain antidepressants
  • Appetite suppressant drugs
  • Certain antifungal medications
  • Certain antibiotics
  • Other opioids
  • Seizure medications
  • Some migraine medications
  • Malaria drugs
  • Some heart medications
  • Blood thinners

While blood pressure changes are not a common side effect of tramadol, some medication interactions can lead to extreme changes in blood pressure.

There are many possible drug interactions for tramadol that can be discussed with your doctor and searched on a drug interactions checker before taking the drug.

People taking tramadol should avoid drinking any alcohol or taking additional opioid medications.

Additionally, there are some people who generally should not take tramadol. These include:

  • People who are allergic to the drug
  • People with slowed breathing
  • People who have acute or severe asthma

Tramadol is the drug’s generic name. It’s sold under several brand names, including:

  • ConZip
  • Qdolo
  • Ultracet
  • Ultram
  • Ultram ER
  1. Food and Drug Administration (FDA). Highlights of prescribing information: Tramadol hydrochloride extended-release capsules. Available at: [Accessed September 2, 2020].
  2. MedlinePlus. Tramadol. [Accessed September 18, 2020].
  3. Food and Drug Administration (FDA). Highlights of prescribing information: Ultram (tramadol hydrochloride) tablets. Available at: [Accessed September 9, 2020].
  4. Drug Interactions between Cymbalta and tramadol. Available at: [Accessed September 18, 2020].
  5. Tramadol tablets. September 1, 2019. Available at: [Accessed September 14, 2020].

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