Skip to Content

Tramal Side Effects

Generic Name: tramadol

Note: This document contains side effect information about tramadol. Some of the dosage forms listed on this page may not apply to the brand name Tramal.

For the Consumer

Applies to tramadol: oral capsule extended release, oral suspension, oral tablet, oral tablet disintegrating, oral tablet extended release

Along with its needed effects, tramadol (the active ingredient contained in Tramal) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking tramadol:

Less common or rare
  • Abdominal or stomach fullness
  • abnormal or decreased touch sensation
  • blisters under the skin
  • bloating
  • blood in the 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 or stomach pain
  • indigestion
  • irregular heartbeat
  • loss of memory
  • numbness and tingling of the face, fingers, or toes
  • numbness, tingling, pain, or weakness in the hands or feet
  • pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion
  • pain or discomfort in the arms, jaw, back, or neck
  • pains in the 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
  • sweats
  • trembling and shaking of the hands or feet
  • trouble performing routine tasks
  • weak or absent pulses in the legs
  • yellow eyes or skin

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

Symptoms of overdose
  • Change in consciousness
  • decreased awareness or responsiveness
  • difficulty with breathing
  • lack of muscle tone
  • lightheadedness
  • loss of consciousness
  • pinpointed pupils of the eyes
  • severe sleepiness
  • slow or irregular heartbeat
  • unusual tiredness

Some side effects of tramadol 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
  • constipation
  • cough
  • diarrhea
  • discouragement
  • drowsiness
  • dry mouth
  • feeling of warmth
  • feeling sad or empty
  • feeling unusually cold
  • fever
  • general feeling of discomfort or illness
  • headache
  • heartburn
  • irritability
  • itching or skin rash
  • joint pain
  • loss of appetite
  • loss of interest or pleasure
  • loss of strength or weakness
  • muscle aches and pains
  • nausea
  • redness of the face, neck, arms, and occasionally, upper chest
  • restlessness
  • runny nose
  • shivering
  • sleepiness or unusual drowsiness
  • sore throat
  • stuffy nose
  • sweating
  • tiredness
  • trouble concentrating
  • unusual feeling of excitement
  • weakness
Less common or rare
  • Abnormal dreams
  • appetite decreased
  • back pain
  • bladder pain
  • blistering, crusting, irritation, itching, or reddening of the skin
  • bloody or cloudy urine
  • body aches or pain
  • change in hearing
  • clamminess
  • cold flu-like symptoms
  • confusion
  • cough producing mucus
  • cracked, dry, or scaly skin
  • decreased interest in sexual intercourse
  • difficult, burning, or painful urination
  • difficulty with 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, or warmth on the 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 the limbs
  • pain or tenderness around the eyes and cheekbones
  • pain, swelling, or redness in the joints
  • skin discoloration
  • swelling
  • swelling of the hands, ankles, feet, or lower legs
  • tightness of the chest
  • trouble in holding or releasing urine
  • trouble with sleeping
  • weight increased or decreased

For Healthcare Professionals

Applies to tramadol: oral capsule extended release, oral tablet, oral tablet disintegrating, oral tablet extended release

General

The most common adverse reactions include nausea, constipation, dry mouth, somnolence, dizziness, and vomiting.[Ref]

Psychiatric

CNS stimulation has been reported as a composite of nervousness, anxiety, agitation, tremor, spasticity, euphoria, emotional lability, and hallucinations. During clinical trials, tolerance development was mild and the reports of a withdrawal syndrome were rare. Symptoms of a withdrawal syndrome have included: panic attacks, severe anxiety, hallucinations, paraesthesias, tinnitus and unusual CNS symptoms (i.e. confusion, delusions, personalization, derealization, and paranoia).[Ref]

Very common (10% or more): CNS stimulation (up to 14%)
Common (1% to 10%): Anxiety, euphoria, nervousness, sleep disorder, insomnia, depression, agitation, apathy, depersonalization
Uncommon (0.1% to 1%): Emotional lability
Rare (less than 0.1%): Hallucinations, nightmares, dependency
Very rare (less than 0.01%): Withdrawal syndrome[Ref]

Hypersensitivity

Rare (less than 0.1%): Anaphylaxis, allergic reactions such as dyspnea, bronchospasm, wheezing, angioneurotic edema, swollen skin[Ref]

Gastrointestinal

Very common (10% or more): Nausea (up to 40%), constipation (up to 46%), vomiting (up to 17%), dyspepsia (up to 13%)
Common (1% to 10%): Dry mouth, diarrhea, abdominal pain, flatulence, sore throat, gastroenteritis viral
Uncommon (0.1% to 1%): Toothache, appendicitis, pancreatitis[Ref]

Nervous system

Epileptiform seizures primarily occurred following administration of high doses or following concomitant treatment with drugs that lower the seizure threshold or trigger seizures.

Serotonin syndrome has been reported during concomitant use of opioids with serotonergic drugs.[Ref]

Very common (10% or more): Dizziness (up to 28%), somnolence (up to 25%), headache (up to 32%),
Common (1% to 10%): Confusion, coordination disturbance, tremor, paresthesia, hypoesthesia
Uncommon (0.1% to 1%): Migraine, sedation, syncope, disturbance in attention
Rare (less than 0.1%): Epileptiform seizures
Postmarketing reports: Seizures

Opioids:
Postmarketing reports: Serotonin syndrome[Ref]

Dermatologic

Very common (10% or more): Pruritus (up to 11%)
Common (1% to 10%): Sweating, rash, dermatitis
Uncommon (0.1% to 1%): Cellulitis, piloerection, clamminess, urticaria, toxic epidermal necrolysis, Stevens Johnson-syndrome, hair disorder, skin disorder[Ref]

Genitourinary

Common (1% to 10%): Menopausal symptoms, urinary frequency, urinary retention, urinary tract infection
Uncommon (0.1% to 1%): Difficulty in micturition, hematuria, dysuria, cystitis, sexual function abnormality[Ref]

Cardiovascular

Reports of QT prolongation and/or torsade de pointes have been received. In many cases, patients were taking another drug associated with QT prolongation, had risk factors for QT prolongation such as hypokalemia, or in the overdose setting.[Ref]

Very common (10% or more): Flushing (up to 15.8%)
Common (1% to 10%): Vasodilation, postural hypotension, chest pain
Uncommon (0.1% to 1%): Palpitations, myocardial infarction, lower limb edema, peripheral swelling, hypertension, increased heart rate, peripheral ischemia, EKG abnormality, hypotension, tachycardia
Rare (less than 0.1%): Bradycardia
Postmarketing reports: QT prolongation/torsade de pointes[Ref]

Other

Very common (10% or more): Asthenia (up to 12%)
Common (1% to 10%): Malaise, weakness, pain, feeling hot, influenza like illness, rigors, lethargy, pyrexia
Uncommon (0.1% to 1%): Tinnitus, vertigo, ear infection[Ref]

Metabolic

Common (1% to 10%): Anorexia, decreased weight, increased blood glucose
Uncommon (0.1% to 1%): Gout
Rare (less than 0.1%): Changes in appetite[Ref]

Endocrine

Very rare (less than 0.01%): Syndrome of inappropriate antidiuretic hormone secretion

Opioids:
Postmarketing reports: Adrenal insufficiency; androgen deficiency[Ref]

Hematologic

Uncommon (0.1% to 1%): Anemia, ecchymosis[Ref]

Hepatic

Uncommon (0.1% to 1%): Cholelithiasis, cholecystitis, ALT and AST increased, abnormal liver function tests[Ref]

Ocular

Common (1% to 10%): Miosis, visual disturbance, blurred vision
Uncommon (0.1% to 1%): Lacrimation disorder
Frequency not reported: Mydriasis[Ref]

Renal

Uncommon (0.1% to 1%): blood urea nitrogen increased[Ref]

Musculoskeletal

Common (1% to 10%): Hypertonia, arthralgia, back pain, limb pain, neck pain, muscle cramps, muscle spasms, joint stiffness, muscle twitching, myalgia, aggravated osteoarthritis
Uncommon (0.1% to 1%): Joint swelling, joint sprain, muscle injury, leg cramps
Rare (less than 0.1%): Involuntary muscle contractions[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Ultram ER (traMADol)." PriCara Pharmaceuticals, Raritan, NJ.

4. "Product Information. Ultram (tramadol)." McNeil Pharmaceutical, Raritan, NJ.

Some side effects of Tramal may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

Hide