Tramadol

Drug Name
Tramadol

Brand Name(s)
Short Acting: Tramacet® and generics (tramadol 37.5 mg and acetaminophen 325 mg), Ultram® (tramadol 50 mg) Long Acting: Durela®, Ralivia®, Tridural® and Zytram XL®

Drug Class
Prescription medication

Tramadol is as an alternative treatment option for osteoarthritis (OA) of the knee and hip for people who have failed treatment with acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) or cannot take these medications.

  • What types of arthritis is tramadol used for?

    Tramadol is as an alternative treatment option for osteoarthritis (OA) of the knee and hip for people who have failed treatment with acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) or cannot take these medications. Tramadol can also be used in conjunction with acetaminophen or NSAIDs.

    Tramadol may be used for short periods of time to help treat pain associated with inflammatory arthritis.

  • How is tramadol administered?

    Tramadol is taken orally in pill form.

  • What is the typical dose and when do I take it?

    Short acting:

    • Tramacet® and generics: One to two tablets every four to six hours (maximum: eight tablets daily). Tramacet contains acetaminophen, maximum dose of acetaminophen from all sources: 4 g/day
    • Ultram®: One to two tablets every four to six hours to a maximum of 400 mg daily

    Long acting:

    • Durela®, Ralivia® or Tridural®: Start with 100 mg once daily; may increase at weekly intervals to maximum 300 mg daily
    • Zytram® XL: Start with 150 mg once daily; may increase at weekly intervals to maximum 400 mg daily
  • How long will it take to work?

    Tramadol typically begins to work within one hour.

  • When should I not take tramadol and call my doctor?

    Tramadol interacts with a number of other medications. Please speak with your health-care provider about whether any of the other medications you currently take interact with tramadol.

    Do not take tramadol if you have an allergy to tramadol.

    A number of tramadol products also contain acetaminophen. If you are taking other acetaminophen products, speak to your health-care providers to ensure that you are not taking more than the maximum daily dose of acetaminophen (max: 4,000 mg/day).

  • What are the side effects of tramadol?

    Nausea, vomiting, dizziness, constipation, headache and drowsiness are common with tramadol. Approximately 40 per cent of people discontinue use of tramadol because of its adverse effects, which limits its effectiveness in treating OA pain.

  • What helps to reduce side effects?

    Do not exceed the maximum recommended daily dose of tramadol. Gradual dosage increases may help reduce some of the side effects. To reduce stomach upset, consider taking tramadol with food. 

    If you experience drowsiness and sedation while taking tramadol please be cautious about operating hazardous machinery, including automobiles, until you are reasonably certain that tramadol does not affect your ability to engage in such activities.

    People who are experiencing sedation and drowsiness may consider taking the medication closer to bedtime.

  • Do I need any monitoring while taking tramadol?

    Routine blood tests or monitoring are not normally required while you are taking tramadol. Your health-care provider may meet with you regularly to ensure that tramadol is adequately controlling your pain and not causing any adverse effects.


This information was last updated November 2017, with expert advice from:

Jason Kielly, B.Sc. (pharm.), Pharm.D.
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health

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