Monday December 22nd 2014

How long does Tramadol take to work?

How long does Tramadol take to work?

Tramadol provides pain relief. But when do the effects kick in? We review the basic pharmacology here.

Tramadol uses

Tramadol is used for both acute and chronic pain conditions and the opioid provides moderate to severe pain relief (analgesia). Doctors prescribe Tramadol for conditions such as post surgical pain, obstetric pain, terminal cancer pain and also use Tramadol as an adjuvant therapy in anesthesia. In fact Tramadol uses are wide ranging, as doctors prefer the drug to heavier opioids that carry higher risk for addiction. This is why medical conditions ranging from treating acid reflux to nerve disorders are all treated using Tramadol.

Tramadol analgesic effects

Doctors use Tramadol for its relatively efficient pain relief and low risk of addiction. But before you take it, you should know that Tramadol causes euphoria. If you think that you might have a problem using Tramadol, please leave your questions below. We’ll be happy to answer them personally and quickly.

The time it take for you to feel the pain relief provided by Tramadol depends on a number of factors. These include:

  • age
  • general health
  • mode of administration
  • type of Tramadol

Types of Tramadol

Tramadol is available in short and long-acting formulations (brand name Ultram ER). Tramadol is also prepared in fixed combination with acetaminophen or is prescribed alone.

Tramadol mode of administration

Doctors generally prescribe Tramadol as an oral tablet, but the medicine can also be delivered via oral drops, rectal suppositories, oral tablets, local injection (dentistry) or via intravenous administration for people who are medically supervised.

When does Tramadol start working?

In healthy adults, pain relief is felt almost immediately if Tramadol is administered locally via intra-dermal injection (through the skin). And Tramadol absorption is similarly rapid in oral liquid doses.

Tramadol levels in the blood peak 2 hours after taking a 100 mg oral dose. In clinical studies, the onset of pain relief was faster with a combination formula of tramadol hydrochloride and acetaminophen (brand name Ultracet) than Tramadol alone. Onset of analgesia (pain relief) occurred in less than one hour. However, it takes 2 days to reach steady-state concentrations of Tramadol in the blood at a dosing rate of four times per day.

As stated before Tramadol works differently for every person. Some people register no pain relief from Tramadol, even after days of taking it and especially if they are taking other opioid pain pills at the same time. Other people feel immediate local pain relief, especially when Tramadol is injected under the skin before dental surgery. And although Tramadol is designed as a low-risk pain reliever, it can be addictive.

Reference sources: Analgesic Efficacy of Tramadol by Route of Administration
Tramadol hydrochloride medication description from Daily Med
Pharmacokinetics of Oral Tramadol Drops for PostOperative Pain Relief
Pharmacologic Management of Pain – National Cancer Institute

Photo credit: ....Tim

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51 Responses to “How long does Tramadol take to work?
Rusty Rivers
11:29 pm August 24th, 2011

I am five months into a Twelve Step program for alcohol and a little over 2 weeks free of over 6 years of morphine used for chronic pain (Avinza 90mg) and 9 or 10 years prior to that of various Codeine types of medication. I am looking for a viable alternative to opioids (I have chronic back pain (laminectomy in 1984, have avascular necrosis and or arthritis in one shoulder (one’s been replaced), and ankles (one is fused) and both hips have been replaced due to AVN. An implanted pump with “micro-dosing” has been mentioned as an option, but I’m not too keen on it unless it either makes the most sense or is a last resort. I’d appreciate any feedback. I have tried Cymbalta (no difference in pain level) and avoid acetominophin and ibuprophen becasue of kidney/liver damage and the former gives me headaches. Celebrex was helpful, but not covered by my insurance. Thanks much for your website/blog – very informative and helpful. A Higher Power is most effective of all and what has gotten me to get off of the morphine and seek more spiritual growth. Thanks again.

Mike
3:36 am November 9th, 2011

tramadol is not addictive and it is not a very good pain reliever. To think anyone with cancer would even consider tramadol to treat pain is a very, very sad notion

10:04 am November 10th, 2011

Hi Mike. Thanks for your comment. In our research, we have found that Tramadol can be addictive to a low percentage of people who can feel its euphoric effects.

What other more effective medications have been recommended to you or have you researched that can treat cancer pain? We’d love to share more information with our audience.

Mike Singer
3:48 am November 14th, 2011

Hi again
I’m a Pharmacologist, so I learned about it in school, but have learned more reading the more literature extensively, taken it myself, and now am conducting a study using it to treat something other than pain. There’s very bad information on the internet regarding its abuse potential, which is really zero. It has the same abuse potential as celebrex. Anywayys, you can buy OTC in MOST countries, besides the US. For example, in most South American countries it’s OTC, but oxycodone requires a special doctor permit to dispense. In the states, not many doctors prescribe tramadol or know much about it. Also, the only reason its not OTC is because the FDA has more important things to review, plus the opioid drugs (vics, oxy) are readily available and have a higher degree of efficacy. And unfortunately are overprescribed and have a higher abuse potential. Tramadol is not a true opioid nor is it a true SSRI… but it does have some qualities of each. the latest publication I’ve seen equated the analgesic efficacy of 100mg tramadol to 60mg codeine sulfate (which also does not make you euphoric). However, 60mg + 600mg APAP (which is the more common formulation) is better than both. Also, taking tramadol in large doses has been reported in most to ALL cases as unpleasant and dysphoric. These are facts I’m giving you and I wish I could just give you one to try. However, that’s illegal and I’d never do something like that :p try it for youself next time you are in Mexico, Central/South Amer, or Europe

Juli
10:17 pm December 21st, 2011

I take pain meds for endometrisis and in the past Vicodin and Norco were what I was offered. I do not have an addictive personality, and I only have to take it 1 week out of each month, so my dr’s were never really concerned with it; but this month I forgot to get my scrip renewed, and my dr wasn’t around, so the nurse offered me a few days worth of Tramadol until I could get in to see my doctor. I’ve only been on it for a few days, but it seems to be working well enough (I’m taking 50, not the 100′s) I do need to take it more frequently than I did Norco, but so long as I keep it on board, it seems to manage my pain well. I have noticed some slight dizziness/drowsiness but that could be unrelated (I have an unpredictable schedule).

We will see how I do next week with any withdrawls.

stephan
11:44 pm December 21st, 2011

I can back what Mike says from personal experience. I have tendonitus in a shoulder and it hurts like hell. my doctor at first prescribed a few tablets of 25mg tramadol there was zero pain relief. I checked the net and saw that the maxium daily dose was 400 mg. so I tried a 100mg dose that i got in Mexico OTC. big mistake. not only did it do NOTHING to relieve the pain, but the mental side effects were very unpleasant. that’l teach me. For me, tramadol is worthless for pain. the only thing that really helped that my doctor was willing to prescribe was vicadin and thats what I use to this day at the prescribed dose for pain relief.

Courtney
3:32 pm January 18th, 2012

I must disagree with Mike. I respect you and understand that you are a professional, however, tramadol does make me euphoric 9 times out of 10. Also, it is and has been addictive to a personal friend of mine. My friend was on it only for three months but once stopped, was in miserable withdrawals for weeks. For my FMS, it is a godsend, and it manages my pain better than anything else, but I do want people to be aware of how it can be.

Elaine Kangas
9:19 pm July 29th, 2012

How long does tramadol stay in your system?

1:50 am July 31st, 2012

Tramadol is usually detectable in a tramadol-specific urine test for 1-2 days after use. More information about how long tramadol stays in the body here: http://prescription-drug.addictionblog.org/how-long-does-tramadol-stay-in-your-system/

eric
7:32 pm October 27th, 2012

Hi i have taken two 50 mg pills one at 8am and one at 2pm around 8pm i wanted to have a few beers would the tramadol affect me then with drinkin?

9:17 am October 28th, 2012

Hi Eric. Yes, it’s possible that tramadol can interact with alcohol if you drink 6 hours after dosing. I’d suggest that you wait at least 12 hours, if not a full day, after dosing with tramadol to be sure that the two central nervous system depressants do not interact in your body.

anna bradley
11:14 pm November 20th, 2012

hi to anybody thinking of taking tramadol, dont i beg of you, this drug is great while your on it but wait till you try and come of it, hell hell hell, jerking tingling legs and arms , sweating panic attacks restlessness, over emotional, flu like symptoms etc, sheer misery, im now trying to come off by reducing 10mg aweek untill im off it , never will i touch this drug again when i eventually get off it,

Leonard
7:33 am November 24th, 2012

Hi,

It is quite ridiculous to make blanket claims for Tramadol. Its effects depend entirely on the individual taking it, as can be seen from the previous posts.

Personally I find it excellent as a painkiller, and it was the only thing that relieved the pain of polymyalgia which I suffered from for a year.

However, I paid the price when I tried to come off it, even though I did it very gradually. Two months of feeling absolutely lifeless and miserable, which I went through earlier this year.

Now I only take 50 mgs occasionally when I need pain relief. I have learned my lesson!

Alan Kinds MD
4:51 am December 14th, 2012

Tramadol is a novel pain medicine. It possesses opioid activity but with an anti-depressant effect. Because it is an opiate receptor agonist, it WILL have some dependence potential. In fact, some individuals experience a horrible protracted atypical withdrawal when stopping with doses as low as 100-150 mg daily. This is well documented.

I think it is a disservice to tell anyone, as some above have, that there is no addiction potential. As for being OTC in many countries, that is true, but so is codeine and hydrocodone. Most of these countries are developing countries who are poor where most people are worried only about where they will get their next meal. Buying OTC tramadol would be considered quite a luxury item for the common man in these locations. Besides most people take the advice of their doctors and only get what is recommended, something our western “know-it-all” pill popping culture could take a lesson from.

Alan Kinds MD
4:57 am December 14th, 2012

Addictive personalities mean nothing to those using any type of chronic opioid, including tramadol. Anyone who takes opioids for more than a few weeks daily, will have some type of withdrawal.

Please don’t think “addictive personality” has anything to do with it. This leads some to believe that addiction is some type of weakness.

Give me 10 days and the substance of my choice and I can get anyone addicted regardless of their personality. It is a physiological certainty with regular use of some substances.

9:19 am December 14th, 2012

Hello Dr. Kind. Thank you very much for your insight. To clarify, isn’t there a distinction between physical dependence and addiction? I think our culture has popularized the word “addiction”, but I think it’s important for people to know that cravings and psychological compulsion to use tramadol are characteristic of tramadol addiction…not simply physical dependence.

Ross Phillips
4:07 am December 15th, 2012

Greetings All:
I have been prescribed and taken Ultram since 2001. After time I build a tolerance, become physically dependent and must taper for a period in order to get relief. When it works it is the only drug that give true relief and works well. It works better than Lortab 10/500 which is the only real opiate that I have tried because of fear of something I can’t get out of.

Presently I am taking 300 mg per day and need to taper. I have set a 300 mg / day limit as I do not want to get to the 400 mg perscription limit and not be able to taper due to work or life in general. I have to have relief to function so have tried and failed as many times as I have succeeded over the years. Rheumatologist is not much help as he has suggested methadone as a substitute which I refused.

Can anyone direct me to a taper plan? How much is too much? Enough?

Any Replies Appreciated.

Jake
3:35 pm December 15th, 2012

Thank you for being honest Dr. Kind. We westerners do not know what we have nor do we appreciate it. Including myself.

Rory
6:47 pm December 16th, 2012

hi there i have used tramadol and i find it does work but my body has become immune to it they say the daily dose is 400 mg. I take anywhere from 350 mg to 400 mg when trying to relief myself of pain for 12 hours. I don’t feel addicted and I don’t suffer withdrawls. I also take oxcontin 10 mg and 20 mg I also find it hard to get relief from this drug too. I’m not by any means a big person i’m 184cm in height and weigh 75kg. I don’t understand why I have to take a large quantity of pills to get an effect. I know it cant be good for me and its hard to explain to my GP that i need a higher dosage for relief without him thinking i’m addicted ? Any explanations or suggestions would be much appreciated

12:35 pm January 2nd, 2013

Hi Rory. The immunity that you describe may be an inborn tolerance for opioids and opiates. I’d suggest that you discuss your tolerance with your GP openly and honestly. If you need to manage pain for a chronic condition, you may need to find an alternative.

Devin Roberts
4:44 pm February 8th, 2013

Rory- some people are born with different abilities to metabolize opiates, do you take any other pills that may inhibit liver enzimes, if not I would say its most certainly just a natural tolerance do to less active liver enzimes

Rory
1:59 pm February 10th, 2013

Thank you for the reply it is much appreciated.And no i don’t take any other pills. I plan to speak more about this to my GP hopefully he can be of a help.

Regards Rory

wounded warrior
6:34 am March 5th, 2013

Good luck having intercourse if you are on Tramadol

Ross Phillips
7:41 pm March 5th, 2013

Can anyone direct me to a taper plan? How much is too much? Enough?

Any Replies Appreciated.

Amanda
8:47 pm March 5th, 2013

I had to take 2 50 mg tramadol this morning for my back and i have to see the dr. Friday to renew my meds and a possible drug screen which they test for tramadol. will this be out of my system by Friday? Please answer ASAP

Brenda Cassidy
12:22 pm April 7th, 2013

Tramadol has not relieved my arthiritic pain not one iota–still waiting for the “euphoria” to at least kick in–nothing yet. If you really have pain, skip this one. Have tried Naproxen, Motrin, Tylenol w/Codeine 3, Valium and bow Tramadol. This is my 4th week of 24/7 severe pain. Will be glad when the doctor gives me something that even half-way does something….:(

mesha
2:17 pm July 23rd, 2013

i had sinus surgury last year and ever since i have had pain off and on. this past weekend i was in so much pain i went to the er. all week i have tried everything from icepacks to otc drugs to get rid of the pain and nothing worked. i finally got tramadols and i was in so much pain i took 200mg just to cut the pain. after that i’m down to 50-100 mg. my husband thinks i’m addicted to tramadols. is this true? and i have talked to my dr about the pain as well and they said do otc and it doesnt work.

9:11 am July 25th, 2013

Hello mesha. If you’re using tramadol as prescribed to treat acute pain, this type of use is therapeutic. Misuse is when you take higher doses of tramadol than prescribed, especially to achieve euphoric effect. Is there any timeline for you on resolution of the pain? Have you seen another ENT specialist for a second opinion?

Nikki
9:54 am February 6th, 2014

I was prescribed tramadol 50mg by my doctor yesterday. I went in as an emergency case because I thought I had kidney problems. It turns out I have lumbago that’s pressing on the sciatic nerve and sending the pain in to my pelvis and groin. It’s one of the worst pains I have ever experienced. I took 2 tramadol last night which kind of number the pain, and then 6 hours later I took 2 more before I went to bed. It was the best nights sleep I’ve had in a long time. I was told to take one four times a day but I’m trying to hold off now as the pain has subsided a bit.

Pautu
5:54 am February 13th, 2014

Hi
I have been using Tramadol inj.(100mg)for almost 3 years due to my chronic spinal chord pain and it works well for me…but from the last two months when i used it.it relief the pain just only around 1 and half hour and need to used again…now i need to used 4 times a day or more..does it mean that my system is getting immune to tramadol?????????

11:28 am February 13th, 2014

Hello Pautu. The medical term you’re looking for is “tolerance”. Yes, you do become tolerant to tramadol after regular dosing for a few weeks, or more. Speak with your prescribing doctor about the situation and seek alternative treatments for pain, or ask for recommendations on how to lower your tolerance to tramadol (a period of abstinence, for experience).

bovo
7:13 pm February 27th, 2014

Why did people take it before being intimate and when must it be taking before intercourse, if it dose work for it

Joy
1:54 am March 7th, 2014

I have been on tramadol for five months for RA. I take one 50 mg in am and one in pm. I want to stop not sure how. Got down to one a day and then tryed to stop I felt like I was scared out of my mind on day two and started back. Can some one please help with info on stopping and what may I go through.

Leonard
6:40 pm March 7th, 2014

Hi Joy,

I know it is difficult. When I stopped I tapered off. From 2 a day I went to one and a half for a couple of weeks and then to one for the same period, then half, and finally none.

I confess I felt terrible, but stuck to it and it finally wore off.

Nemesio
6:02 pm April 8th, 2014

Doest Tramadol HCL ER coms 500mg?

P.O.
12:47 pm April 14th, 2014

I take Zydol tramadol 100mg 4 times a day for about 4 years now and if pain gets really bad I take oramorph on top. I slso take Seroxat for panic attacks. I have been told both seroxat and tramadol have serotonin in them? Anyway I always think tramadol dosnt work but when I stop taking them my pain comes back.I dont find them addictive I sometimes take 150 mg.

12:50 pm April 14th, 2014

Hello P.O. Keep in mind that addiction is different than dependent. While you may be/become physically dependent on tramadol, you may not develop addiction (which is mainly psychological, in nature). Are you worried about the amount of tramadol you are taking?

Beki
10:43 am May 2nd, 2014

I take tramadol regularly for sciatica and a problematic epidural during an emergency caesearean last year. I ran out of my prescription 2 days ago and unfortunately it was a fiesta (i live in spain) so couldn´t get any until this morning. I can honestly say the withdrawal effects are absolutely horrendous. I could not move from the sofa, the pain in my back was worse than i remembered even before prescription. My legs were in agony and i had the worst cold sweats and brain zaps ever! And i am on a relatively average dose of 200mg daily. (50mg taken 4 times a day) I never used to even so much as take a paracetamol but i can honestly say i couldnt wait to get my pills this morning. Guess that means I am physiologically addicted?

11:03 am May 14th, 2014

Hello Beki. Withdrawal precipitated by lowered or missed doses of tramadol is the main symptom of tramadol dependence. Be careful not to confuse this with addiction, which is principally a psychological condition. From your description, it sounds like you are dependent on tramadol. To address dependence, you can seek help from your prescribing doctor to recommend a 4-6 week long taper so that withdrawal symptoms are minimal.

Nemesio
9:09 pm May 19th, 2014

I’ yuse tramdol 300 mg and dosen’t make me a good effect. What can i do.

chris
6:56 am June 17th, 2014

The doses talked about above are very very low for my pain I have taken 2000mg mg slow release at once from that My pain can be handled but 400mg maximum is a joke from that sr or 50mg instant release with little euphoria and mild relief give me panadine forte any day which only 30mg of codine and 500mg of paracetamol

Lisa
12:57 am July 8th, 2014

Will the tramadol kick in about 2 hours after I take it? Because I’m in pain bad and I took 2 pills of tramadol…

Kingsley
7:09 pm July 27th, 2014

Hi am kingsley i have tramadol 50 mg capsules …. please tell me how many can i take for a day and what time should i take them and hour, minute before I’m intimate with my girl ?please i want to know how many mg in a capsules and also tell what are the effect ?

fred
12:15 pm August 6th, 2014

I am now two and a half years on Oxycontin. As a result of surgery gone wrong the dosage has increased to 60 mg per day. I suffer morning withdrawal symptoms and severe constipation. To reduce this I am on a laxative which in turn causes severe stomach cramps. I’m looking for something to ease me off this medication and in time to hopefully ease me off it forever. At the beginning the medication did give relief from pain and discomfort but, now the addiction to this drug is worse than the problem caused by surgery.
Please advise if you can!
Sincerely, Fred

mike
12:24 pm August 16th, 2014

Just started tramadol 50mg , for back pain . Took it last nite and woke up this morning in pain . Do i have to take this at least 4 times a day to even work.

Tim ParaNurse
4:40 pm September 5th, 2014

I’m a paramedic and in school for RN. I had a laminectomy in 2011 and have been on Tramadol since about a month after my surgery. I appreciate your article about it. I’ve found that it is quite accurate to my experience with the drug. Initially, I took about 6 50mg doses per day, but have weaned myself down to only 1 per day. Occasionally I take one more later in the day, but not very often. I weigh 160 lbs, and even at the 50mg dose, it will peak at right around two hours with a slight euphoria.
I have found that one untoward effect is that it will keep me awake or wake me up in the night depending on when I take it. I no longer take it before bed. Instead, I sleep at night until I awake with discomfort (usually around 4-6 a.m.). I usually start feeling pain relief within ten to 15 minutes, and I fall back asleep. Occasionally, I’m unable to go back to sleep. I have noticed another side affect of a mild decrease in sex drive on occasion and delayed orgasm during sex. At higher doses, one may have very little sex drive. I try to keep the medication doses as low as possible. The little bit of euphoria is short-lived, which keeps the addiction rate down, but the pain relief is effective for the chronic pain I have.

Tim ParaNurse
4:48 pm September 5th, 2014

To “mike” that posted on August 16th: you may have to combine it with a muscle relaxer to be able to sleep through the night. You may have to experiment with taking the drug at different times and doses as well. My post above tell about my habits after a couple years of experimentation and finding out what works best for me.

Missyj
4:25 pm October 13th, 2014

My dentist prescribed this for pain management while the antibiotics work before an extraction. She also prescribed 600 mg ibuprofen on top of Ultracet. I took just one of the Ultracet, and a half hour later when the pain had not eased, I took another and the ibuprofen. That was 1.5 hours ago and I am still in pain.
I understand there are different doses, so I’m wondering if I should just take more.
tramadol 37.5mg acetaminohine 325 mg in each tab is what I was given.
I can’t eat, or sleep and barely swallow. What is the normal and/or Max dose of these?

Ivana @ Addiction Blog
8:02 am October 14th, 2014

Hello Missyj. For the short-term (five days or less) management of acute pain, the recommended dose of ultracet is 2 tablets every 4 to 6 hours as needed for pain relief, up to a maximum of 8 tablets per day. Of course, you should first have your doctors clearence before you start increasing doses.

Missyj
9:54 am October 14th, 2014

For me, it appears to be cumulative. The first dose didn’t do much, but the second dose 4 hours later was far more effective. I was able to sleep last night. Now if I could just stop itching I’d be perfect.

kris
9:05 pm October 22nd, 2014

This guy Mike is an idiot, of course its addiction.

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