Wednesday April 1st 2015

Tramadol overdose: How much amount of tramadol to OD?

Tramadol overdose: How much amount of tramadol to OD?

It depends.

The amount of tramadol that can cause tramadol overdose varies greatly by person and their exposure to opiates or opioids. And how much tramadol is safe also depends on individual opiate tolerance, as well as mode of administration.  for example, snorting tramadol effects are more dangerous than taking tramadol orally.  If you take tramadol regularly, can you prevent an unintentional tramadol overdose? In this article, we’ll explore how much tramadol it takes to OD along with the risk factors for tramadol overdose. At the end, we invite your questions about tramadol and overdose.

Tramadol overdose – How much is too much?

The amount of tramadol which can provoke overdose depends on your previous exposure to opioids. How long does tramadol stay in the system? Tramadol has a half life of about 6 hours, but can be detected for days after use.  But, if your body is already tolerant to tramadol, opiates, or opioids, you can take more tramadol safely. However, safe doses will vary between different strengths and formulas of tramadol. And if tramadol is mixed with other medications, such as acetaminophen, it can be much easier to overdose on the secondary active ingredient. There are some basic guidelines you can follow to safely take tramadol.

At 500 mg, you can begin to experience severe side effects such as seizures. However, tramadol overdose doesn’t actually occur unless you take between 2.65 and 8.2 grams, which is about 5-18 times the recommended maximum daily dosage. You may end up in the hospital if you take 500 mg of tramadol, but you probably won’t die. Further guidelines for tramadol dosing follow:

Opiate naive patients – For example, a doctor will start out an opioid-naпve patient at only 25 mg at a time, and no more than 100 mg in one day. This is to avoid potential side effects rather than to prevent overdose.

Opiate tolerant patients – Once you’ve developed a tolerance for opiates and opioids, you will probably have to have your dosage increased – but you should never start taking more tramadol without medical supervision. As doctors increase doses to accommodate patient tolerance, they consider a number of different variables, including your age, weight, general health, and any other medications you might be taking. The safe dose of tramadol varies greatly from person to person. In individuals with an opiate, opioid or synthetic opiate tolerance, 450 mg is the maximum recommended daily dosage for tramadol.

How does unintentional tramadol overdose happen?

You might accidentally take too much tramadol for a variety of reasons. You may not be getting adequate pain relief from your prescribed dose after using it for an extended period and developing a tolerance to tramadol. If you increase the amount or the frequency at which you take it, it’s easy to unintentionally overdose on tramadol. Getting “high” on tramadol is another way that accidental overdose occurs, particularly since this takes larger amounts of the drug than are normally prescribed. In fact, you’re much more likely to overdose when you chew, crush, snort or inject tramadol pills. Tramadol abuse greatly increases the risk of death and overdose. This medication should only be taken swallowed as a whole pill, and only in the doses recommended by your doctor.

Tramadol overdose complications

The most dangerous complication of tramadol overdose is slow or shallow breathing. Tramadol overdose can even cause your breathing to stop completely. Other medications combined with the tramadol may also cause overdose, or make these effects more pronounced.

Tramadol overdose prognosis

Since it’s pretty difficult to overdose on tramadol, recovery is probable after an OD. If you’ve taken a high dose of tramadol and experience adverse side effects, prognosis and recovery without long term damage is possible if breathing has not been compromised. During these more serious cases of tramadol overdose, doctors may administer oxygen to help you breath better. But to be clear: Tramadol overdose can be deadly. Furthermore, the lack of oxygen reaching your brain due to depressed breathing can cause permanent brain damage. Luckily, it’s hard to accidentally take this much tramadol.

Tramadol overdose death rate

Unintentional deaths by overdose are unfortunately on the rise among all opiate medications; there’s been a nationwide increase in the use of painkillers. The misuse and abuse of tramadol by recreational drug users accounts for a large portion of the increase in drug poisoning and drug deaths. However, prescriptions for higher doses of tramadol also increase the risk of overdose or serious health problems.

Tramadol overdose amount questions

If you have any questions about safe amounts of tramadol in your system, please leave them here. We are happy to try to help answer your questions about tramadol, and will try to respond with a personal and prompt reply for all legitimate queries.


Reference Sources: Toxnet: Tramadol
Medline Plus: Tramadol
FDA MedWatch: Tramadol hydrochloride tablets

Photo credit: allisonturrell

Leave a Reply

44 Responses to “Tramadol overdose: How much amount of tramadol to OD?
5:18 am August 30th, 2012

I started taking this drug about a week ago after my carpal tunnel surgery and up til tonight I didn’t have any issues with it but tonight I’m just feeling different and it’s really starting to scare me should I worry?

11:47 am September 1st, 2012

Hi Mindi. Can you describe the symptoms that you are experiencing as well as the dosage of tramadol you take? Also, please call your prescribing doctor to report these side effects ASAP.

8:28 am September 17th, 2012

Hi- I have been taking tramadol for over 4 yrs now. I have worked my tolerance up to about 25 a day-taking 4 at a time every few hours. I have never had a seizure but I kno this is a ridiculous amount of any kind of pills to take that much. I want to stop but I am afraid of withdrawals-brain zaps. Do not feel like I could taper. If I have them I will take them. Ugh! How did I get myself in this mess!! Sooo anyway guys I need help. Should I ask the doc for something to help me get off of these like suboxon (sp). Any advice would be appreciated. :)

7:31 pm September 17th, 2012

Hello dbi. Thanks for your message and for reaching out for help. I’d suggest that you call the 1-800 anonymous hotline number for drug treatment to learn more. The National Drug and Alcohol Treatment Referral Service is open 24 hours a day at 1-800-662-HELP and can link you to a variety of services, including detox clinics in your area. But once off tramadol, how will you stay off? You’ll need to address the mental and emotional compulsions that drive your tramadol use if you want to really live a life without tramadol. But you can do it!

Please let us know if this helps.

Always on the go...
6:38 pm October 7th, 2012

I have been taking tramadol consistently for 3-4 years now. For a long time I kept my dosage under the required daily maximum. Every once in a while I would take 500-600 mgs and it helped with no apparent side effects. Over the last few months I have noticed that I am consistently taking higher dosages than recommended (500-800 mg) daily. I don’t ever jump to a higher dosage but slowly increase it. I first started taking this medication for lower back and hip pain. It seemed to relieve the pain enough and didn’t put me to sleep. Quite the opposite, it energized/calmed me (the anti-depressant effect.) I have Adult ADHD but have never taken medication for it (tramadol seems to have a positive affect on this however.)

I have two-three times had the shortness of breath and it sacred the S*** out of me. Every few months I slowly reduce my dosage in order to make sure I have the capability of weaning myself off. I drink a ton of caffeine! Coke, Coffee, 5 hour energy, etc..

Here is the issue…I am always on the go, so reducing the dosage is hard because it lowers my energy (and mood) so taking it helps me manage activities. I am an executive and massively involved in activities. I think that while I started to take it for the pain relief, I now take it for the energy and difficulty of reducing dosage.

Any recommendations on decreasing dosage, managing this or alternative recommendations? Thanks for the help.

Also, I take the 100mg time release capsules available in Mexico.

12:40 pm October 17th, 2012

Hi Always on the Go… Thanks for your questions. It does seem like you have developed quite a tolerance to tramadol. Apart from playing with the level of tolerance (which I don’t really recommend as this might provoke withdrawal symptoms, which can include seizures) I’d suggest that you look into other pain relief alternatives, such as a controlled release version of oxycodone or other opioid(s). Tramadol might just not be working for you and is actually in a totally distinct class of opioids in and of itself. And I would certainly suggest that you consult your prescribing doctor (with full disclosure) to seek a professional opinion. It seems to me that you’re playing with fire with such a high dose of daily tramadol…and that you can find another option that can work better for you.

8:53 am January 17th, 2013

Hi, I’ve been prescribed Tramadol and paracetamol for severe tooth ache (open to nerve) while I await a dentist appointment on about a weeks time. I’ve been told to take two tramadol tablets four times a day BUT I find I cannot last longer than 5 hours (not 6) before I’m in excruciating agony… This means I’ve upped my intake to 5 times a day which is 500mg per day along with 4000mg of paracetamol… I feel very euphoric, sweaty and a little uncoordinated when on them but no pain which is great… Am I taking too much of a risk at these levels ?

10:51 am January 18th, 2013

Hi Dave. I think that you need to consult a pharmacist. It’s possible that you have become opioid-tolerant, but experts set the limit at 450 mg tramadol per day. It may help to also seek out a prescription for a strong opioid like hydrocodone or oxycodone during the days before treatment.

Concerned Friend
1:23 am March 28th, 2013

My family member is taking 50mg Tramadol with a quantity of 240. He is a recovering addict. He just filled his prescrition and ten days later his bottle is almost empty. He said he was doubling the dosage. The directions were to take two pills every six hours. He has also gone through a bottle of Xanax within nine days. Last time he ran out of Tramadol he started to have seizure symtoms but more thrashing like. I believe his body is going through withdrawl at this point. Is he taking lethal doses?? I’m worried about him having seizures or worse.

2:36 pm March 28th, 2013

Hi Concerned. The dosage and use sounds like drug abuse. I’d suggest that you consult with the National Drug Abuse Hotline at 1-800-662-HELP to find local resources in your area to get more information and start to help your friend address drug abuse.

8:21 pm May 20th, 2013

I took 100mg of tramadol 3 or so hours ago. Is it safe to have a couple glasses of wine?

1:16 pm May 21st, 2013

Hi Jim. You’ll need to get clearance to drink from your prescribing doctor while on tramadol. If you can’t cut down or stop for the duration of the prescription, you might want to evaluate your drinking.

John fountain
8:11 pm June 1st, 2013

Hi all, I’ve been taking tramadol 50mg between 9-12 capsules a day for about two years now and I am thinking of upping my dosage to 12 -16 a day ? I have osteoporosis it’s pretty damn painful , and it’s getting worse . I know that I am de

8:58 am June 3rd, 2013

Hi Josh. Check with your doctor first. Perhaps there is another opioid medication which you might need to consider, as it seems that your tolerance to tramadol has increased. Alternative options for pain relief include hydrocodone and oxycodone, although these are more addictive and powerful painkillers.

louis moelli
4:20 am July 12th, 2013

I have been aflicted with Aachnoiditis now for ove 20 years. (at least nobody has or wiill diagnose it).It is fustating and sickening to think that doctors will not tell the patient of what could happen-ie,.–(a life time of pain). If I wee told the facts and the possible consequence,I would have un out of that offece not waked…. A living hell!

I took two Tamadol and 4 tamadol at 50mg. I still feel the pain in my foot and intermittant stabinh pain-thank God is is rare.

I do not know what to do, I am deapeate.

Lou Moelli

10:47 pm July 16th, 2013

Hi There,
I take 4 50mg at night a few hours before I go to sleep for a torn tendon in my ankle. I do not take any during the day so the max per day (and at one time) is 200mg. I have been slightly increasing a quarter of the round pill at a time and refuse to go about 200mg. After reading several stories and researching, I just want to be sure that this amount is safe. Thank you for your time and knowledge.

11:38 pm August 9th, 2013

I have had bankart surgery to left shoulder and have cfs. I take up to 6 x 50mg tramadol 3 times a day 3x 500mg co dydramol and solpadol4 times a day can’t remember dosage. Of solpadol. I also take antihistamen and a few paracetamol during day up to 6 paracetamol over counter strength. is this ok , it does nothing for the pain and I want to up it, what would u recommend

11:09 am November 14th, 2013

I took 650mg of Tramadol a few months ago, After an unsettling trip to the E.R. I woke up feeling like I was in someone else’s body. I just felt like this wasn’t the same person I was 2 days ago. Since I’ve developed moderate anxiety. Worsening insomnia. On top of that about 3/4 of the time I smoke weed which is pretty often I have these horrible panick attacks where I swear i’m gonna die. Point being i’m worried about serious mental/physical health disorders that could result from this. Should I be concerned?

12:26 pm November 14th, 2013

Hello Jack. Symptoms such as panic attack can be related to marijuana use, especially if it’s chronic. Have you thought about seeing a psychologist to learn new ways of coping or to talk about drug use in general? I’ve been there – and it really helps to consider an entire lifestyle change if you’re feeling off balance and panic overtakes you…

12:22 pm December 4th, 2013

Hi, my mother recently passed away from Tramadol toxicity. She has been an alcohol abuser for over 40 years. The toxicology report states that she had 14mg per litre of Tramdol in her blood. Could anyone give me any indication as to how many tablets she may have taken to get this high a concentration? I will add that she had a BMI of 30.1 was aged 63, smoked and drank and was on heart medication so her metabolism may have been poor. Thanks in advance

2:10 pm December 5th, 2013

Hello Bereaved. I’m so sorry to hear of your loss. You’re probably looking for some answers. The best place to start would be the coroner directly. Then, seek expert help with a toxicologist or even a Medical Review Officer at a diagnostic testing lab. You need medical expertise in order to get the answer you’re looking for. Bless and peace to you in your time of difficulty.

10:03 pm February 5th, 2014

If someone you know overdosed on tramadol, what are the long term effects from it?

4:11 pm March 30th, 2014

I know someone who has taken 8 pills, 400 milligrams for there first time and he got really dizzy, vommited, shaky, and light headed. I talked to him the next day and he felt better but is still a little worried. Is there still a chance for him to OD? My question is whether or not there is a time period for OD’ing and if I should be worried. He is a big guy, 6 foot 2 and was wondering what the person should do. Thanks.

2:43 am May 9th, 2014

I am highly addicted to tramadol. My fiance gets 50mg every month and I go through it within two weeks by taking 5-7 at a time..I have no insurance for rehab and I’m in need of some serious help

1:37 am May 10th, 2014

i currently take alot of pain medications and at the moment i take 8 50mg tramadol but am thinking of upping this as its not working. i should also add that split throughout the day i take 15mg procloperazine, 8 30/500 cocodamol, 150mg arthrotec, 20mg diazepam and 200mg omeprazol. what are your suggestions please as pain is really bad and need answers. i have fibromyalgia and chronic pelvic pain.

1:53 am May 14th, 2014

A former heroin addict, i gave up 15 years ago and am still on methadone, but only !0ml daily (i sometimes save some and get high on around 60ml) I am also an alcoholic, no matter how much i try- at present 1/2 bottle of vodka daily. i am buying tramadol and using 20 50mg tablets at a time (1000mg) obviously this is not healthy – i have been admitted to hospital twice with pancreatitis and abuse the morphine patches, 25mg per hour 3 day dispersal – i use 5 or 6 at a time. how likely am i to die? i am 56 and first took drugs at 12, heroin at 17 but did not become addicted to heroin until my mid 30s. Please, advice other than ‘just say no’ would really be appreciated

10:57 am May 14th, 2014

Hello Tim. How about formal treatment? Have you considered options for either inpatient, residential treatment for addiction? It’s intensive, but with a history like yours and multiple substances, you’ll probably need help during detox and then a prolonged stay to address underlying psycho-emotional issues which compel the drug and alcohol use. My best wishes go out to you.

2:45 am June 1st, 2014

I bearly got prescribed tramadol 50 mg for boxers fracture I rook one at 7am today then 1pm another at 6pm I’m experienceing slightly smaller breaths especially wen yawning should I b concerned? I’m not over doing meds so far 150mg today is this normal I feel fine just shortness of breath it bearly started after third pill today I might just b over thinking what should I do ?

9:11 am June 17th, 2014

Ive only taken tramadol once before a couple yrs ago just yesterday I was perscribed tramadol 50mg it says take one tablet two times aday as needed ive taken 3 tranadols throughout the day but I dont know if I might have taken them to close together like maybe an hr or 2 to 4 hrs apart im also diabetic type 1 the only symptoms ive had is just really tired & calm & a little bit of dizziness & fast heartbeat should I worry? Are those signs of possible accidental overdose? Im a little afraid if I fall asleep ill fall into a coma so if you can help me in anyway you can id really apprechiate it. Thank you

5:02 pm June 26th, 2014

I once took 8x50mg tramadol all at once…that was around 10ish…after 3-4 hours, all that had happened was: I was hungry, but felt queasy & my vision and speech were bit slurred and blurred…

8:50 am August 13th, 2014

I work in a drug and alcohol rehab a client has said he took 400 tramadol over 4 days last week (50mg tablets). Is this possible without dying ? He has abused very high levels of tramadol in the past.

2:11 pm August 13th, 2014

Hi Lynn. Tramadol 50 mg to 100 mg can be administered as needed for pain relief every 4 to 6 hours, but it shouldn’t exceed 400 mg per day. If he took 400mg over the course of 4 days, and has a high tolerance to them, he should be ok.

7:41 pm September 16th, 2014

Im taking now up to 12-14 pills a 50mg during the day, as my pains getting worse and worse. So Im painfree in some few hours. And only this. There are no highs and euforia, and I dont think of this medication when there is no pain. Obviously, Im getting tolerant and need another kind of strong painkillers. But, I have a psyciatric diagnosis(borderline), and afraid to get another serious problem, like addiction, if I get a real opiate. To my deep regret, my doctor is not very competent, and I cannot go on with increasing the doses. Im really desperate!

4:52 am October 1st, 2014

My boyfriends sister just died sep 9 2014. She had a huge amount of tramadol in her system. They are thinking she may have committed suicide. She was only 27. I miss her. Life is too short. You only live once.

4:35 am October 15th, 2014

I have a rare form of muscular dystrophy & have to take 400mg a day, as prescribed by my Neurologist. I just worry that I’ll forget & take too many.

3:12 pm October 17th, 2014

Hi Lewis. Make a schedule with the time and days you need to take the medication. Then, make a system and only cross out the hour after you take it. You can set your alarm to ring and remind you every time it’s time to take tramadol again. This way you will always know if you took it, and when to take it. Hope this helps.

10:21 pm October 22nd, 2014

I have severe digestive problems and was prescribed Codeine, several weeks into using this I bought a box of 100 tramadols (50mg) off the black market (pharmaceutical grade with a pharmacy tag) and took the recommended dose. I didn’t take them to get high, only to stop the debilitating cramps and diarrhoea. Only tonight I noticed for some completely unknown reason (memory lapse) I might have taken an extra 350mg on top of my ‘daily dose’. I feel ok so far. I wouldn’t recommend this medicine to people looking to get high but it does genuinely help with digestive/IBS/crohns disease.

11:56 pm October 23rd, 2014

My mother recently passed away due to a supposed toxic level of this medicine. She had been taking it for awhile and never took too much. Gow would she have died? Could someone have given this too her without her knowledge in some way

11:13 am November 10th, 2014

61 years old, I live in Europe and have been on Tramadol (liquid, drops-pump) for the last 3 years. Most of it without medical supervision.
I like the relaxing effect; I actually don’t need the pain-killing effect anymore.
The amount I take is fluctuating. When I reach a high (up to 2,500mg/2,5g per day) I feel i have to make an effort to reduce, and usually manage to gradually go down to 2 or 300mg per day, with some withdrawal effects. I never stopped totally in these 3 years, but I can stay on 2-300mg for longer periods.
Looks like I have developed an addiction …
I also take Urbanyl on prescription to treat a light form of epilepsy I have had since I was a child.
I’m an alcoholic, who stopped drinking back in 1986. Never had a drink since then, with the help of AA. I keep in touch with the program by reading daily thoughts, but very seldom go to meetings.
But I can identify my relationship to Tramadol, in some ways, to the one I had to alcohol, before I stopped drinking 28 years ago.
I’m confused, because I (falsly??) think that I can keep on like this, and my past experience tells me it is not possible. I’m probably not honest with myself.

What’s the way to handle this?

The answer is probably in my above comments, but I would be overly happy to be able to share…

11:06 pm December 15th, 2014

My sons ex girlfriend takes 400mg of tramadol a day with 4000mg of paracetamol. She has severe mood swings and her personality has changed completely. She has lied to people making up horrible stories about my son. My son has had a breakdown and I’m worried his ex partner is going to harm their two young children. She has been on Tramadol for three years with this dose and had no review.. Please can you advise.

Sam reese
12:33 am January 31st, 2015

My friend is unfortunately addicted to tramadol she is always taking one after another in one day she had taken 10 150mg which is 1500mg I know addiction is hard to overcome but maybe if she new what risks she is doing to her body she would think again.

Paul Pepper
12:29 am February 3rd, 2015

I have taken large doses of many types of narcotic pain medications for several years. Due to a few serious accidents I have been survived. Tramadol seems to be the safest pain med I have taken. I always have to take large doses of whatever I take. Currently I take up to 800mg in two doses 400mg each within 4 hours. I also combine vistaril with each dose which allows the tramadol to work more effectively. I don’t recommend that anyone try this. Im just sharing my own information. I have a large ceiling of tolerance to most medications.

10:54 pm February 12th, 2015

I am a Nigerian, 22years old and I’m addicted to tramadol, each time I try to stop its useage, I begin to experience flu, I yawn and sometimes I keep sneezing. I also get so dizzy and it follows up with a stronng headache. Please how do I discontinue use without getting any harm? Please I really do need your help. I want to stop taking it…

1:48 pm February 17th, 2015

Hello Mesh. Here are two links that will provide detailed info on how to stop using tramadol and how to ease the withdrawal symptoms. The links are: and

Leave a Reply