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Does Ultram make you tired?

Yes, Ultram can make you feel tired and sleepy. But not everyone who uses this type of pain killer will feel sleepy. Still, you should be aware of the potential side effects of opioids like ultram such as decreased reaction time, clouded judgment, drowsiness and tolerance. But what can you do about fatigue caused by Ultram? And does Ultram come with other risks? We explore here.

Ultram does not make everyone feel tired

Before we enter a discussion about how Ultram and Ultram ER work, we should address the fact that NOT EVERYONE who takes these pain medications will experience symptoms of sleepiness. The range is between 8-25% of people in clinical trials who report feeling tired after taking Ultram and Ultram ER. A couple of variables seem to impact the probability that you may experience extreme fatigue.

1.  longer periods of time taking Ultram (7 days vs. 90 days)
2.  increased doses of ultram (100 mg vs. 400 mg.)

In other words, the longer you take Ultram, and the higher the doses of Ultram ER, the more likely it may be that you experience somnolence (drowsiness). However, the frequency of events such as sleepiness depends upon several factors including clinical setting, your level of opioid tolerance, and a host of factors specific to you as an individual.

Why does Ultram make you sleepy?

Doctors anticipate sleepiness as a possible side effect of taking Ultram. The main ingredient in Ultram and Ultram ER (tramadol) is in a class of medications called opiate agonists. Does Tramadol have opiates in it? No, Tramadol is a centrally acting analgesic not related chemically to opiates. So why does tramadol make you feel sleepy?

In general, Ultram works by changing the way the body senses pain. Opioid agonists like Ultram relieve pain by chemically binding with cell receptors in the central nervous system. But as the molecules that make up Ultram bind to specific parts of the brain to block pain, they also bind to other receptors and cause known adverse reactions. In other words, sleepiness is one such predictable, biological response triggered by Ultram.

What can you do if you’re tired because of Ultram?

1. Give it a week

If you’ve just started taking Ultram, give your body a few days to even out. Although Tramadol action time for pain relief is relatively quick, sleepiness may take some to resolve iteslf as your body develops tolerance to Ultram. Tolerance can develop within 5-7 days, so give yourself time. Additionally, it is possible that you are exhausted due to previous sleep deprivation due to unrelieved pain. So if you sleep a lot, but are able to fully wake up in between, take time to rest. It’s also possible that multiple medical conditions, advanced disease, additional medications, and declining function may be causing sleepiness. Speak with your doctors about these possiblities.

2. Reduce or discontinue dosing

Extreme sleepiness (somnolence), however, may be a sign of overmedication. In this case, you can talk with your prescribing doctor about the possibility of lowering doses of Ultram to both manage pain while still feeling alert. Or you may need to change medications and discontinue use of Ultram totally. Either way, your doctor can help advise you.

3. Counteract sleepingess with stimulants

Finally, you may seek further medications to deal with the sedative effects of Ultram, if necessary. Ask your doctor about the use of central nervous system stimulants such as caffeine, modafinil, or amphetamine to counteract sleepiness caused by Ultram.

Risks of Ultram addiction

Tramadol can be habit-forming. Although some people may debate Ultram addiction potential, expert agree that you should not take a larger dose of Ultram, take Ultram more often, take Ultram longer than prescribed or in a method other than prescribed by your doctor (no crushing, chewing, snorting or injecting Ultram).

Do you think that you may be addicted to Ultram? Call your doctor if you want to take extra medication or if you notice any other unusual changes in your behavior or mood. And leave your questions and comments about Ultram here. We’ll be happy to help where we can.

Reference sources: The American Society of Health Pharmacists info on tramadol
Opioid Adverse Effects
Pharmacologic Management of Cancer Pain from Cancer [dot]  Gov
Daily Med drug info on Ultram
Daily Med drug info on Ultram ER
VA clinical practice guidelines for substance abuse
Washington State Department of Labor and Industries Opioid Treatment Agreement

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6 Responses to “Does Ultram make you tired?
6:18 pm November 9th, 2011

Hi, I’ve been taking four 50mg tramadols a day under prescription for 3 years. My doctor doesn’t understand why I need no more than that but isn’t curious about my physiology but I’d like to know why . I can’t get out of bed without them, feel drained of all vitality, hope and full of anxieties I should have shucked years ago. Can’t get through my day at the office without the second dose. I’m totally dependent on the good feelings they give me. I cycle to work and sometimes find that physical activity lessens the need – sometimes I forget to take my dose “on. time” I am an opiate addict and need to go to rehab soon. I feel like dying when I don’t take my dose on time. Utter despair.

10:02 am November 10th, 2011

Hi Salamandada. If you’ve developed tolerance and have cravings for Tramadol, you will most likely go through withdrawal when you cut back on doses or stop completely. If you are ready for this, I can help you find a detox in your area…and try to hook you up with addiction treatment. Just email me your zip code and I’ll look into it for you.

Also, if you know that you are addicted to opiates and want to learn more about the brain science behind it, check out more on tramadol by searching for “tramadol” on Addiction Blog, or starting with this post on the ingredients in tramadol:


11:11 pm February 16th, 2012

I have been taking Fioricet and my Dr. just gave me a script for Ultram 50mg. I took Ultram a long time ago when they stopped selling Darvocet and found it to be ineffective. I don’t remember what dosage was prescribed at that time but I am wondering if Ultram will be as effective as the Fioricet. I have a lot of pain in my back due to scar tissue and arthitis and Fioricet doesn’t quite cut it for pain relief so my question is would Ultram work or not for the pain?

12:27 pm February 17th, 2012

Hi sunmoon69. Thanks for your question.

The question is rather difficult to answer. Each person has a different pain tolerance ( so it will really depend upon how well you tolerate pain, and how Ultram works in your body. Ultram can induce physical dependence and increased tolerance with time, however. So perhaps you can try it out and then ask your doctor is there is another option for long term management of chronic pain.

Quenan Ellis
12:58 pm June 4th, 2013

I just want to know how to get off of the stuff, and keep my job while I’m doing it. Any suggestions? I take 200 mg daily, and have for approximately 6 years. Thank you!

12:54 pm June 5th, 2013

Hi Quenan. Talk with your prescribing doctor or a pharmacist about a personalized tapering schedule. Experts recommend a gradual taper down of dosage over the course of a few weeks so that withdrawal is much less severe. This way, you eliminate tramadol without jerking the nervous system into a serious reaction.

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