How much tramadol is too much?

It depends – while it’s difficult to overdose on tramadol, too much tramadol can cause serious health problems at relatively low doses. More information on the tramadol prescription strengths, maximum daily dosage, and fatal dose amounts here.

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How much is too much tramadol?  It depends.

While it’s difficult to overdose on tramadol, you can experience serious health problems at relatively low doses of the medication. This is especially true if you’re not taking tramadol as directed (crushing, injecting, or snorting tramadol hcl), or haven’t taken tramadol before. In this article we explore the various prescription strengths of tramadol, the maximum recommended daily dosage, and fatal dose of tramadol. And we invite your questions about tramadol use at the end. We try to answer all tramadol questions personally and promptly…and if we can’t, we will refer you to someone who can.

Tramadol strengths

The available strength of tramadol depends on the specific formulation you are taking and if it’s mixed with other medications, or not. Tramadol is available in an immediate-release tablet which lasts from 4-6 hours. The extended-release version of the medication is only taken once daily.There’s also a version of tramadol combined with acetaminophen, a non-narcotic painkiller.

1. Generic immediate release tramadol – Generic tramadol tablets are available in 50 mg doses.

2. Generic controlled release tramadol– The controlled-release version of tramadol comes in 100mg, 200mg, and 300mg strengths. Strengths over 100mg are only for those with a tolerance to the medication.

3. Brand name tramadol formulas – Tramadol is available in an immediate-release, 50 mg form under the name Ultram. Other brand names include Ryzolt and Ultram ER come in the 100-300 mg doses. Tramadol is also found in Ultracet, combined with acetaminophen, at a dosage of 37.5 mg.

How much tramadol is safe?

The safe amount of any narcotic depends on a person’s individual tolerance to opioid medications. Tramadol is always started at a smaller initial dose of 100 mg per day. In patients who’ve experienced more exposure to the drug, safe doses may be as high as 450 mg a day. However, this is a determination that needs to be made by the prescribing doctor, and may change over time as a tolerance to the effects of the tramadol develops.  Similarly, how long tramadol stays in your system is affected by opioid tolerance, individual metabolism and dosing regimen.

Immediate release tramadol

People who haven’t taken tramadol before will start out with a low, immediate-release dose. They’ll be prescribed 50 mg tablets to be taken every 4-6 hours for pain – but they may be instructed to only take half the dose, starting at 25 mg for the first few days, so that they don’t take more than 100 mg in one day.

After using tramadol for some time, doctors will adjust the dosing regimen for each person individually. These tramadol dosing changes take personal medical history into account, especially as it pertains to analgesic pain medications. The current daily dose, degree of opioid tolerance of the individual, and their general health will all be considered when a doctor starts thinking about increasing tramadol dosage.

Controlled release tramadol

The starting dose for controlled release tramadol is usually 100 mg a day. This provides continuous, around-the-clock pain relief for people with chronic pain. This may be increased to 200 or 300 mg a day as time goes on.

If someone has taken a different narcotic for pain before trying tramadol, a higher initial dose may be needed. A tolerance to one opiate medication can result in a heightened tolerance for other, similar medications. The doctor will have to determine the equivalent dose of tramadol for the current dose of any other narcotic that a patient has been taking.

How much tramadol can you take at once?

In its immediate release form, no more than 100 mg of tramadol should be taken every 6 hours. Those who have never used the medication before should start on a much lower dose of tramadol, however, because 100 mg may be too much. Furthermore, only one extended release tramadol tablet should be taken at any given time. The maximum dose of extended release tramadol it’s safe to take is 300 mg, because that’s the largest dosage the drug comes in. Taking two of these pills at once could cause very serious side effects, most notably seizures.

How much tramadol to overdose?

The amount of tramadol that causes an overdose depends on personal tramadol or opioid/opiate dependence. In individuals without a tolerance, of course, it will take less tramadol to overdose, but the amount is still fairly high. In general, doses greater than 450 mg in one day can cause serious health problems, including seizures and serotonin syndrome. It’s very important to follow your doctor’s advice when taking tramadol, because taking any more than prescribed has the potential to cause serious adverse effects.

Toxic levels of tramadol in the system

Levels far below the toxic dose – starting around 500 mg – can easily cause seizures and other serious health issues. But you can overdose on tramadol taking any type of formulation of the medication. And methods of abusing tramadol make overdose more likely. Specifically, crushing extended release tramadol and either snorting it, or dissolving it in water and injecting it, greatly increases your risk of overdose. When taken orally, tramadol is slowly released into the bloodstream over the course of a full day. But high doses of tramadol or snorting or injecting immediate release tramadol can result in near immediate effect of tramadol on the brain and can cause overdose, especially if more than two pills are taken at a time.

How much tramadol is fatal?

While taking more than the recommended dosage of tramadol probably won’t kill you, as mentioned previously, this practice has some serious health risks. Overdosing on tramadol is more difficult than many stronger opioid medications – fatalities have been reported at doses between 2.65 and 8.2 g, 5-18 times the recommended maximum daily dosage. So although it would be difficult for an adult to take enough tramadol to be fatal, it’s very easy to exceed the maximum safe dose of 450 mg a day.

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How much tramadol should I take?

You should take the amount of tramadol prescribed to you by your doctor. Never take more than recommended by a medical professional, and only take this oral medication as directed.  Keep in mind that tramadol show in drug tests that are specific to synthetic opiates, and that tramadol use can be tracked and recorded by your prescribing doctor.

How much tramadol questions

Do you still have questions about tramadol use? Please leave us your tramadol questions below. We will be happy to answer you with a personal and prompt response, or refer you to someone else who can.

Reference sources: Toxnet: Tramadol
FDA MedWatch: Tramadol hydrochloride tablets
Medline Plus: Tramadol
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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