Tolerance to tramadol

Tolerance to tramadol occurs over the period of a few weeks, as doctors are advised only to increase tramadol doses every five days. More here on how tolerance to tramadol is different than dependence and/or tramadol addiction.

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Are you finding tramadol is no longer working for you?

Tramadol is meant to help treat ACUTE moderate to severe pain. However, tramadol is not meant to be taken over an extended amount of time. If you take tramadol for more than a few weeks, or so, you can develop a tolerance to tramadol.  So how addictive is tramadol?  (fairly addictive) and when does tolerance become a problem?

If you’re worried about your tramadol use, tramadol dependence time and fear becoming addicted, you’re in the right place. In this article, we look at tramadol tolerance and its relationship to physical dependence and tramadol addiction. We also talk about what you can do for your tolerance to tramadol. We invite you to please ask any questions you may have about tramadol at the end.

Tramadol tolerance symptoms

There are two main symptoms of tramadol tolerance.

1. You think you can no longer feel tramadol working .

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2. You find that you need higher doses of tramadol in order to feel pain relief.

REMEMBER: If you experience these symptoms it DOES NOT mean that you’re addicted to tramadol. Tolerance to tramadol is merely a sign that your body has adapted to the presence of tramadol in the body system.

Developing tolerance to tramadol

For the most part, tolerance to tramadol means you need higher doses of tramadol more often in order to feel the effects of the pain treatment. Tolerance doesn’t affect the overall effects of tramadol nor how long it works. But how does tramadol tolerance relate to dependence and addiction? And who becomes tolerant of tramadol?

Everyone and every body is different. While many people may never develop a tolerance to Tramadol, others may develop tolerance quickly. It all depends on your personal body chemistry and how you are using tramadol. Many times, dependence and addiction can coexist with tolerance to tramadol. One may lead into the other. So as your body develops tolerance and you take more tramadol, your body can become dependent on the drug in order to function properly. Once your body has developed a dependence, this means you will experience withdrawal symptoms one you stop taking tramadol. And while physical dependence isn’t itself “drug addiction”, it can be the precursor to psychological dependence on tramadol – a major characteristic of addiction.

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Tramadol tolerance: How long?

Every person is different. But, it is possible to develop tolerance to tramadol within a few weeks of taking tramadol regularly. In fact, it is common to that the body becomes resistant to the effects of tramadol over the course of a few weeks as doctors are advised only to increase doses very five days. Physical dependence can accompany tolerance just as quickly, making withdrawal symptoms more likely.

High tolerance to tramadol

Tramadol is prescribed at 100 mg daily. Doctors will increase dosage by 100 mg every five days to adjust for how the body can tolerate tramadol. However, you shouldn’t exceed 300 mg of tramadol a day. At this rate, 300 mg tramadol hydrochloride is considered a high tolerance. If analgesic relief does not occur at 300 mg tramadol, your doctor at this point may recommended you try another pain medication to help relieve your symptoms.

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How to lower tolerance to tramadol

If tramadol is no longer working for you because of tolerance, you can adjust the body’s exposure to the drug with the help of your prescribing doctor. The most effective recommendation is that you stop taking tramadol altogether to give your body time to rewire and become used to not having tramadol in the system. However, tramadol withdrawal may occur with unpleasant symptoms. Tolerance still effects the brain and may develop into tramadol dependence. When this happens, it is important to work with your doctor to decrease your doses under medical supervision as to ease any potential withdrawal symptoms.  What are symptoms of tramadol withdrawal? Imagine a really, really bad flu.

Additionally, there is a possibility you may never regain the ability for tramadol to work to relieve pain. This medication may simply not work for you. Instead you may need to switch to another medication that would work with your particular body.

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Building up tolerance to Tramadol questions

Do you have any more building up tolerance to tramadol questions?  Please leave them here.  We do our best to answer you personally and promptly.

Reference Sources: Daily Med: Tramadol Hydrochloride
Pub Med Health: Tramadol
National Library of Medicine: Physical dependence potential of daily Tramadol dosing in humans
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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  1. Tramadol tolerance is a reality, and may lead to dependence or addiction. So it becomes really difficult to withdraw due to the withdrawal symptoms which are painstaking. Normally when I feel it’s no longer working, I reduce it by 50% and when I feel the withdrawal symptoms, I increase again and it really works. Unfortunately there is no Tramadol rehab, so it will force you to withdraw it your self which is dangerous.

  2. I take 4 tramadols for my pain and now my whole body itches. It’s been 16 hours ago since I took them. I just started taking Benadryl with it bc everytime I take tramadol I start to itch. I told my pain management doctor but he still wants me to take it. It takes a hour and a half before it kills the pain. He will not give me anything stronger. I can’t take ibuprofen bc of my kidneys. What can I do?

  3. I had shoulder surgery and they gave me Tramadol 50 mg I only took 2 pills 6 hours apart that was Thursday and I still feel dizzy and shaky I don’t take drugs usually for pain they told me I need to so sorry I did. How long will these symptoms last?

  4. I have been prescribed tramadol for about four years now maybe even longer. I began taking it prior to it becoming a schedule IV controlled substance. I also have a history of substance abuse. I found that tramadol was like no other pain pill I’ve ever taken. I have been able to take none to five pills daily for several years now without having any sorts of cravings or withdrawals. My doctor upped my dose to 4 50mg pills daily. After not taking a day off of the for probably close to three years I decided to “test” my dependency on them. I am now eight days without taking any and I have like 100 pills left. Let me tell you I’ve gone through some crazy withdrawals in my lifetime the worst being Oxycontin. This week I have had what I’d say close to ZERO signs of any withdrawals. I was overly sleepy the first few days but part of that was due to me not getting enough sleep to begin with. I noticed some muscle spasms in my legs and feet when laying down but nothing more at all. Now I realize everybody is different so this doesn’t mean everyone else will have the same experience I’ve had. I have also stopped taking them because I want to lower my tolerance so I don’t have to take 4 or more pills to achieve the effects of the pill. How long would you imagine one would have to lay off them if they’ve been using them everyday for about three years if one wants to regain their tolerance?

  5. After a couple of years of use of Tramadol, always trying to keep the dosage under conrol, I find myself needing to increase the dosage for psychological reasons first and foremost (I have adverse reactions to anti-depressants with very heavy sweating all night). So because I was sort of suicidal, the doctor asked me to increase the dose. I went up to 200 from 150 and felt a slight improvement psychologically. However, my joint pains and tendinitis have flared up and I’m starting to realize that Tramadol doesn’t seem to be working for me at all any more. Is it possible that going from 150 to 350 mgs suddenly makes no difference at all to the pain?

    1. Hi Jeanne. I suggest that you consult with another doctor about your issues. Also, you may consider seeing a therapist for you suicidal thoughts.

  6. I returned home from hospital after 5 surgeries to find that my surgery’s got a zero Tramadol policy. I have to write almost a begging letter to get 100 Tramadol when 100 divided by 4 gives me 25 days of no pain I have no cover for 5-6 days. No can’t keep having to do these 6 days its barbaric in 2017 last few days I am down to 3 a day still in constant pain. No other pain relief given was given co-codamol which caused vomiting. Today I submitted my begging letter again. I intend to somehow cut them down to 2 a day the withdrawal symptoms I all live with but I won’t b costing the NHS money I have condition called neurosarcoidosis type 2 diabetic .

  7. I have been taking a small dose every day (75mg) for over five years. Now my doctor is refusing to refill the prescription saying that I am taking too many. The dosage is to take three 37.5mg per day, every 8 hours. I have been on this dosage forever. Not quite sure what to do or expect. Took my last dose yesterday morning. Everything I have read scares me about withdrawl since I am the breadwinner in the family.

  8. I was recently rx’d Tramadol at 50mg a day, every six hours, while waiting for insurance to approve an expensive medication for my spinal arthritis and fibromyalgia. I am only taking one 50mg tablet a day, and have felt great relief. How many days is likely to be able to take at a 50mg/day dose before developing dependence? I would like to avoid any withdrawal symptoms.

    If I experience any withdrawal symptoms and try to taper, can i cut my pills? It is not available in a smaller dose than a 50 mg tablet, so I was planning to taper by taking 50mg every other day, and then every 3 days, etc.)

  9. Hi , I have MS and I have been on fentanyl and then hydromorphone and now down to morphine as I want to get of of opiates. I suffer from severe pain in my legs so now I am not able to get around much because of the pain. Was wondering if Tramadol might be an option to talk over with my Dr ? Thanks.

  10. I’ve been taking tramadol four years for pain. The funny thing is it doesn’t do anything for my pain. I did however immediately notice that it was a miracle drug for my GAD. Up until a few months ago I was taking 50mg 3x daily without any tolerance issues. Then a few months ago I found myself taking twice the dosage for the same effect. I’m weaning off and in two weeks I’m down to 25mg 3x daily. I have to admit that withdrawal is NASTY! Having said that, for me, if I can reset in a year or so and achieve the same results, I would. OK, might!

  11. I am taking about 600mg a day of tramadols. Is it possible I can have a high tolerance for abuse of this medicine,since I am taking 600mg a day. When I take 300mg it doesn’t work for me. How can i manage taking tramadols when i take a lot at a time???.

    1. Hi Chas.
      300 mg tramadol hydrochloride is considered a high tolerance, so 600mg is way above the maximum level. If analgesic relief does not occur at 300 mg tramadol, your doctor at this point may recommended you try another pain medication to help relieve your symptoms. Do not attempt to cut down or increase tramadol dose on your own, you can hurt yourself. Instead, consult your doctor about any changes you plan to make.

    1. Hi Omar. I suggest that you speak with your doctor to help you plan an individualized tapering schedule. Also, call the helpline displayed on the website to get in touch with a trusted treatment consultant.

  12. HI AB, I have a question regarding tolerance on tram’s…..
    Ive veeng going on tramadol for a little more than a year now, 200mg/d
    right now have I tapered down to 12mg/d and was wondering if this will reduce tolerance, or do I need to stop completely for this to work ? Thanks again

  13. I’ve read experiences of some saying they had seizures during withdrawl after quitting “cold turkey”. How likely are these more extreme symptoms? I’ve been off of Tramadol a week now and am concerned if I should be trying to taper off of it or if I’ll be fine with my current course of action.

  14. I have weaned off of Tramadol because of immunity. I was on it for over 6 months. How long should I be completely off of Tramadol before trying it again to see if it once again relieves my pain?

    1. Hi Ruby. It’s different for all people. I suggest you consult with your doctor since he/she knows your medical history.

  15. Update to my earlier comment: After taking Tramadol since May 2012 I find the less I take it the better it works. The past 6 months or so the Tramadol would not kick in until two days of dosing! I cannot wait two days for pain relief sometimes. So I have several days I cut back by over 50% and then when I really need it to work it does. Less is more 🙂

  16. I take 59 mg n morning and 50 mg at night for neck pain for 4 years. U said not intended for long tee dose. Can u explain? Is this just n reference to increased dosage

    1. Hello Char. The longer you take a medication, the more your body depends on the chemical. This is why withdrawal symptoms occur if you stop taking doses. This means your brain stop naturally producing the chemicals it get from Tramadol. Plus, the longer you take and the higher the dose-the more difficult and uncomfortable withdrawal symptoms will be. Symptoms include feelings of panic, chills, hallucinations, tingling in the hands and feet, and others.

  17. I am prescribed 100mg 2x per day for chronic pain that will never go away. My doc went with Tramadol to avoid narcotic starting with 50mg 1x per day then increased it because of the anti depressant’s been 2 years now and at this point I’m actually starting pain management next month. What is your experience a safe daily lifetime plan will be? I’ve been suffering for 12 years and tramadol gives the best overall lasting relief. I take 2 to 3 an hour before I get up and moving, and then another dose 9 to 10 hours later.

  18. Hello Josh. Longer term tapering can reduce the intensity of withdrawal symptoms when you stop using tramadol. Tramadol is an especially particular drug, in that it manifests withdrawal symptoms that are both typical of opioid medications and atypical. It’s probably best to follow the long term tapering regimen set up by your doctor for best results. It may take time, but it’s in your best interest!

  19. I started taking Tramadol 4 weeks ago at 100mgs 4 times a day to Detox off Methadone. I now find myself dependant on Tramadol. My Dr. said to decrease 50mgs a week for 8 weeks or so. Is there a easier or quicker way to stop my dependancy since i have only been on for such a short time??? Desperate to be free from dependance….

  20. Hi Addiction Blog,

    I just wanted to leave helpful info on how I deal with Tramadol tolerance. I’ve been using Tram for almost a year now. I’ve found the best way to counteract the tolerance is to switch to another pain med every 3 weeks. I use as little as is effective, even though my prescription is for 50 mg every 6 hours I only use 50 mg as needed on my really bad days. I start with 50mg’s 1-4 days a week, and SLOWLY increase my dose up to 150 mg over three weeks then switch to Tylenol with Codeine #3 for three weeks.

    I was switching to Cannabis every three weeks but Cannabis causes way too much anxiety, depression and mania.

    Also your dose is affected by how much you weigh, when I was 225 lbs, I needed twice as much. After losing 50 lbs my dose has been cut in half. So if you have lost or gained weight while taking this medication you should talk to your Dr. about any issues that may have arisen from weight change as I had to. I found that the dose I was using at 225lbs, even though it had become ineffective, was causing mood swings at my lower weight of 180. I was having issues with being very quick to anger and sometimes my face would flush. After my dose was adjusted for my weight loss all these symptoms stopped.
    Also if you use it only when you have to your withdrawal is not that bad, you might experience mild flu like symptoms for 4-6 hrs, but nothing dramatic. I think people who are not familiar with REAL withdrawal pain tend to over dramatize. Don’t let the over reacting people on the web scare you. Besides if your stopping Tram. use and you have withdrawal taking 1/2 your normal dose usually stops all the withdrawal symptoms.


  21. Hi Patti. Of all the opiate/opioid narcotic pain relievers, tramadol is thought to have the lowest risk of dependency. However, becoming dependent on tramadol is not the same as being addicted to it. IF you take tramadol for a few consecutive weeks on a daily basis, your body will become dependent but you can get off tramadol and go through withdrawal at any time after that. Addiction, on the other hand, is characterized by psychological need to take tramadol. In other words, tramadol can affect the mind AND the body, but if you’re taking it as described and don’t like to get high…you will only be dealing with the body.

    Does that help?

  22. I´d like to switch tramadol for other drug as a way to avoid tolerance development for a while and return after a year to tramadol. I think that after a year of use it, the pain is coming again, so maybe it´s a little too late. But high neuropathic pain seems to be refractary to other drugs. So my question is, if my body really developed tolerance, i have to assume that the limit of 400 mg a day will have the same effect in my body than 200 mg a day when i started to take it? Tolerance means that i need more drug to give me the same effect, so i can take 600 mg a day with the same risk that starting with 400?

  23. Hello Marc. This is a good question. Perhaps your body has a natural tolerance to tramadol. It is chemically unique from other opioids, so report your symptoms and concerns to your prescribing doctor. Perhaps other opioids may be more beneficial, especially if you are experiencing break through pain on tramadol.

  24. I started taking Tramadol two weeks ago using 300- 400mg daily , which is 2x50g 4 times. I have been prescribed this for pain management for kidney stones , it is the only one so far that makes the pain tolerable other than opiates. I am waiting for an operation to have it removed but that will be upto a month away. What I would like to know is this dose likely to be a problem over this time frame, because it seems to have less effect already.

  25. Hi Charlene. Thanks for your question. It’s possible that your body has developed a physical dependence on tramadol and may experience withdrawal symptoms when you try to reduce dosage or stop taking tramadol. And while tramadol may be able to provide pain relief over time, long-term studies usually define safety in terms of 6-12 months instead of years. Are you thinking of using tramadol for a while?

  26. I am taking 50 mg around 9-10 a.m. and another 50 mg at 5-6 p.m. everyday. I have been doing this for 9 months. It is keeping my neck pain under control. I do not seem to need more than that. If I keep it at this amount, is this okay to take daily? I do not like to take medication, this is the only thing I take besides hormone replacement therapy. I am concerned that prolonged used of Tramodol is not good for me, but really helps the pain.

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