Your dose of tramadol will depend on your level of pain and how you react to the medication. Your doctor may start at a low dose and gradually increase it to find the dose that works for you.
This is a typical dosing schedule for someone just starting to take tramadol regular-release tablets:
Your doctor will most likely start with 25 milligrams (mg) each morning.
That may increase by separate doses of 25 mg every three days to reach a maximum dose of 100 mg a day (25 mg, four times a day), depending on how much the medication is relieving your pain.
If necessary, your doctor may increase by separate doses of 50 mg every three days to reach a maximum of 200 mg a day (50 mg, four times a day).
A normal adult dose should not go above 400 mg a day.
For someone with cirrhosis (liver damage), the daily dose should not be above 100 mg in a 24-hour period.
People with kidney disease, the daily dose should not be above 200 mg.
For someone older than 75, the daily dose should not be above 200 mg.
You can take regular and dissolving tablets with or without food about every four to six hours as needed. Before you take the tramadol tablets, make sure your hands are dry and remove the medication from the packaging very carefully.
Don’t push dissolvable tablets through the foil packaging. Place the tablet on your tongue immediately. You should usually take the long-acting, extended release tablets or capsules at the same time every day. Don’t chew, open, split, or crush the medication. Swallow tramadol whole with a glass of water.
Serious side effects have been reported with tramadol including the following:
seizures. Tell your healthcare provider right away if you have some or all of the following symptoms of seizures:
body convulsions (shaking and trembling)
temporary loss of consciousness
serotonin syndrome. Tell your healthcare provider right away if you have some or all of the following symptoms of serotonin syndrome:
fast heart rate
high blood pressure
restlessness or agitation
nausea or vomiting
decline in muscle coordination
rise in body temperature
discontinuation symptoms. Do not stop tramadol without first talking to your healthcare provider. Stopping tramadol suddenly may cause serious symptoms including the following:
shaking or shivering
upper airway symptoms
Tramadol can cause dizziness or drowsiness. Thus do not drive or operate heavy machinery until you know how tramadol affects you.
Also do not take tramadol if you:
are allergic to tramadol or any of its ingredients
have a history of respiratory depression in unmonitored settings or the absence of corrective measures
have a history of acute or chronic bronchial asthma or hypercapnia in unmonitored settings or the absence of corrective measures
Just like all medicine, Tramadol may cause some side effects. Tell your doctor if any of these symptoms are severe or do not go away:
difficulty falling asleep or staying asleep
uncontrollable shaking of a part of the body
changes in mood
heartburn or indigestion
Also some side effects can be serious. Therefore if you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:
difficulty swallowing or breathing
swelling of the eyes, face, throat, tongue, lips, hands, feet, ankles, or lower legs
agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
nausea, vomiting, loss of appetite, weakness, or dizziness
inability to get or keep an erection
decreased sexual desire
changes in heartbeat
loss of consciousness