Hypersensitivity

The use of tramadol is contraindicated for patients with a history of allergy to any opioid.

Hypersensitivity side effects including anaphylactoid reactions have been reported

after first doses of tramadol as well as in patients with a documented history of

codeine allergy. Angioedema has been reported rarely.

Metabolic

Metabolic side effects including hyponatremia have been reported.

Other

Other side effects including withdrawal symptoms and, rarely, auditory hallucinations have been reported. A case of vocal cord closure has also been reported.

Pregnancy and Lactation Class:

Tramadol is pregnancy Category C and is considered possibly unsafe for use during lactation.

Special Considerations: Tramadol is generally considered to be less addictive than

many other opioid analgesics, but it is still an opioid mu receptor and has the potential

for abuse. Do not share this medication with others, and certainly do not crush the pills

for inhalation or injection. Seizures are the unique tramadol side effect and is

especially a concern if used taken in higher than the recommended dosage or if you

have a history of seizures.

Life Threatening Tramadol Side Effects:

Seizures are the most important tramadol side

effect to consider. They are more common in people with a history of seizures,

and if you have a history of seizures you should be sure your physician knows about

this history, and if used tramadol dosing should be minimized. The other serious

side effects can be primarily grouped into the allergic side effects including

angioedema, anaphylaxis, severe rashes including the Stevens-Johnson Syndrome and

toxic epidermal necrolysis, and those side effects shared with most opioids including

withdrawal syndrome if discontinued suddenly, dependency and abuse, respiratory

depression, and depression/suicide. Other serious tramadol side effects can be the

serotonin syndrome, and orthostatic hypotension (drop in blood pressure on sitting

or standing).

Common Tramadol Side Effects

Tramadol side effects include many of the gastrointestinal

side effects associated with other opioid agonists including constipation, nausea,

vomiting, dyspepsia and occasionally diarrhea. These are due to the opioid mu receptors

in the GI tract that lead to increased stimulation of the circular muscles and

decreased stimulation of the longitudinal muscles of the colon wall. This leads to

poor propulsive effect of the bowel content and increased churning of the bowel

content, as well as causing dryer and firmer stool, and slower transit time.

It can also lead to decreased feeling of fullness in the distal colon and reduced urge

to defecate. Non GI tramadol side effects that are common include somnolence,

itching, dizziness, sweating and flushing.

What is Tramadol

You should not take this medication if you are allergic to tramadol,

if you have ever been addicted to drugs or alcohol, or if you have ever

attempted suicide. Do not take tramadol while you are intoxicated

or taking any of the following: alcohol or street drugs, narcotic pain medicine,

sedatives or tranquilizers, or medicine for depression, anxiety, or mental illness.