Tramadol side effects

List of side effects
Seizure Risk Concomitant use of drugs that enhance seizures Anaphylactoid Reactions Respiratory Depression Interaction with Central Nervous System (CNS) Depressants Increased Intracranial Pressure or Head Trauma

Seizure Risk
Seizures have been reported in patients receiving tramadol within the recommended dosage range. Spontaneous post-marketing reports indicate that seizure risk is increased with doses of tramadol above the recommended range. Concomitant use of tramadol increases the seizure risk in patients taking: promethazine, etc.), or Return to top
 * Selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics),
 * Tricyclic antidepressants (TCAs), and other tricyclic compounds (e.g., cyclobenzaprine,
 * Other opioids.

Concomitant use of drugs that enhance seizures
Administration of tramadol may enhance the seizure risk in patients taking: Return to top
 * MAO inhibitors
 * Neuroleptics, or Other drugs that reduce the seizure threshold.

Anaphylactoid Reactions
Serious and rarely fatal anaphylactoid reactions have been reported in patients receiving therapy with tramadol. When these events do occur it is often following the first dose. Other reported allergic reactions include pruritus, hives, bronchospasm, angioedema, toxic epidermal necrolysis and Stevens- Johnson syndrome. Patients with a history of anaphylactoid reactions to codeine and other opioids may be at increased risk and therefore should not receive Tramadol. Return to top

Respiratory Depression
Administer Tramadol cautiously in patients at risk for respiratory depression. In these patients, alternative non-opioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures. Return to top

Interaction with Central Nervous System (CNS) Depressants
Tramadol should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers or sedative hypnotics. Tramadol increases the risk of CNS and respiratory depression in these patients. Return to top

Increased Intracranial Pressure or Head Trauma
Tramadol should be used with caution in patients with increased intracranial pressure or head injury. The respiratory depressant effects of opioids include carbon dioxide retention and secondary elevation of cerebrospinal fluid pressure and may be markedly exaggerated in these patients. Additionally, pupillary changes (miosis) from tramadol may obscure the existence, extent, or course of intracranial pathology. Clinicians should also maintain a high index of suspicion for adverse drug reaction when evaluating altered mental status in these patients if they are receiving Tramadol. Return to top