Tramadol Dosage Instructions

Tramadol Dosage Instructions

Since the effective painkiller, tramadol tablets, are available in two convenient forms, the dosage schedule slightly differs. This is due to the form's time to take effect, as one works instantly (fast-acting tramadol) and one works slower over a period (slow-acting tramadol).

These forms do not differ in terms of its potency and safety profiles, only in the time it takes to work. The availability of these forms helps patients choose a therapy that will treat their condition in the most convenient, effective manner.

To ensure the best results from the medication, patients are encouraged to follow a strict tramadol dosage routine. Having a schedule will help patients take all their required doses in the necessary times of the day.

A general tramadol dosing plan is as follows:

1. Fast-acting tramadol A 50 mg to 100 mg single tablet taken every 4 to 6 hours, as needed. One 25 mg tablet should be taken every morning at first. It must be taken four times a day. Thereafter, the dose can be increased to 50 mg to 100 mg.
2. Slow-acting tramadol This form is not recommended for use in acute pain. The dose can start at 100 mg taken once every day. It can be increased by 100 mg every five days.

*Maximum daily dose recommended is 400 mg.

The use of slow-acting tramadol is especially beneficial in the older population, as they have chronic pain conditions. A study posted by JPSM proved tramadol's efficacy in treating osteoarthritis with a once-a-day formulation.

For improved tramadol effects, patients should follow these tramadol dosage instructions:

  • The tablet, especially the slow-acting tablets, should not be crushed or dissolved as this can cause adverse effects.
  • Tramadol must be taken with water only.
  • If a dose of tramadol is missed, it should be taken as soon as it is remembered. However, if it is too close to the next timed dose, the missed dose must be averted.
  • Tramadol should never be mixed with alcohol or other prescription medications unless specified otherwise.
  • Patients must follow weaning off process when they want to stop the use of tramadol. This reduces the effect of withdrawal symptoms.

How Long Does Tramadol Last?

Tramadol's durational effects vary with its two forms. This is due to the different design and release-technology of these forms. The durational effects of tramadol are influenced by the number of tramadol dosage times and adherence to guidelines.

However, tramadol (fast-acting) shows its effects 30 to 60 minutes post-ingestion. This is a quick-acting formulation which lasts for 4 to 6 hours. This form is prefered by patients who need quick, targeted pain relief, as it can be used as soon as the pain is felt.

Tramadol (slow-acting) shows its effects some time after it is taken. The active ingredient is released over 12 to 24 hours in the day, eliminating the need for multiple doses during the day. Slow-acting tramadol is considered an around-the-clock pain reliever. The formulation is designed to have 20% of its dose released over 12 hours and the rest released over 24 hours. This form only needs to be taken once a day.

How Long Does Tramadol Stay in Your System?

The breaking down of tramadol happens in the liver by the help of enzymes. This creates active compounds (metabolites) which stay in the body to continue producing the pain-relieving effects. Afterwards, the kidneys excrete the treatment through normal functions of the body, such as urination.

The half-life of tramadol is 6.3 hours, with its primary active metabolite having a half-life of 8 hours. Half-life involves the time it takes for the body to eliminate half of a specific medication dose. Various factors affect how long a tramadol dosage stays in the system.

These factors include:

  • The amount of tramadol taken.
  • The frequency of doses.
  • Metabolism - A slow metabolic rate may increase the time it takes for tramadol to be excreted.
  • Route of administration - Generally, tramadol drops or injections are excreted faster than pills.
  • The function of the organs - Impaired liver or kidney function increases the time it takes to excrete tramadol.
  • Age - If the patient is over 75, it may take them longer to get rid of tramadol.
Tramadol Withdrawal Symptoms

Tramadol Withdrawal Symptoms

The process of discontinuing tramadol is slightly different from other opioid medications, partly due to its complementary process of inhibiting neurotransmitters. According to the Drug Enforcement Agency, patients may face one of two types of withdrawal.

The first type is the typical withdrawal symptoms of opioids, including flu-like symptoms. The second type of withdrawal is referred to as atypical withdrawal.

These symptoms are:

Insomnia Panic attacks
Restlessness or nervousness Confusion
Body aches and pains Paranoia and anxiety
Nausea Hallucinations
Diarrhoea Numbness and tingling

Atypical withdrawal symptoms are rare and will hardly occur if the patient correctly comes off tramadol. The common withdrawal symptoms will last between 4 to 10 days. Based on how the patient feels, the best length of time between tramadol dosage reductions is determined.

How to Come Off Tramadol Safely?

Patients must not suddenly stop the use of tramadol 50 mg. This is often referred to colloquially as quitting 'cold turkey' which is advised against. This can be challenging as they can experience symptoms that may require emergency care, or cause them to start abusing tramadol. The cravings that may arise results in the patients going back on tramadol to stop these symptoms.

To prevent these unpleasant feelings, patients need to stop using tramadol gradually over time. This allows the body to regulate to the lower doses of tramadol until its use is entirely and safely stopped. The Drug Withdrawal Research Foundation says that it will not prevent typical withdrawal symptoms entirely, however, it will subside them.

Those who have used tramadol short-term will require to decrease their dosage by a small amount each day. However, this process is done slowly over weeks for long-term users until they are completely detoxed from tramadol.

A time cannot be put on the tapering off schedule of tramadol, as it is based on various factors. These factors include the duration of treatment, the amount they were taking and the frequency of doses in the day. However, it is strongly advised to follow a tapering off process whenever a patient wants to terminate tramadol use.

Check out the following link for more information about painkillers - or read more in the blogs below!

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Updated: 27th January 2021
Review Due: January 2022



Fueled with a passion to try and help people less fortunate than himself Steve immersed himself in the medical industry. By researching new and innovative medical advancements and regularly sharing important information on social media Steve intends to make a difference where it matters most, people's health. His wealth of knowledge and keen eye for detail will help keep our readers informed and contribute towards improved health.

Megan Byrne – Mar 05, 2021
Hello Steve, having taken Tramadol in the past and struggled to manage my pain properly, I found your article very helpful. Following the dosage instructions and knowledge of potential side-effects is essential to pain management and I believe your blog helps give a better understanding of this. Megan Byrne

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