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Updated on February 14, 2022

How Long Does Tramadol Stay in Your System?

What is Tramadol?

Tramadol, which is the generic name for Ultram or Conzip, is a chronic pain relief medication. Like all narcotics, it works by binding to opioid receptors in the brain. It has been used to treat moderate to severe pain since the 1960s for its analgesic properties.

Since 2016, there have been over 120 million tramadol prescriptions in the United States. Tramadol is considered safe to use because it has a low potential for addiction and abuse at prescribed doses, though addiction is still possible. The pain-relieving effects are far less than more intense opioids like codeine.

However, Tramadol poses several potential health complications for both casual and excessive users. 

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How Long Does It Take to Feel the Effects of Tramadol?

Tramadol works on the opioid pain receptors located in your brain and throughout your central nervous system. It also weakly reduces the reuptake of two neurotransmitters: serotonin and norepinephrine. The pain relief effects start approximately an hour following a dose and peak in two to four hours.

There are also extended relief forms of Tramadol that distribute dosages in phases over a longer period. This means that a single extended relief pill is present longer in your system. While it is active, tramadol depresses breathing and causes the pupils to constrict.

Tramadol reduces movement in your digestive system, so food takes longer to digest. You may experience constipation. Tramadol also dilates your blood vessels, so you may experience flushing, itching, sweating, and dizziness or faintness when you get up after lying down.

How Long Does Tramadol Stay in Your System?

The amount of time any drug remains in the body can vary based on individualized factors. I.E., body composition, lifestyle, etc. The half-life of Tramadol in moderate drug use is 5 and 9 hours.

The half-life of Tramadol is dependent on the amount taken. Because of this, a higher dose can lead to a severe Tramadol overdose that is difficult to reverse even with multiple doses of Narcan.

Urine Drug Test

Urine tests can detect the presence of Tramadol in the system. Tramadol stays in the urine for 1 to 4 days (24 to 72 hours).

Hair Drug Test

It is still possible to detect Tramadol in hair follicles for up to 90 days after the last use. Hair tests are generally used to support urine test findings. Hair tests also increase the detection window as most drugs are flushed out of the system within a few days to a week.

Saliva Drug Test

Saliva tests for Tramadol can detect the drug anywhere from 24-48 hours after the last dose. Saliva drug screens are rare due to the short window of detection. 

Blood Drug Test

Blood tests, except to test for alcohol, are expensive and only detect recent use. It’s unlikely that a person will receive a blood test for Tramadol. Tramadol stays in the blood for up to 48 hours.

6 Factors That Affect Detection Time

For some individuals, it takes significantly longer to break down tramadol. Factors that can affect Tramadol’s detection time include:

1. Age

Older people metabolize more slowly. They are also more likely to take additional medications that affect metabolism and are at higher risk for impaired kidney or liver function. These factors may all affect Tramadol’s detection time.

2. Dosage

Higher doses of Tramadol take longer to metabolize.

3. Frequency of Use

Tramadol collects in the body as more doses are taken. If some of the previous doses have not entirely broken down, your body will likely take longer to metabolize the extra quantities.

4. Metabolism

A slower metabolic rate heightens the amount of time it takes tramadol to break down. Activity level, body composition, and diet can all affect metabolism.

5. Reduced Kidney or Liver Function

Impairment of the body's organs to remove waste will increase the amount of time Tramadol remains in the body.

6. Route of Drug Administration

Generally, tramadol injections or drops are quickly absorbed and excreted faster compared to tramadol in pill form.

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What are the Side Effects of Tramadol?

Tramadol can produce a high when taken in excess. However, as an opioid, Tramadol disrupts certain brain functions and can severely strain bodily organs. Here are the most common side effects of Tramadol use:

  • Vomiting
  • Nausea
  • Headache
  • Dizziness
  • Irritability
  • Dry mouth
  • Constipation
  • Lethargy 
  • Heart issues
  • In rare cases, hallucinations, anxiety, and shakiness.

Tramadol's side effects can vary based on individual health factors and body composition.

Can Tramadol Cause Long-Term Damage?

Just like other prescription pain medications, Tramadol drug use can cause long-term damage, especially in cases of substance abuse. Here are the most common long-term effects:

Liver damage

Tramadol use can cause acute liver failure. This condition can be fatal. However, even in cases where the person survives, liver failure tends to scar liver tissue, and the risk for liver failure and liver cancer increases significantly. 

Kidney damage

In cases of chronic drug use, Tramadol harms the kidney. Once filtered through the kidney, Tramadol can leave behind trace elements, known as metabolites, that in excess begin destroying healthy kidney cells. This form of kidney damage takes place over a longer period of tramadol addiction.

Substance dependency

In moderate use, Tramadol has little to no addictive properties. However, Tramadol abuse can lead to addiction. Additionally, in rare cases, Tramadol causes substance dependency in individuals that had no prior substance dependencies. Addiction and dependency may cause withdrawal symptoms when a person decides to stop using the drug abruptly.

Behavioral changes

Substance misuse/abuse changes the way the brain works. It can rewire the reward center and cause extreme prioritization of the drug. Tramadol withdrawal can cause psychosis


Although rare, Tramadol can cause seizures after taking high or low doses. 

Heart damage

Tramadol has been linked to serotonin syndrome. This is a condition characterized by an overabundance of serotonin in the brain resulting in anxiety, jitters, heart rate issues, and in extreme cases, hospitalization. 

How Is Tramadol Eliminated From The Body?

Tramadol elimination is a two-part process. It begins in the liver, where the body processes the drug. Tramadol, in particular, is heavily processed by the body. When taken orally, Tramadol is over 60% bioavailable. 

After multiple doses, the bioavailability can exceed 90%. This means that the liver processes Tramadol so thoroughly that it is easily and widely absorbed into a person’s system.

The second part of the elimination happens in the kidney. The result is metabolites, essentially what’s leftover from the processing. In cases of excess or tramadol abuse, these metabolites build up and wreak havoc on the body.

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Symptoms of Tramadol Overdose

The best (and the only) way to remove Tramadol from your system is to stop taking the drug altogether. This will give your body time to process the drug and eliminate it.

To prevent Tramadol overdose, healthcare professionals recommend that you only take the correct dosage at the correct schedule as prescribed by your doctor. If you suspect a Tramadol overdose, look for these signs and symptoms:

  • Breathing problems (slow, erratic, shallow, or stopped)
  • Cold, clammy skin
  • Cyanotic (bluish) lips and fingernails
  • Gurgling, snore-like noise or choking sounds
  • Muscle weakness
  • Non-responsiveness to any form of stimuli
  • Pupillary constriction
  • Slow, erratic, or undetectable pulse or heartbeat
  • Seizures
  • Unconsciousness

Drug dependence, drug interactions, drug misuse, and addiction can all lead to Tramadol overdose. If you know someone who needs addiction treatment, seek help to get professional medical advice. In many cases, addiction therapy is needed to assist recovery.

Treatment Options for Opioid Abuse & Addiction

There are several options for people suffering from opioid addiction. These include:

Medication-Assisted Therapy (MAT)

There are three medications approved to treat opioid use disorder: buprenorphine, methadone, and naltrexone. These medications are used only with medical supervision.

Buprenorphine and methadone can help you manage withdrawal symptoms throughout the detoxification process. Because of this, a person experiences reduced cravings for opioids, thereby restoring balance in the brain circuits.

Naltrexone is less commonly used, but it blocks your opioid receptors, making it impossible to get high. Medication-assisted therapy is most effective when combined with other forms of treatment.

Inpatient Programs

Inpatient programs are the most intensive and effective treatment options for opioid addiction.

These programs guide you through medically supervised detoxification, then behavioral therapy and other services (possibly including MAT), will be added to your treatment.

They typically last 30, 60, or 90 days. However, they may be longer if necessary.

Partial Hospitalization Programs (PHPs)

PHPs are also known as intensive outpatient programs (IOPs). They are the next most intensive type of treatment for opioid addiction.

They provide similar services to inpatient programs such as detoxification, behavioral therapy medical services, and custom treatments such as MAT.

The difference is that in a PHP, the patient returns home to sleep. Some programs will include transportation and meals, but this varies by program.

Partial hospitalization programs are helpful for both new patients and patients who have completed inpatient treatment and still need intensive recovery therapy.

Outpatient Programs

Outpatient programs work best for people who have a high level of motivation to recover. They create treatment programs that work around your schedule.

These programs can either be an effective treatment option for new patients or a part of an aftercare program for people who complete inpatient or partial hospitalization programs.

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  1. El Sayed, Abdel-Aziz Y, et al. “Development and Validation of High-Performance Liquid Chromatography–Diode Array Detector Method for the Determination of Tramadol in Human Saliva.” Sohag University, 2011
  2. Hadland, Scott. “OBJECTIVE TESTING – URINE AND OTHER DRUG TESTS.” PubMed Central, 2016
  3. Dadpour, Bita, et al. “Arterial Blood Gas Analysis of Patients with Tramadol-Induced Seizure; a Cross Sectional Study.” Archives of Academic Emergency Medicine, Shahid Beheshti University of Medical Sciences, 1 Mar. 2020 Grond, Stefan, and Armin Sablotzki. “Clinical pharmacology of tramadol.” Clinical pharmacokinetics vol. 43,13 : 879-923 Subedi, Muna et al. “An overview of tramadol and its usage in pain management and future perspective.” Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie vol. 111 : 443-451 Schug, Stephan A. “The role of tramadol in current treatment strategies for musculoskeletal pain.” Therapeutics and clinical risk management vol. 3,5 : 717-23.

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