Updated on April 3, 2024
5 min read

Tramadol Overdose: Signs, Symptoms, and Risks

Signs and Symptoms of a Tramadol Overdose

Tramadol overdose symptoms can be dangerous or even fatal. Overdose symptoms include:3,4

  • Seizures or frequent seizures
  • Nausea
  • Vomiting
  • Drowsiness
  • Dizziness
  • Blurred vision
  • Anxiety
  • Apnea or other breathing disruptions
  • Loss of consciousness
  • Coma
  • Cold, clammy skin

You may experience mild occurrences of some of these symptoms when you start using Tramadol. However, if you start experiencing a tramadol overdose or severe symptoms, contact medical help immediately.     

Risk Factors of a Tramadol Overdose

Like other opioids, misusing Tramadol can lead to an overdose. However, different factors can lead to an overdose.3

These include:

  • Frequent doses or repeated use 
  • Taking higher doses
  • History of mental health issues
  • History of substance abuse
  • Family history of substance abuse
  • Higher tolerance for Tramadol

How Much Tramadol Results in an Overdose?

Taking more than 2,000 mg of Tramadol can lead to an overdose. This is at least five times the recommended daily dose.3

Smaller doses pose a lower risk of overdose, but how the drug is ingested can play a role. The faster the dosage enters your bloodstream, the higher the risk of overdose.4


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Who is at Risk of a Tramadol Overdose?

According to the United States Drug Enforcement Administration (DEA), the following people are most likely to abuse tramadol:4

  • Those who are already suffering from narcotic addiction
  • Those who are in chronic pain
  • Health professionals

Men are more likely to overdose on prescription painkillers. However, overdose cases in women have risen in recent years.4

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What are the Long-Term Effects of a Tramadol Overdose?

Using too much tramadol puts a person at risk for various health issues. For example:3

  • Increased tolerance
  • Tramadol dependency
  • Withdrawal symptoms
  • Seizures
  • Respiratory problems
  • Constant fatigue and weak muscles
  • Kidney and liver damage
  • Cognitive impairment
  • Problems at work or school
  • Problems with family and friends

Tramadol Overdose Treatment

If someone is experiencing tramadol overdose symptoms, call for medical help as soon as possible. Call 911, poison control, or rush to a nearby hospital.3

During treatment, healthcare providers will monitor your vitals and breathing. They may also connect you to oxygen if your levels aren’t high enough. If there are any cardiac issues due to an overdose, medical professionals may use various types of treatment including:3

  • Medication
  • Defibrillation

You’ll also undergo medication-assisted treatment. This may involve using Naloxone to manage tramadol overdose symptoms.3

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Treatment for Tramadol Addiction

Like other opioids, Tramadol addiction treatment requires medical assistance and support. However, not everyone responds to treatment in the same way.

Talk to your doctor about available treatment options that cater to your needs. Some examples include:

How to Take Tramadol

Tramadol comes in 4 different forms:3

  • A tablet
  • A liquid solution
  • An extended-release tablet
  • An extended-release capsule

The tablet and solution are usually taken with or without food every four to six hours. Meanwhile, both extended-release forms should be taken once per day.3 

Make sure to take Tramadol as directed by your healthcare provider. Taking more Tramadol than prescribed can lead to serious side effects, accidental overdose, or death.1

Side Effects & Risks of Tramadol Use

Like all drugs, potential side effects can occur. Possible side effects of Tramadol include:1

  • Drowsiness
  • Headache
  • Dizziness
  • Nausea
  • Vomiting
  • Constipation
  • Sweating
  • Lack of energy
  • Dry mouth

The side effects of tramadol are usually mild and typically ease in a few days of use. However, you should contact your healthcare provider if you experience severe side effects.

Severe Side Effects of Tramadol Use

Some users of tramadol experience more severe side effects that require immediate medical attention, including:1

  • Serotonin syndrome
  • Extreme drowsiness
  • Shallow or slowed breathing
  • Physical dependence
  • Extreme fatigue
  • Androgen deficiency
  • Seizures
  • Tramadol addiction or abuse
  • Tramadol overdose or poisoning

Additionally, the medication’s warning label includes a risk of suicidal ideations. This is especially concerning when it’s prescribed to people with depression or those who previously attempted suicide.

What is Serotonin Syndrome?

Serotonin syndrome is a potentially life-threatening drug reaction. It’s caused by having too much serotonin in the body.7

Misusing Tramadol can lead to serotonin syndrome. However, a Tramadol overdose can also trigger it.

Symptoms of serotonin syndrome include:7

  • Tremors
  • Nausea
  • Sweating
  • Muscle spasms
  • A rapid spike in blood pressure
  • Rapid breathing
  • Elevated heart rate
  • Muscle rigidity
  • Shivering
  • Fever
  • Diarrhea
  • Seizures
  • Agitation
  • Confusion
  • Dilated pupils

The risk of serotonin syndrome increases when you mix tramadol with other medications. This includes antidepressant and antipsychotic medication.

Drug and Alcohol Interactions

Oftentimes, combining tramadol and other medications leads to dangerous interactions. When combined with tramadol, some drugs can cause respiratory depression and decreased heart rate.3 

Common medications that can moderately or severely interact with tramadol include:3

  • Acetaminophen (Tylenol)
  • Alprazolam (Xanax)
  • Celecoxib (Celebrex)
  • Cyclobenzaprine (Flexeril)
  • Duloxetine (Cymbalta)
  • Escitalopram (Lexapro)
  • Pregabalin (Lyrica)


Tramadol is a prescription opioid used to alleviate moderate to severe pain. Like other opioids, tramadol carries a risk of addiction and dependency.

However, because Tramadol is a Schedule IV drug, its potential for addiction and abuse is low. Despite this, misusing Tramadol can cause negative side effects and overdose. 

Tramadol overdoses can be life-threatening. Contact a medical professional immediately if you experience a Tramadol overdose.

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Updated on April 3, 2024

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