Ultram Symptoms, Signs and Side Effects

Ultram pill bottle spilled onto table

Ultram is the brand name version of tramadol that is used to treat moderate to severe pain. It is also available in an extended-release form that can prevent pain for longer periods of time. Ultram is an opioid-like drug that binds to opioid receptors in the brain to reduce the intensity of pain. It also prevents the reuptake of neurotransmitters such as norepinephrine and serotonin, which reduces a person’s perception of pain. Together, these effects can generate a euphoric feeling, thus creating a risk for addiction.

Ultram was originally thought to be at low risk for addiction because it binds opioid receptors with a lower affinity than other opioids. However, it is now appreciated that the long-term use of Ultram can lead to addiction and dependence. Ultram was recently reclassified as a Schedule IV controlled substance by the Drug Enforcement Administration. Such classification means Ultram has the potential to be misused.

Individuals who misuse Ultram are also more likely to use it in combination with other drugs, which can increase the risk of serious side effects. The side effects of Ultram abuse include life-threatening complications such as respiratory failure and seizure.

Symptoms of Ultram Abuse

The Drug Enforcement Administration reported that 3.2 million people over the age of 12 admitted to using tramadol for non-medical reasons at some point in their lives. People who misuse narcotics, patients with chronic pain and health care workers are at the highest risk for Ultram addiction.

There are physical and psychological symptoms of Ultram addiction that can manifest in many different ways. Ultram addiction symptoms include:

  • Cravings for Ultram
  • Intense anxiety when the drug is unavailable
  • Developing a tolerance to Ultram and taking larger doses than what was prescribed
  • Changing the route of intake by snorting or injecting Ultram
  • Spending large amounts of time taking the drug or recovering from its use
  • Difficulty meeting major responsibilities due to the use of Ultram
  • Continuing to use the drug despite detrimental effects on health, relationships and overall well being
  • Withdrawal symptoms such as paranoia and hallucinations when Ultram is not taken
  • Mood changes and suicidal thoughts

Ultram Side Effects

With any medication, there is a risk of side effects and adverse effects that may occur. Individuals who take Ultram will experience side effects similar to those associated with other opioid drugs. Some general side effects of Ultram use include:

  • Nausea
  • Vomiting
  • Stomach pain
  • Constipation
  • Drowsiness
  • Dizziness
  • Headache
  • Itching

Ultram also affects the reuptake of serotonin and can induce a condition called serotonin syndrome. This symptom occurs when there is an accumulation of serotonin in a person’s body. Other adverse effects related to Ultram usage include:

  • Slow heart rate
  • A weak pulse
  • Chest pain
  • Rapid heartbeat
  • Light-headedness
  • Noisy, shallow breathing
  • Seizures

Side effects from the long-term use of Ultram can significantly impact one’s health. Lasting and permanent damage to organs and important body symptoms can occur with long-term use of Ultram including:

Risk of Combining Ultram with Other Drugs

There are several drug interactions that one should be aware of when using Ultram. It is important to use precaution when taking multiple medications. You can consult your doctor or pharmacist with your concerns about drug interactions. Harmful Ultram drug interactions involve drugs like:

  • Monoamine oxidase inhibitors (MAOIs): MOAIs are a class of drugs used to treat depression and panic disorders. The use of Ultram with MAOIs increases the risk of seizures.
  • Serotonin reuptake inhibitors (SSRIs): Because Ultram also affects the reuptake of serotonin in the brain, the use of SSRIs with Ultram can increase the risk of serotonin syndrome and seizures.
  • Central Nervous System Depressants: The use of Ultram with any drugs that depress the activity of the central nervous system can cause adverse effects including respiratory depression. Central nervous system depressants include alcohol, other opioids, and benzodiazepines.

Signs of Ultram Overdose

Ultram overdoses can occur when too much of the drug is ingested or Ultram is taken in combination with other drugs. If you or someone you know is experiencing an Ultram overdose, seek medical attention immediately. Ultram overdose symptoms include:

  • Shallow or absent breathing
  • Irregular heartbeat
  • Weakness or lethargy
  • Small pupils
  • Unconsciousness
  • Vomiting
  • Rigid Muscles
  • Cold and clammy skin
  • Skin discoloration

Again, if an overdose is suspected, call 9-1-1 immediately. An overdose is a life-threatening situation.

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National Institutes of Health. “The Essence of Drug Addiction.” Accessed September 7, 2019.

Drug Enforcement Administration. “Tramadol (Trade Names: Ultram, Ultrace)” October 2018. Accessed September 7, 2019.

Abdelaleem SA, Hassan OA, Ahmed RF, Zenhom NM, Rifaai RA, El-Tahawy NF. “Tramadol Induced Adrenal Insufficiency: Histological, Immunohistochemical, Ultrastructural, and Biochemical Genetic Experimental Study.” J Toxicol. 2017. Accessed September 7, 2019.

Boston University for sexual Medicine. “Androgen insufficiency in men”. Accessed September 7, 2019.

National institute of diabetes and digestive and kidney diseases. “Adrenal Insufficiency & Addison’s Disease.

Sub Laban T, Saadabadi A. “Monoamine Oxidase Inhibitors (MAOI).” Updated 2019 Apr 7. Accessed September 7, 2019

National Cancer Institute. “Central Nervous System Depressants.” Accessed September 7, 2019

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.