• Agitation
• Bloating and gas
• Constipation
• Diarrhea
• Dizziness, head rush (orthostatic hypotension)
• Drowsiness (somnolence)
• Dry mouth
• Feeling of elation
• Flushing (redness, warmth, or tingly feeling)
• Headache
• Indigestion
• Loss of appetite
• Nausea
• Sleep problems (insomnia)
• Weakness, muscle fatigue
  

Seek urgent medical attention if any of the above symptoms persist, or if the more severe reactions appear:

• Seizure
• Anxiety
• Convulsive movements
• Hallucinations
• Nervousness
• Tremor
  

Seek emergency help for severe allergic reaction and related tramadol side effects:

• Airway constriction (bronchospasm) and wheezing
• Airway obstruction (angioedema)
• Chest pain
• Coma, unconsciousness
• Convulsions
• Fainting
• Fatal epidermis cell death (Stevens-Johnson syndrome)
• Fever
• Heart pain
• Hives
• Irregular heartbeat
• Itching (pruritus)
• Lack of responsiveness
• Lack of muscle tone
• Lightheadedness
• Loss of coordination
• Muscle stiffness or tremor
• Pinpointed pupils
• Red, blistering, peeling skin rash
• Seizures
• Severe sleepiness
• Swelling of the mouth, face, lips, or tongue
• Tightness in chest
• Vomiting
  

Patients on tramadol may be more likely to have a seizure if they take certain medications for nausea, or have a history of one of the following:

• Alcoholism
• Central nervous system infections
• Drug withdrawal, addiction
• Epilepsy
• Head trauma or injury
• Metabolic disorders
• Seizures
• Use of certain antidepressant or muscle relaxant medicines
• Avoid tramadol if you take the anti-seizure medication Tegretol.

Always check with your doctor before combining tramadol with other medications, especially those listed below. Combinations may provoke very serious tramadol side effects:

Anti-seizure medication

• Tegretol

Antidepressants (tricyclic):

• amitriptyline (Elavil, Etrafon)
• clomipramine (Anafranil)
• imipramine (Janimine, Tofranil)
• desipramine (Norpramin)
• escitalopram (Lexapro)
• fluoxetine (Prozac, Sarafem)
• fluvoxamine (Luvox)
• imipramine (Tofranil)
• nortriptyline (Pamelor)
• paroxetine (Paxil)
• sertraline (Zoloft).

MAO inhibitors:

• isocarboxazid (Marplan)
• phenelzine (Nardil)
• rasagiline (Azilect)
• selegiline (Eldepryl, Emsam)
• tranylcypromine (Parnate)

Anti-anxiety drugs:

• Valium and Librium

Other medication:

• carbamazepine (Tegretol)
• warfarin (Coumadin)
• digoxin (Lanoxin, Lanoxicaps)
• ketoconazole (Nizoral)
• erythromycin (E-Mycin, E.E.S., Ery-Tab)
• rifampin (Rifadin, Rimactane, Rifater)
• St. John's wort
• quinidine (Quinaglute, Quinadex, Cardioquin, Quinora)

Drugs that induce sleepiness and/or tiredness:

• other pain medications
• cold medicine
• muscle relaxants
• medicine for seizures
• Current alcohol use, past alcoholism
• Centrally acting analgesics
• Hypnotics
• Narcotic pain medicine
• Psychotropic drugs
• (such as for bipolar disorder, schizophrenia)
• Sedatives or tranquilizers
• Street drugs
  

This is an incomplete list, therefore verify all other medication or vitamin intake with a physician.

Inform your doctor immediately of any plans to become pregnant since tramadol can cause fatalities in newborns. Discontinue breastfeeding since tramadol can be transmitted through mother’s milk.