Tramal Retard
Tramal retard is a pain medicine that belongs to the opioid group and is used to treat moderate to severe pain by affecting nerve cells in the spinal cord and brain.
Form
depottabletti
Strength
200 mg
Active Ingredient
Tramadol hydrochloride
Manufacturer
Grünenthal GmbH
How to Use
Dosage
The doctor will decide your dose based on your pain. Usually, adults and children over 12 years take 1-2 tablets (50mg) twice a day, or 1 tablet (100mg, 150mg, or 200mg) twice a day, preferably in the morning and evening.
Method
Take the tablets by mouth. Swallow them whole with enough liquid. Do not split or chew them. You can take them with or without food, preferably in the morning and evening.
Important
Do not take more than 400 mg of tramadol hydrochloride per day, unless your doctor tells you to.
Possible Side Effects
COMMON
- •Dizziness
- •Nausea
- •Headache
- •Drowsiness
- •Tiredness
- •Constipation
- •Dry mouth
- •Vomiting
- •Sweating
RARE
- •Effects on heart and circulation (e.g., fast strong heartbeat, rapid pulse, feeling faint or collapse), especially when standing up quickly or during physical activity
- •Gagging, stomach upset (e.g., pressure in stomach, bloating), diarrhea
- •Skin reactions (e.g., itching, rash)
- •Allergic reactions (e.g., trouble breathing, wheezing, swollen skin) and shock (sudden circulatory collapse)
- •Slow heart rate
- •Increased blood pressure
- •Unusual sensations (e.g., itching, tingling, numbness), tremors, epileptic seizures, muscle twitching, uncoordinated movements, temporary loss of consciousness (fainting), speech problems
- •Epileptic seizures, especially with high doses or with other medicines that can cause seizures
- •Changes in appetite
- •Hallucinations, confusion, sleep problems, delirium, anxiety and nightmares
- •Mental side effects (e.g., mood changes like irritation or increased mood, changes in activity like less or more active, changes in perception and judgment)
- •Medicine dependence
- •Blurred vision, small pupils (miosis), large pupils (mydriasis)
- •Slow breathing, shortness of breath (dyspnea)
- •Worsening of asthma (though not proven to be caused by tramadol)
- •Respiratory depression (if recommended dose is exceeded or other CNS depressants are used)
- •Muscle weakness
- •Difficulty or pain when urinating, less urine (dysuria)
- •Elevated liver enzyme values
- •Decrease in blood sugar levels
- •Hiccups
- •Serotonin syndrome (symptoms like agitation, hallucinations, coma, fever, changes in heart rate and blood pressure, muscle twitches, stiff muscles, coordination problems, stomach issues)
- •Withdrawal symptoms if treatment is stopped suddenly (e.g., restlessness, anxiety, nervousness, shaky feeling, hyperactivity, sleep problems, stomach and bowel issues, panic attacks, hallucinations, unusual itching, tingling, numbness, ringing in ears, confusion, delusions, changes in personality, changes in reality perception, paranoia)
Important Warnings
- Do not use if you are allergic to tramadol or any other ingredient in this medicine.
- Do not use if you have poisoning from alcohol, sleeping pills, other pain medicines, or medicines that affect mood and feelings.
- Do not use if you are taking or have taken MAO inhibitors (medicines for depression) in the last 14 days.
- Do not use if you have epilepsy that is not controlled by medicine.
- Do not use if you are in replacement or withdrawal treatment for opioid addiction.
Show 11 more warnings
- Talk to your doctor if you feel like you might faint (consciousness disturbance) or are in shock (cold sweats).
- Talk to your doctor if you have increased pressure in your brain (due to head injury or brain disease).
- Talk to your doctor if you have trouble breathing or have epilepsy/seizures, as the risk of seizures may increase.
- Talk to your doctor if you have depression and take antidepressants, as some of them can interact with tramadol.
- Talk to your doctor if you have liver or kidney disease.
- This medicine contains tramadol, an opioid. Repeated use can lead to addiction and misuse, which may cause life-threatening overdose.
- Tramadol is not recommended for children with breathing problems.
- Do not drink alcohol while taking Tramal retard, as it can increase the medicine's effects.
- Do not use Tramal retard if you are pregnant.
- Do not use Tramal retard more than once during breastfeeding, or if you use it more often, you should stop breastfeeding.
- Tramal retard can make you feel sleepy, dizzy, or blur your vision, affecting your ability to react. Do not drive or operate machinery if your reactions are affected.
Use in Elderly Patients
Category D
Avoid use in older adults. Serotonergic. Prodrug. Genotype affects the response. Reduce the dose in moderately severe and severe renal impairment. Increases the risk of confusion and falling. Need for laxative is often necessary. Consider potential interactions. (updated 18.8.2025)