Substances | 4 min read

How Long Does Tramadol Last? Timelines, Risks, and Treatment

Medically Reviewed

Medically Reviewed By

Dr.Po

July 07, 2025

Written By

Amanda Stevens, B.S.

On July 7, 2025

What you will learn

Tramadol is FDA-approved for the treatment of moderate to severe pain, but may also be prescribed off-label for other conditions.
Tramadol is an opioid pain medication that has a risk for abuse and dependence, but it is generally considered to have a lower addiction potential compared to Schedule II opioids.
Several factors can influence how long Tramadol lasts, including your age, metabolism, and medical conditions.
Tramadol typically begins to take effect within 30 to 60 minutes and can last up to 6 hours for the immediate-release formulation. While the drug itself is cleared from the body much sooner, traces may remain detectable in hair tests for up to 90 days.
Common side effects of Tramadol include headache, nausea, mood changes, and drowsiness.
Signs of Tramadol overdose include pinpoint pupils, slow breathing, blue lips or fingernails, and a weak pulse.
If you or a loved one is experiencing signs of a Tramadol overdose, call 911 immediately. If available, administering naloxone may help reverse the opioid effects of Tramadol overdose, but it may be less effective for Tramadol-induced seizures due to its serotonergic activity.

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How Long Does Tramadol Last?

The effects of Tramadol typically stay in your system for approximately 4 to 6 hours, but it can remain in your system for much longer. The detection window for drug tests varies widely depending on the type of test and can range from 2 days to 3 months.

What Is Tramadol?

Tramadol is an opioid medication prescribed for moderate to severe pain. Brand names of the drug include Ultram, Qdolo, and ConZip. Due to its potential for abuse and dependence, Tramadol is classified as a Schedule IV controlled substance, indicating a relatively low potential for abuse compared to Schedule II or III opioids.[1]

Tramadol is FDA-approved for moderate to moderately severe pain and may also be prescribed off-label for conditions such as restless leg syndrome and premature ejaculation.[2] Tramadol is available in both immediate-release and extended-release formulations.

How Long Does It Take for Tramadol to Start Working?

Immediate-release doesn’t mean the drug starts working immediately. Instead, it means the entire dose of the drug is released into the system as soon as you take it. For immediate-release Tramadol, you may begin feeling the effects of the drug within half an hour to an hour, and these effects can last up to four to six hours. [3]

How Long Does Tramadol Stay In Your System?

The amount of time Tramadol stays in your system can depend on several factors, including the dose of Tramadol taken and your metabolism. Still, Tramadol’s half-life is approximately 6 to 8 hours.

On average, urine tests can detect Tramadol for up to four days after your last dose. [4] For a saliva test, the detection window for Tramadol is only 48 hours.[5] Hair follicles can maintain traces of opioids like Tramadol for up to 3 months or more.[6]

Factors that Affect Tramadol Duration of Effects

The duration for which Tramadol lasts can depend on several factors, so it varies from person to person. The amount of time Tramadol lasts, as well as its detection window, can depend on individual factors like: [7]

Age
Metabolism
Tramadol dosage
Any existing medical conditions
Liver function
When you last ate

Side Effects of Tramadol

Like other pain medications, Tramadol can cause some side effects. Some of these side effects may be serious. It is essential to know the difference between mild and severe side effects so that you can respond appropriately and seek medical attention as needed.

Common Side Effects of Tramadol

Some of the more common side effects of Tramadol include: [8]

Nervousness
Drowsiness
Headache
Mood changes
Heartburn
Dry mouth
Uncontrollable shaking (one part of the body)

If these side effects are severe or persist for more than a few days, tell your doctor.

Serious Side Effects of Tramadol

Some of the side effects of Tramadol are more serious and warrant an immediate call to your healthcare provider or emergency medical attention. These more serious side effects include: [9]

Irregular heartbeat
Hives
Rash
Blisters
Headache
Extreme fatigue
Muscle weakness
Muscle spasms
Muscle cramps
Agitation
Hallucinations
Nausea or vomiting
Trouble concentrating
Hoarse voice
Chest pain
Dizziness
Loss of coordination
Seizures
Loss of consciousness

Adverse Effects of Tramadol

Since Tramadol is an opioid narcotic, one of the primary concerns is the potential for addiction. Along with the risk of substance abuse and physical dependence comes the possibility of withdrawal symptoms and even overdose.

Tramadol Addiction

If you or a loved one is prescribed Tramadol, be aware of the potential for developing dependence, an opioid addiction, or opioid use disorder. Signs and symptoms of Tramadol addiction include: [11]

Intense cravings for Tramadol
Using Tramadol in dangerous situations
Needing higher doses of Tramadol to achieve the same effects
Continuing use of Tramadol even though it’s causing problems at work, school, or in relationships
Using more Tramadol than intended or for a longer period than intended
Spending a lot of time acquiring, using, or recovering from Tramadol
Giving up social or recreational activities due to Tramadol use
Unsuccessful attempt to stop using Tramadol or reduce the amount you use
Experiencing withdrawal symptoms when abstaining from Tramadol

Risk Factors for Opioid Use Disorder

Anyone can develop an addiction to opioid painkillers like Tramadol. Certain risk factors may increase your vulnerability to opioid addiction, including: [12]

Personal or family history of substance abuse
Mental health conditions such as ADHD, anxiety disorders, or PTSD
Behavioral disorders like conduct disorder
Domestic violence in childhood
Poor school performance
Child abuse or neglect
Chronic pain

Tramadol Withdrawal Symptoms

Withdrawal symptoms from Tramadol can include both opioid-like and atypical symptoms such as anxiety, panic, or paresthesia due to its serotonergic properties. Medication-assisted detox may be recommended to manage withdrawal symptoms such as: [13]

Chills
Fever
Diarrhea
Nausea
Vomiting
Trouble sleeping
Anxiety
Agitation
Restlessness
Intense cravings
Dilated pupils
Increased blood pressure
Increased heart rate
Excessive sweating
General pain

Tramadol Overdose

An overdose of Tramadol can be deadly. Combining Tramadol with other opioid painkillers or alcohol increases the risk of a fatal overdose. Signs that a person may have overdosed on Tramadol include: [14]

Cold or clammy skin
Pinpoint pupils
Low blood pressure
Muscle weakness
Unusual snoring
Slowed breathing
Weak pulse
Seizures
Coma

Signs of Tramadol overdose should be treated like a life-threatening emergency. Administer naloxone if available and call 911. Seek emergency medical attention.

Safe Guidelines for Tramadol Medication Usage

Tramadol is a centrally acting analgesic with weak opioid activity and additional serotonergic/noradrenergic effects. While it carries a risk of addiction, it is considered less potent and less addictive than Schedule II opioids. If you or a loved one is prescribed Tramadol, there may be some things you can do to reduce your risk of adverse effects.

Tell your doctor about any past substance abuse or history of substance abuse in your family.
Tell your doctor about any physical or mental health conditions you have.
Take Tramadol only as prescribed. If pain is not well controlled, consult your healthcare provider before adjusting the dose.
Don’t stop taking Tramadol without notifying your healthcare provider. They may taper your dose to prevent severe withdrawal effects.
Never take another person’s prescription for Tramadol or any other prescription medication, and don’t give your prescription medication to anyone else.
Report any side effects or symptoms of addiction to your doctor right away.

Opioid Use Treatment Is Available

Tramadol is a highly addictive opioid medication. If you or a loved one is experiencing signs of opioid use disorder, it’s essential to reach out for help immediately. Left untreated, this severe substance use disorder can lead to various adverse outcomes such as injuries, overdose, and incarceration, among others. Medication-assisted detoxification services and opioid recovery treatment are available to you. You’re not alone, and there is hope for the future.

Frequently Asked Questions About Tramadol Duration

Is 50 milligrams of Tramadol strong?

Since Tramadol is an opioid painkiller, any dose of this drug could be considered strong. Even so, 50 milligrams is the typical starting dose for immediate-release Tramadol. [12] Your response to the effects of this drug can vary based on several factors, including age, height, weight, metabolism, and others.

Is Tramadol more potent than hydrocodone?

No. Hydrocodone is generally considered more potent than Tramadol. While both are opioid medications, Tramadol also acts as a serotonin and norepinephrine reuptake inhibitor, making its mechanism different and generally milder in terms of opioid strength. Hydrocodone is a schedule II controlled substance, whereas Tramadol is classified as a schedule IV drug, indicating that hydrocodone has a higher potential for abuse and dependence than Tramadol under the Controlled Substances Act.

Does Tramadol make you sleepy or awake?

Both reactions are possible. Drowsiness is a common side effect of Tramadol, but it may have the opposite effect on some people. Medication usage should never be for a purpose other than that prescribed.

Does Tramadol show up on a drug test?

Yes, but it depends on the type of test. If you have a prescription for Tramadol and are asked to take a drug test, it’s essential to provide documentation of your prescription to the lab at the time of testing.

How long do Tramadol side effects last?

Tramadol is associated with both short-term and potential long-term side effects, though most side effects resolve within hours to days. Persistent or long-term side effects are less common but may occur in some individuals. If you’re experiencing severe or chronic Tramadol side effects, tell your doctor as soon as possible.

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MEDICAL CONTENT WRITER

Amanda Stevens, B.S.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more

Read our Editorial Policy What processes do we go through in order to ensure our data remains accurate and up-to-date? Find out more on our editorial policy.