Tramadol Trouble

From my blog Twisty Tree at

I had a not very nice time last night :(. I was in a lot of pain after carrying around a little lost dog (who is safely back home) so I decided to take some pain killers. Tramadol.

About an hour after I had taken it I woke up with a pounding heart, nausea, and high anxiety. I tried to go back to sleep but really couldn't and I was worried I was having an adverse reaction, so I asked Bran to stay up with me while I waited it out. He, of course, stayed up with me and would until I was alright. Honestly, I wanted him to stay up incase I stopped breathing. I hadn't actually taken very much, 100 mg, but I had also has a voltarin and a panadeine forte earlier in the day, so maybe it mixed somehow? After about an hour and a half I was through the anxiety attack and falling asleep, so we wen't back to bed. I still ended up waking up with a pounding heart over the course of another hour and a half every time I started to fall asleep, but it calmed down quickly. Not so much fun. I felt very sick today as well. I barely moved from the couch and needed Bran to help take care of me. I'm feeling mostly better now, after having taken a few naps through out the day.

So lesson learned. Tramadol does not agree with me and i'll need to find an alternative. I don't want to go through such a scary situation again. Also I was/am still sore :( so it didn't really help so much...

Has this happened to anyone else?

Hi, Emma. I’m taking a fair amount of Tramadol these days. It agrees with me really well until I get a bit too much in my system. I’m fine with one, but as soon as I go over (sometimes I take an extra half), I get anxious. It seems to be on a knife edge for me at the moment. Other than that, Tramadol is the only pain killer I don’t hate. Unlike some others, it doesn’t constimpate me, doesn’t make me foggy, doesn’t make me feel like I have ants crawling up my legs. Everything’s good as long as I keep the dose low and spread out.
Lately, I’ve been alternating a half and a full tablet, every 4-5 hours. That seems to keep me in a pretty steady state. Over the course of a day, I take between 4 and 5 tablets (200-250 mg).

Hey Emma!,

It's not just you. Tramadol makes me SO jumpy. I cannot sleep if I have it and it was only 100mg too. Like you I woke up twitching and short of breath. I would feel worse the next day because I didn't sleep. I now refuse to take it. I ask my Doc for anything else.

I currently take Panadol Osteo, which is an extra strong paracetamol and a extra strength ibuprofen. The stronger stuff, ie. codine, makes me loopy in the head.

I find is really facinating (odd) that what some people tolereate well, others cannot tolerate at all.

For what is worth, my two cents. I do hope you find a way to manage your pain effectively soon


You may want to ask your DR before cuttung the tramadol time-released in half. I think they are formulated to deliver 20-30% initially then release the rest over some time. If you cut it in half you may get more or all of it to soon. It probably is no big deal but, if you take one whole on AND a half???

Robert, the tablets I was splitting were the regular (immediate release) kind. No problem with cutting them in two. You are right about not cutting the extended-release ones. The ER ones are like a pill within a pill, and the drug is released gradually over 24 hours. I believe they also contain a substance which allows the drug to be released a bit at a time.
I went to the Dr this week, and told her that I was getting the “jumpies” sometimes after taking regular Trramadol, and also having breakthrough pain. She wrote me a prescription for the ER, and said it would eliminate the peaks and valleys. The ER tablets I got are 200 mg (so slightly less than the 250 or so I had been taking most days). She said I could top up with a half tablet if I needed it, but not to exceed the 400 mg/day maximum.
I was wondering whether this was going to work. I was pleasantly surprised! I’ve used the 200 mg ER for two days running, and I’ve been very comfortable, free from anxiety, and I haven’t even needed a top up. I even slept through the night, which was a pleasant surprise. I’m sold!
Maybe an idea for you, Emma?

The symptoms you reported are an adverse reaction to Tramadol. It can range from scary to merely annoying. (When I first started taking opiates for pain, they made me really antsy and unable to sleep). You could try asking for a smaller dose or try a different opiate. Tylenol #3 is pretty well tolerated. Since you have nausea associated with taking the Tramadol, it would be a good idea to request an anti-nausea drug too. Always, always, always make sure that you eat something before taking a short acting opioid. It goes a long way in preventing nausea.
Extended release drugs are wonderful for chronic pain. Like Seenie says, there are no highs or lows. They also have less of the common side effects like nausea, drowsiness, anxiety, insomnia, etc… The really great thing is that they last so long. I take one Opana in the morning and one in the evening. I also have vicodin for break through pain, but I don’t need it as often. It great to have the pain under control and still feel sober!