Tramadol — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Tramadol?
Tramadol is a centrally acting opioid analgesic with additional serotonin and noradrenaline reuptake inhibiting properties, used for moderate to moderately severe pain. This medication is commonly prescribed in New Zealand and is funded by Pharmac for moderate to severe pain.
What is Tramadol Used For?
Tramadol is prescribed for moderate to moderately severe pain that does not respond adequately to non-opioid analgesics. It is used for acute pain (e.g., post-surgical, dental), chronic pain, and musculoskeletal pain.
How Does Tramadol Work?
Tramadol works via two mechanisms: it binds to mu-opioid receptors (though with lower affinity than morphine) and inhibits the reuptake of serotonin and noradrenaline, which modulates pain signals in the spinal cord. Both mechanisms contribute to its analgesic effect.
How to Take Tramadol
Available as immediate-release tablets/capsules (taken every 4–6 hours) and modified-release formulations (taken every 12 hours). The usual adult dose is 50–100 mg every 4–6 hours as needed, with a maximum of 400 mg/day. Take with food to reduce nausea. Modified-release tablets should be swallowed whole.
Common Side Effects of Tramadol
- Nausea and vomiting (especially when starting)
- Dizziness
- Constipation
- Headache
- Drowsiness
- Sweating
- Dry mouth
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Seizures (risk increased with higher doses, in patients with epilepsy, or with serotonergic drugs)
- Serotonin syndrome (with SSRIs, SNRIs, MAOIs)
- Respiratory depression (less common than with other opioids)
- Dependence and withdrawal
- Severe hypoglycaemia (rare)
Drug Interactions
Tramadol may interact with other medicines. Always inform your doctor and pharmacist of all medications, supplements, and herbal products you are taking. Key interactions include:
- SSRIs and SNRIs (serotonin syndrome risk — use with caution)
- MAOIs (contraindicated)
- Carbamazepine (reduces tramadol levels significantly)
- Benzodiazepines and other CNS depressants (enhanced sedation and respiratory depression)
- Warfarin (tramadol can enhance anticoagulant effect)
New Zealand Prescribing Information
Tramadol is funded by Pharmac and available as 50 mg capsules (immediate-release) and 50 mg, 100 mg, 150 mg, 200 mg modified-release tablets (Tramal®, Tramal SR®, and generics). It is a Class C controlled drug in New Zealand, requiring a special prescription. Tramadol has significant potential for abuse and dependence — use the lowest effective dose for the shortest necessary period.
Frequently Asked Questions
Is tramadol an opioid?
Yes — tramadol is classified as an opioid, though it has a different mechanism from classical opioids like morphine. It is a Class C controlled substance in New Zealand. It carries risks of dependence, abuse, and withdrawal, and should be used with caution.
Can I take tramadol with antidepressants?
Tramadol combined with SSRIs (like fluoxetine or sertraline) or SNRIs increases the risk of serotonin syndrome — a potentially life-threatening condition. Always inform your doctor and pharmacist of all medicines you take before starting tramadol.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider with any questions you may have regarding a medical condition or medication. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for the most current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: