How Long Does Tramadol Stay in Your System?

Tramadol is a synthetic opioid analgesic medication used to treat moderate to moderately severe pain. It has brand names including ConZip, FusePaq Synapryn, Rybix, Ryzolt, and Ultram. Knowing how long it stays in your system can help you understand the precautions needed to avoid drug interactions and possible overdose. There is a special concern with this medication being used for children, so discuss this with your doctor.

How Tramadol Acts in Your System

Tramadol works on the pain receptors in your brain and throughout your central nervous system, inhibiting the reuptake of two neurotransmitters, serotonin, and norepinephrine. The pain relief effects begin about an hour after a dose and peaks in two to four hours. There are extended relief versions of tramadol that dispense dosages in phases over a longer time frame. This means that a single extended relief pill acts longer in your system.

While it is active, tramadol depresses breathing and causes the pupils to constrict. It reduces motility in your digestive system so food takes longer to digest and you are likely to have constipation. It dilates your blood vessels, and you may have flushing, itching, sweating, red eyes, and experience dizziness or faintness when you get up after having been lying down.

Tramadol is broken down in the liver and excreted mostly by the kidneys in the urine. However, about 7 percent of people are "poor metabolizers" of tramadol, and it takes them longer to break it down. As a result, they have more active drug in their bloodstream for a longer time. These people are especially at risk if taking other medications that further reduce the actions of the enzymes that break down tramadol.

The half-life of tramadol in the blood is between five and nine hours, and even longer for people who have been taking multiple doses. That is the time it takes half of a dose to be inactivated by the body. Complete elimination takes about five to six times as long as the half-life.

Tramadol can be addictive even at prescribed doses. If you stop using it suddenly, you may experience withdrawal symptoms. Your doctor will give an appropriate schedule when its time to stop using tramadol to avoid this.

Preventing Tramadol Overdose and Life-Threatening Interactions

To prevent an overdose of tramadol, you must only take the amount prescribed on the schedule prescribed. It is also dangerous to crush or cut extended relief tablets or capsules as that will release a larger dose all at once.

Tramadol interacts with many other medications, which can lead to life-threatening interactions including breathing problems, sedation, and coma. Of special concern are interactions with benzodiazepines, monoamine oxidase inhibitors (MAOI) and alcohol. Discuss all medications you take, plan to take, or plan to stop taking with your doctor so these can be screened and adjusted to prevent a dangerous interaction.

Do not drink alcohol, take medication containing alcohol, or use street drugs while taking tramadol or your risk a serious, possibly life-threatening interaction.

Symptoms of a tramadol overdose can include:

  • Decreased size of the pupil of the eye
  • Difficulty breathing
  • Drowsiness
  • Unconsciousness
  • Coma
  • Slowed heartbeat
  • Muscle weakness
  • Cold, clammy skin
  • Decreased respiration
  • Seizures

As with the case of all opioid drugs, tramadol overdoses can be treated with Narcan if they are detected early enough. If you think someone has overdosed, call 9-1-1 immediately.

Bottom Line

A number of variables come into play when determining how long tramadol remains in the body, including your metabolism, body mass, age, hydration level,health conditions, and other factors. Tramadol is detectable in the urine for one to four days. It generally will not show up as a positive for opiates on a drug screening test such as might be done for employment, but tramadol can be detected on a prescription drug screening test. If you must take any form of urine drug test while on tramadol, disclose your prescription to the testing lab so your results can be interpreted appropriately.

Was this page helpful?

Article Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration (FDA). Ultram CIV (tramadol hydrochloride) tablets; 2016.

  2. Ryan NM, Isbister GK. Tramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely. Clin Toxicol (Phila). 2015;53(6):545-50. doi:10.3109/15563650.2015.1036279

  3. ARUP Laboratories. Drug plasma half-life and urine detection window; 2019.