How Long Does Tramadol Stay in Your System?

Tramadol in Your Blood, Urine, Hair, & Saliva

Symptoms of Tramadol overdose

Verywell / Cindy Chung 

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.

Tramadol is not screened for on standard 5-panel and 10-panel drug tests, however, it will show up on other drug tests for prescription pain medications.

How Long Does Tramadol Stay in Your System?

Blood: Up to 48 hours

Urine: 24 to 72 hours

Saliva: Up to 48 hours

Hair: 30 to 90 days

How Long Does It Take To Feel the Effects?

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.

How Long Does Tramadol Last?

According to the FDA, 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. The half-life 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 is broken down in the liver and excreted mostly by the kidneys in the urine. About 30% of the dose is excreted unchanged, 60% excreted as identified metabolites, including M1 and N-desmethyl tramadol, and 10% excreted as unidentified metabolites.

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.

False Positive Testing

While there aren't many substances that can trigger a false positive for tramadol, tramadol triggers a false positive for other substances. As a result, you will want to alert your testing facility in advance that you are prescribed tramadol. Specifically, tramadol and its metabolite N-desmethyl tramadol can trigger false positives for PCP. Tramadol also can trigger false positives for Buprenorphine.

Factors That Affect Detection Time

About 7% of people are "poor metabolizers" of tramadol, due to reduced activity of the CYP2D6 isoenzyme of cytochrome P-450. For people in this population, it takes significantly longer to break down tramadol as well as tricyclic antidepressants and other drugs. As a result, they have the more active drug in their bloodstream for a longer time. These people are at risk if taking other medications that further reduce the actions of the enzymes that break down tramadol.

In addition, there are other factors that can affect the drug's detection time, including:

  • Dosage: Higher doses will take longer to metabolize.
  • Frequency of Use: Tramadol accumulates in the body as more doses are taken; if some of the previous dose hasn't completely broken down, your body will likely take longer to metabolize additional doses.
  • Metabolism: A slower metabolic rate will increase the amount of time it takes tramadol to break down; activity level, diet, body composition can all affect metabolism.
  • Reduced Kidney or Liver Function: Impairment of the organs the body uses to get rid of waste will increase the amount of time tramadol stays in your body.
  • Age: People over the age of 75 metabolize more slowly, may be taking additional medications that affect metabolism, and are also at a higher risk for impaired kidney or liver function. All of these factors usually result in a slower metabolism for older people.

Drops or Injections vs. Pills

The pill form of tramadol is absorbed slower by the body as well as excreted more slowly than either the drop or injected form.

How to Get Tramadol Out of Your System

Contrary to popular belief, exercising or drinking water will not help you metabolize tramadol significantly faster to "beat" a drug test. The only way to get tramadol out of your system is to stop taking the drug and allow your body time to process and eliminate it.

If you suspect an overdose of tramadol, administering Narcan (naloxone), often available at local health departments as a nasal spray, will inhibit the dangerous effects of too much tramadol on the respiratory system, though it will not speed up elimination of the tramadol. Keep this in mind as it may be necessary to administer a second dose of naloxone if enough tramadol remains in the body.

Symptoms of Overdose

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

Symptoms of a tramadol overdose can include:

  • Constricted pupils
  • Blue or purplish-black fingernails and lips
  • Pulse (heartbeat) is slow, erratic, or not detectable
  • Slow, shallow, erratic, or stopped breathing
  • Unconsciousness
  • Making a snore-like gurgling noise or choking sounds
  • Non-responsive to outside stimulus
  • Muscle weakness
  • Cold, clammy skin
  • Seizures

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 you risk a serious, possibly life-threatening interaction.

As with the case of all opioid drugs, tramadol overdoses can be treated with Narcan (naloxone) if they are detected early enough. If you think someone has overdosed, call 911 immediately, administer naloxone, and begin CPR if possible.

Getting Help

If you suddenly stop taking tramadol, you may experience opioid withdrawal symptoms, such as anxiety, muscle aches and pain, excessive sweating, and insomnia.

Tramadol withdrawal symptoms begin one to two days after the last dose, peak after day three, and subside within one to two weeks.

Tramadol carries a high risk of dependence, even when taken as prescribed. Treatment options for opiate use disorder include:

  • Medication-assisted treatment (MAT) with buprenorphine or methadone
  • Harm reduction psychotherapy
  • Programs designed to help get you off of opiates in a sustainable way

If you are not in a position to stop using or to get into a treatment program, make sure to employ harm reduction methods:

  • Don't take more than your prescribed dose.
  • Pursue a safe supply; always use a prescription rather than purchasing a substance of unknown purity.
  • Seek out a safe space to use where you can be supervised by a professional.
  • Let a loved one who carries and knows how to use naloxone know that you are going to be using.

If want to stop taking tramadol, consult your doctor. When transitioning off of opioids like tramadol, your doctor may prescribe other medications to ease withdrawal symptoms and prevent breakthrough pain.

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