How Long Does Ultram Stay in Your System?

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While timelines vary based on many factors, Ultram is generally detectable in urine for up to four days. Determining exactly how long Ultram (tramadol) is detectable in the body depends on many variables, including which kind of drug test is being used.

Ultram, which is called tramadol in its generic form, is also known by its other brand names Ultracet, Conzip, Ryzolt, and Rybix. This medication is prescribed to treat moderate to severe pain. While safe and effective when used as directed, misuse increases the risk for dependence.

Factors Affecting Detection Times

The timetable for detecting Ultram in the system is dependent on a number of factors. These include:

  • Age
  • Body mass
  • Health conditions
  • Type of test used
  • Hydration level
  • Metabolism
  • Physical activity

Because there are so many variables that impact detection times, it is almost impossible to determine the exact amount of time Ultram will show up on a drug test.

How Long Ultram Remains in Various Tests

The following is an estimated range of times, or detection windows, during which Ultram can be detected by various testing methods:

  • Ultram can be detected in a urine test from one to four days.
  • A blood test can detect Ultram for approximately 12 to 24 hours.
  • Ultram can be detected in a saliva test for one to two days.
  • Ultram, like many other drugs, can be detected with a hair follicle drug test for up to 90 days.

Ultram is metabolized by the liver, where it is broken down into metabolites that are then excreted by the kidneys. Ultram has a half-life of around five to six hours. The half-life of a medication is how long it takes for a person's body to eliminate half of the substance from the body.

Potential Risks

Ultram is in a class of medications called opiate (narcotic) analgesics and therefore can be very addictive. If it's taken over a long period of time, Ultram can create a physical dependence.

According to the 2017 National Survey on Drug Use and Health, 1.7 million people in the United States over the age of 12 reported abusing tramadol in the past year.

Ultram use can also have other adverse effects. Even when taken in prescribed amounts, Ultram can cause seizures after it has been used over a long period of time.

Also, because Ultram is an opioid painkiller, there is a chance of overdose, especially when combined with other central nervous system depressants or alcohol.

Side Effects

Ultram, like other opioid painkillers, can cause serious side effects, some of which can be severe, including:

  • Agitation, hallucinations, fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination
  • Blisters
  • Changes in heartbeat
  • Decreased sexual desire
  • Difficulty swallowing or breathing
  • Hives
  • Hoarseness
  • Inability to get or keep an erection
  • Irregular menstruation
  • Loss of consciousness
  • Nausea, vomiting, or loss of appetite
  • Rash
  • Seizures
  • Swelling of the eyes, face, throat, tongue, lips, hands, feet, ankles, or lower legs
  • Weakness or dizziness

These side effects can occur even when taken as directed, but misuse may increase the risk for severe side effects.

Overdose Symptoms

Symptoms of an Ultram overdose may include the following:

  • Cold, clammy skin
  • Coma
  • Decreased pupil size
  • Difficulty breathing
  • Extreme drowsiness
  • Muscle weakness
  • Slow heartbeat
  • Unconsciousness

If you or someone you know experiences overdose symptoms while taking Ultram, get emergency medical attention immediately.

Drug Interactions

There is a long list of medications that might produce negative reactions when taken along with Ultram. Some of those medications include:

  • Anticoagulants such as Coumadin (warfarin)
  • Certain medications for migraine headaches such as Axert (almotriptan), Relpax (eletriptan), Frova (frovatriptan), Amerge (naratriptan), Maxalt (rizatriptan), Imitrex (sumatriptan), and Zomig (zolmitriptan)
  • MAO inhibitors including Marplan (isocarboxazid), Nardil (phenelzine), Eldepryl (selegiline), and Parnate (tranylcypromine)
  • Muscle relaxants such as Flexeril (cyclobenzaprine), Phenergan (promethazine), and Rifadin (rifampin)
  • Sedatives and sleeping pills
  • Selective serotonin reuptake inhibitors (SSRIs) such as Celexa (citalopram), Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine), and Zoloft (sertraline)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as Pristiq (desvenlafaxine), Cymbalta (duloxetine), and Effexor (venlafaxine)
  • Tranquilizers
  • Tricyclic antidepressants such as amitriptyline, amoxapine, Anafranil (clomipramine), Norpramin (desipramine), Silenor (doxepin), Tofranil (imipramine), Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine)
  • Wellbutrin (bupropion)

Be sure to tell your doctor about any and all prescription and over-the-counter medications, vitamins, herbs, and supplements that you're taking.

A Word From Verywell

Ultram can generally be a safe and effective pain reliever when it is used as directed. Always talk to your doctor about any concerns you may have with regards to your medication. If you have developed a dependence or addiction, treatment options are available.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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Article Sources
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  1. American Addiction Centers. How long does tramodol stay in your system? Updated March 12, 2019.

  2. Food and Drug Administration. Ultram (tramadol hydrochloride) tablets. Updated March 2008.

  3. SAMHSA. 2017 NSDUH annual national report. Published September 14, 2018.

  4. MedlinePlus. Tramadol. Updated October 27, 2020.