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Whether This Dose Of 50mg Of Tramadol Is Safe To Take Over The Long Term?
Posted on
Thu, 15 Oct 2020
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 15 Oct 2020
Answered on
Wed, 4 Jun 2025
Last reviewed on
Question : Hello, I have suffered from lower back pain for a while. I am a fit 44 year old. Nothing terrible and I have had MRIs and have some minor disc protrusion but nothing serious or that the doctors are particularly worried about. I am a keen runner also.
I have tried physio and a variety of painkillers over the years, when I get flare-ups. Recently it is has been a little bit worse, likely due to my sitting position from working at home. My doctor has prescribed with with 50mg of Tramadol to take on an as-needed basis, which I have been taking for about 6 months. In short, the drug has drastically improved my quality of life. I don’t take them every day, just when the pain is bad. I probably use on average about 300 mg a week.
My doctor is happy prescribing me this amount, as long as the benefits continue and I don't need to increase the dose.
I just wanted to get a second opinion. I have read that tramadol can be addictive, so want to be careful how often I take them. But, on the other hand, more than any other painkiller I have tried, they make my back feel 100 percent better. It has been life-changing.
My question for the doctor is whether this dose is safe to take over the long term, i.e. if I took this drug for 10 or 15 years. From what I can see on the web, tramadol is relatively safe, with the exception of the addiction risk. But if I took this typical dose (300 mg a week) could it cause me any problems with my organs later in life or do you think the drug is safe enough?
Many thanks in advance,
Luke
I have tried physio and a variety of painkillers over the years, when I get flare-ups. Recently it is has been a little bit worse, likely due to my sitting position from working at home. My doctor has prescribed with with 50mg of Tramadol to take on an as-needed basis, which I have been taking for about 6 months. In short, the drug has drastically improved my quality of life. I don’t take them every day, just when the pain is bad. I probably use on average about 300 mg a week.
My doctor is happy prescribing me this amount, as long as the benefits continue and I don't need to increase the dose.
I just wanted to get a second opinion. I have read that tramadol can be addictive, so want to be careful how often I take them. But, on the other hand, more than any other painkiller I have tried, they make my back feel 100 percent better. It has been life-changing.
My question for the doctor is whether this dose is safe to take over the long term, i.e. if I took this drug for 10 or 15 years. From what I can see on the web, tramadol is relatively safe, with the exception of the addiction risk. But if I took this typical dose (300 mg a week) could it cause me any problems with my organs later in life or do you think the drug is safe enough?
Many thanks in advance,
Luke
Brief Answer:
hard to say.
Detailed Answer:
There are classes of drugs by the FDA based on danger of addiction. Tramadol is in a lower risk that almost any other opiate. All opiates can produce tolerance--needing more to get the same effect and withdrawal... feeling really bad if you don't get it. The FDA has judged (correctly) the risk of these are less. There is also psychological dependence which is the progressively becomeing more divorced from reality on one's use. And having really strange thoughts to keep taking it. This is totally independent of the addictive issues mentioned. We see a LOT of psychological dependence on antibiotics that have zero psychological effects---but some people get weird about germ phobia. So, this is a risk of tramadol.
BUT, tramadol at moderate overdoses (about 3 to 5 times more than ANY doctor would EVER prescribe or about 10x more than you take) can cause fatal seizures. More likely and at lower doses if someone has seizures or other conditions that cause seizures. These seizures can be fatal. They are NOT caused by taking the drug just for a long time.
Long term liver/lung/organ damage from tramadol is a no except m a y b e teeth from dry mouth.
So, there is a real addiction risk. It is not the worst. And that is about it for its risks.
And... on it's benefits. It has two effects. It has mild narcotic effects like oxycodone/methadone/etc. These increase with increasing dose but there is a real limit on how much someone can take without seizures.
AND it damps down painful nerve activity like an anti-epileptic. No other opiate has this. People with painful nerves can have this drug
hard to say.
Detailed Answer:
There are classes of drugs by the FDA based on danger of addiction. Tramadol is in a lower risk that almost any other opiate. All opiates can produce tolerance--needing more to get the same effect and withdrawal... feeling really bad if you don't get it. The FDA has judged (correctly) the risk of these are less. There is also psychological dependence which is the progressively becomeing more divorced from reality on one's use. And having really strange thoughts to keep taking it. This is totally independent of the addictive issues mentioned. We see a LOT of psychological dependence on antibiotics that have zero psychological effects---but some people get weird about germ phobia. So, this is a risk of tramadol.
BUT, tramadol at moderate overdoses (about 3 to 5 times more than ANY doctor would EVER prescribe or about 10x more than you take) can cause fatal seizures. More likely and at lower doses if someone has seizures or other conditions that cause seizures. These seizures can be fatal. They are NOT caused by taking the drug just for a long time.
Long term liver/lung/organ damage from tramadol is a no except m a y b e teeth from dry mouth.
So, there is a real addiction risk. It is not the worst. And that is about it for its risks.
And... on it's benefits. It has two effects. It has mild narcotic effects like oxycodone/methadone/etc. These increase with increasing dose but there is a real limit on how much someone can take without seizures.
AND it damps down painful nerve activity like an anti-epileptic. No other opiate has this. People with painful nerves can have this drug
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
To confirm:
Detailed Answer:
No long term risks with tramadol.
400 is reasonable as a safety cut off. 300 is fda approved. They approve doses with the understanding that it allows room for error above the approved dose.
The key unique point on tramadol isn't it's opiate effect but it's effect on pain through an additional effect on nerves. Glad that is working out for you.
Looking extensively over the journals, there are some slight indications of liver effects by tramadol, but it sure isn't common. Furthermore the effects I'm seeing like some liver enzyme elevations, are not clearly indicating anything serious.
There's a lot of reason to suppose it safe and not much to indicate risk.
And... there is strong indication that the liver metabolism of tramadol varies widely between different people, so.. there might be the rare individual with a rare unexpected result... I'm reaching here....
To confirm:
Detailed Answer:
No long term risks with tramadol.
400 is reasonable as a safety cut off. 300 is fda approved. They approve doses with the understanding that it allows room for error above the approved dose.
The key unique point on tramadol isn't it's opiate effect but it's effect on pain through an additional effect on nerves. Glad that is working out for you.
Looking extensively over the journals, there are some slight indications of liver effects by tramadol, but it sure isn't common. Furthermore the effects I'm seeing like some liver enzyme elevations, are not clearly indicating anything serious.
There's a lot of reason to suppose it safe and not much to indicate risk.
And... there is strong indication that the liver metabolism of tramadol varies widely between different people, so.. there might be the rare individual with a rare unexpected result... I'm reaching here....
Above answer was peer-reviewed by :
Dr. Prasad
Thank you, Doctor. You've been very helpful indeed. Take care and all the best, Luke
Brief Answer:
you are very welcome
Detailed Answer:
Thank you for using our service
Regards
you are very welcome
Detailed Answer:
Thank you for using our service
Regards
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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