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The recommended therapeutic dose of immediate release tramadol for pain relief is 50-100mg every 4-6 hrs, with a max. daily dose of 400 mg. The recommended daily max for extended release is 300mg.
If you do not have much opiate tolerance at the moment, I would not go outside the bounds of the therapeutic recommendations. Start small you can always take some more. Once taken, you can't take less. Like any CNS depressant drug, you should be careful about the additive effects of other depressant substances like alcohol, benzos, and other opiates. If using anything else, keep that in mind when deciding how much tramadol to take.
You probably also want to think about how far you want to get down the tolerance and dependence road. Regular and increasing doses will lead inevitably to addiction, as it will with any opiate.
Too much will leaving you puking, or at least in my case. My sister and I had a bottle and decided to take a some and go out, no drinking included. We ended up taking around 700-800mg over the course of 2-3 hours. We both spent the night puking, until our throats were raw from dry heaving. Heaving so bad that I broke several blood vessels in my eyes.
Definitely a first and last.
My hamster doesn't like to preach but the HUGE doses of up to 900mg daily scares him. The little guy has a spinal injury and has been weaned off Morphine Hydrochloride oral solution (nasty stuff he tells me!!!) on to 200mg twice daily of slow/extended release Tramadol. My hamster doesn't feel any kind of "high" like he did with the Morph that would make him want to use any higher dose than that, just sustained pain relief. My hamster's Doctor tells him that 400mg is the most that should be taken daily, either as extended release or in divided doses if immediate release tabs (100mg every 4-6 hours). My hamster was confused as to why SWIM above recommended only 300mg extended release daily, so double-checked with his Doctor today. He was informed that 400mg is the MAXIMUM recommended dose for both types of Tramadol and he should continue with 200mg extended release morning and evening. Maybe it's a different country thing??? My hamster says he can't imagine why anyone would use Tramadol immediate release recreationally and is interested to know what benefits other than pain relief are experienced at high doses????
When you go over the 400mg mark... Then you're risking seizures... Even then you're risking having seizures at any dose. Its just a roll of the dice. Swim was taking up to over 800mg's and she was good until one day she seized. After that swim knew she had to stop... The withdrawal was bad but life without tramadol was better than with it.
Obviously dangerous dosing isn't going to be an across the board number. There are many factors that will determine what is dangerous for one person, that are totally different for another.
If you're looking for a recommended dose just below overdose, I don't think you've come to the right place.
SWIM is sorry to say but, what people have taken and still have been ok will tell you absolutely nothing. Tramadol is an unusual opioid in a sense that it can (although other opioids also lower the seizure threshold to some extend) and will cause you seizures if you take too much. It is really bad that people view is as a safer opioid when in fact it is the most dangerous one in the sense that even one time use can cause you permanent brain damage.
For other opioids it is pretty simple: when you increase the dose you increase the risk of adverse effects and can determine a relatively safe dose by knowing your individual tolerance. This is not the case for tramadol. From what SWIM has read regarding anecdotal evidence as well as scientific evidence, tolerance to seizure threshold loweribg effects does not happen. There are reports from people taking high doses (more than one gram) for extended periods of time, then taking a relatively small amount (400mg for example) and having a seizure.
400mg is the max daily dose, 800mg giving a 25% chance of seizure. Opioid tolerance won't affect this, antidepressant tolerance may do. Taking antidepressants or serotonin-increasing drugs simultaneously will increase the risk.
I've been on 400mg prescribed for 3ish years, history of high antidepressant doses. SWIM, 2.4g tramadol one off without problem, titrating dose slowly upwards though didn't increase due to signs of serotonin syndrome. Without being careful, knowing exactly what to look for, being around doctors and a huge range of drugs to counter any potential problems overdosing tramadol isn't advisable. There isn't really a rush, high, etc. Conventional opioids are safer and likely more abusable to overdose. And in the same situation and able to think clearly (ie. not in pain), SWIM would not have pushed the tramadol anywhere near that high.
Bullfrog took tramadols several times while he was a heroin smoker as well.This was before he knew much about it and when he didnt find out the full facts about some substances before taking them.As he had taken most opiate drugs before he thought it would be relatively safe especially because his tolerance to opiate drugs was high.He took 500mg and about 4hrs later he had a seizure.He hadnt had one before or after this so it had to be the tramadol.He doesnt think that tramadol is a 'recreational' substance.
Remember that the seizure threshold can be lower if you are coming off drugs like tranquilizers or having alcohol withdrawal. Also, alcohol in extremely high doses can have a paradoxical effect that causes seizures in some people when you think a high does of a CNS would do the opposite.
SWIM always recommends taking the lowest dose to get where you want to be and try to take breaks to avoid tolerance build-up. SWIM has never had to take more than 300mg (150mg X 2) for good pain relief and mild euphoria.
SWIM understands how those more experienced with potent opiates could think Tramadol is very weak. SWIM equates Tramadol to taking a large does of Tylenol along with a small amount of cocaine. Very mild euphoria with an amped up feeling.
SWIM would agree that there is a nice, speedy euphoria with Tramadol for SWIM. SWIM would likely be considered quite opiate naive to this crowd, with most of experience coming from reasonable amounts of Tussionex or 5mg Percs. The most SWIM would ever do in one dose of percs would be 10mg and that would make SWIM fly. Opiates in general, or at least at these lower doses, don't produce the nod - they produce euphoria and an inflated sense of well being.
Well, SWIMs local doc won't prescribe any opiates now due another local "pain management" doc getting busted by the feds, so she wrote SWIM a scrip for 30 Trams. SWIM was skeptical but found they give him a nice buzz and do seem to lift his mood in the classic AD (never taken one) described way. Went back to get a refill and she shut him down and tried to refer to an ortho doc for my "shoulder pain". Knowing that would come with more expense (office visit, MRI, etc) and likely not net much in the way of pain meds, SWIM bailed on that thought and found Tramadol online.
It was easy to get and relatively cheap. The plan is to use 100mg in morning then a 50 bump around lunch, a couple of days a week, always taking a minimum of two days off and never more than 3 days in a row, to avoid tolerance and/or addiction.
my experience..... ive had numerous seizures trying to take ultram to get well. having an opiate tolerance i had to take alot. i took 12 50mg once woke up in the hospital 2 days later. i dont remember having the seizures but it happened in front of my kids which scared the crap out of them. be careful as our tolerances increase we start to think we can handle any amount of anything. that how we end up checking out. i also had a seizure taking 350mg, however i was on methadone maintenance at the the time. that was a stupid choice seeing as how that combination can be deadly.
Hey guys. SWIM has taken Tramadol recreationally for a while. SWIM was prescribed them originally, but very much enjoyed the buzz and relaxed feeling.
SWIM can now get his hands on as many tramadol as he wants. either 50 or 100 mg capsules.
I know SWIM will be building a tolerance, but how much tramadol is TOO much to be taking in one day?
Any thoughts and the usual helpful advice welcome.
I'm prescribed 400mg a day instant release as an off-label anti-depressant. I've never had a seizure on it or have a family or personal history of seizures (i had multiple in one hour non-tramadol related but its a long story)but from what I've read on Tramadol which I admit is ridiculously a lot. The lowest reported seizure was at 100mg and the maximum habit per day I've heard about is 1500mg without seizures.
If you want the ballpark figure of how much is too much I would say 500mg or 600mg absolute maximum for someone healthy with a built up tolerance to Tramadol over years. 600mg is where my dog with a horses constitution found tram to possibly have a ceiling effect or at leasta vast increase in negative side effects (norepinephrine increase i would guess) and of course seizure threat.
Noones given me a real answer yet - What dose of Tramadol is DANGEROUS to take?
Maybe you are one of those individuals for whom tramadol has a limited recreational value at relatively safe doses. My own impression is that 900mg might be overdoing it. I don't use more than 100mg, but if I wanted to do more I'd stick to the recommended max of 400mg/300mg daily for sustained release. There are differing conclusions in research into tramadol and seizures. It's not really possible to say exactly how much tramadol could be taken safely by any one person, there are only predicted or possible outcomes based on studies and reports.
Gardner et al (2000) concluded that "in a general population, risk of seizure may be associated with long-term therapy with tramadol or the presence of cofactors, or confined to a small sensitive population subset."
Raffa and Stone (2008) say something similar on possibly susceptible groups, as well cofactors such as taking other drugs which lower seizure threshold:
"It has long been known that the usual high-dose toxicity of tramadol in animals and in humans results in seizures rather than respiratory depression. The small number of seizures, and the exceedingly small number with tramadol alone, makes it difficult to define susceptible individuals. There might be a susceptible subset (also true for other opioids?) for reasons yet unknown. However, a letter-to-editor suggested that tramadol may cause seizures at recommended dosages, particularly when administered together with antidepressant medications, which themselves lower seizure threshold. Subsequent studies suggested a relatively low risk. Yet, periodically, a letter-to-editor implies a greater risk."
Petramfar and Haghighi (2010) found that "Tramadol may provoke seizures in patients with epilepsy and also in previously healthy people even within the recommended dose ranges."
Potscha et al (2000) suggest that tramadol may have an anticonvulsant effect at lower doses.
Seizures are not the only potential adverse effect of large doses. Adverse effects are more likely at around twice the recommended daily dose. These effects can include (amongst others) hypo and hypertension, respiratory depression, changes to heart rate such as bradycardia and tachycardia, confusion, urinary retention, and blood disorders (BNF 63 2012).
Sources: Tramadol and seizures: a surveillance study in a managed care population. Gardner et al, Pharmacotherapy. 2000 Dec;20(12):1423-31. Unexceptional Seizure Potential of Tramadol or Its Enantiomers or Metabolites in Mice. Robert B. Raffa and Dennis J. Stone, Jr JPET 325:500–506, 2008. Tramadol Induced Seizure: Report of 106 Patients. P Petramfar, A Borhani Haghighi 2010. British National Formulary 63, March 2012.
Last edited by Mindless; 22-03-2012 at 09:53.
Last night I had a really bad stomach ache. I've been prescribed 50mg tramadol by my gp. I took 2 as usually that's what helps me out with the pain. I did feel better but not completely perfect. So around 2 hours later I took another 2. All was well and no pain at all. Euphoric and all the good stuff.
Fast forward to today I woke up buzzed and it felt nice. 2 hours later I threw up. Which is where I'm at right now. Blahh I hate throwing up.
Seems like the OP is fishing for experience reports that would indicate how much people have taken and "got away with" because several people have stated clearly that 400 mg is the seizure threshold but he is not trying to hear it. More than 400 mg per day is bad bad bad. Hope that's clear enough. From what I've heard and I've read a lot of experience reports about tramadol, it's not worth trying to find your threshold above that level. Not worth it.
My shark-friend had a seizure when she took 900 mg of tramadol over the course of four hours (semi-accidental, although she was being very reckless about her dosage). She is 150 pounds. When she took 800 mg at once a month before that, she had very strange symptoms, perhaps very quick seizures, just a 1-second black-out plus electrical shock feeling. So if you feel something like that, you're probably at a dangerous level. She should have heeded the signs and didn't. Don't wind up in the hospital.