Based on NIH | Can tramadol cause fatigue, and how common is this side effect?

Tramadol can cause fatigue in some people. Fatigue is part of its central nervous system effects and is listed among common side effects such as drowsiness (sleepiness), dizziness, and weakness. ^{[1] [2]} Tramadol may also make you feel lightheaded or faint, especially when standing up suddenly, which can add to a sense of tiredness. ^[3] These effects tend to be more noticeable when you first start the medicine or when the dose is increased. ^[4]

What fatigue from tramadol looks like

• Feeling unusually tired, low energy, or weak during the day. ^[1]
• Sleepiness or drowsiness that can impair alertness and coordination. ^[3]
• Dizziness or lightheadedness, which can make fatigue feel worse. ^[3]

Because tramadol acts on opioid receptors and also affects serotonin and norepinephrine, it can slow the nervous system, leading to drowsiness and fatigue as part of its typical side-effect profile. ^[4] Fatigue is listed among nervous-system reactions (along with drowsiness, somnolence, headache, vertigo, and weakness) in official product labeling. ^[2] These effects can be more frequent in the early phase of treatment and may lessen as your body adjusts. ^[5]

How common is fatigue with tramadol?

While exact percentages vary by study and formulation, clinical trial summaries consistently report fatigue, sleepiness (somnolence), and dizziness among the most commonly observed side effects. ^[5] In pooled assessments of tramadol for chronic pain, the most frequent adverse events included nausea, dizziness, constipation, vomiting, and somnolence; fatigue is typically reported within the nervous-system category alongside drowsiness and weakness. ^[5] Official labeling describes fatigue and somnolence as expected adverse reactions for tramadol, similar to other opioid analgesics. ^{[6] [2]}

Who is more likely to feel fatigued?

• New starters or dose increases: Side effects often occur during initial treatment and can be dose dependent. ^[5]
• Older adults or those with other sedating medicines: Combining tramadol with other central nervous system depressants (like benzodiazepines, sleep aids, or alcohol) can intensify drowsiness and fatigue. ^[7]
• People who stand up quickly: Tramadol can cause dizziness and fainting when rising from lying or sitting; getting up slowly can help. ^[3]

Safety tips to manage fatigue

• Take the lowest effective dose and avoid other sedatives when possible. ^[7]
• Rise slowly from bed or a chair to reduce lightheadedness. ^[3]
• Do not drive or operate machinery until you know how tramadol affects your alertness. ^[3]
• If fatigue is persistent, severe, or accompanied by symptoms like nausea, loss of appetite, or vomiting, speak with a clinician to check for rare complications (such as adrenal or sodium-related issues). ^{[8] [9]}

When to seek medical advice

• Ongoing or worsening fatigue that does not improve after a few days. ^[5]
• Fatigue with confusion, severe drowsiness, or poor coordination, which may increase injury risk. ^[3]
• Fatigue with additional symptoms such as rash, nausea, vomiting, loss of appetite, or unusual weakness, which can signal other medical issues. ^[8]

---

Quick reference: tramadol and fatigue

• Fatigue is a recognized side effect of tramadol and relates to its sedative (drowsiness/somnolence) effects. ^{[1] [2]}
• Common central nervous system side effects with tramadol include somnolence, dizziness, headache, and weakness; fatigue is often grouped within these. ^[5]
• Side effects are usually more frequent early in treatment and may lessen over time. ^[5]
• Use caution with activities requiring alertness until you understand your individual response. ^[3]