There have been reports that tramadol may damage the liver. People can reduce the risk of liver damage by avoiding taking tramadol alongside alcohol and certain other drugs.

The reports state that taking this medication in high doses over an extended period may cause liver damage. People should not take tramadol without consulting a doctor.

This article looks at how tramadol affects the liver and the other risks of this medication. It also lists the steps that people can take to protect their liver health.

Tramadol is a prescription drug that can relieve moderate to severe pain. Healthcare professionals use it to treat chronic pain or pain following surgery. Tramadol works by changing how the brain perceives and responds to painful stimuli.

Tramadol is a controlled substance, and a person may only use it under the close supervision of a doctor. This is because tramadol has the potential to cause addiction, and people can misuse it.

Share on Pinterest
FRED TANNEAU/AFP via Getty Images

There is some debate as to whether tramadol is harmful to the liver. Tramadol is generally safe to use, but in some cases — such as overdose or prolonged use — it may damage the liver.

A 2015 study found that there was a risk of increased liver and kidney damage due to the long-term use of tramadol. Other research has shown that taking tramadol with acetaminophen may cause complications, including acute liver failure.

Tramadol is a type of opioid. Researchers have found that opioids, in general, have an association with higher incidences of adverse effects in people with existing liver damage. Therefore, people with liver damage should not use opioids unless other options are unsuitable.

Tramadol is mostly safe and rarely causes liver damage. However, in some cases, the drug has contributed to health problems such as seizures, high blood pressure, and heart problems.

Learn more about the side effects of tramadol.

There are some ways in which a person can protect their liver from damage when using tramadol.

  • Dosage: Taking the lowest dose possible for the shortest period will reduce the risk of liver damage.
  • Alcohol: A person should avoid drinking alcohol while taking tramadol, as this can cause liver damage.
  • Other medications: There are many other medications that people should avoid combining with tramadol, including any that may cause drowsiness.

Opioid use has other associated risks.

Side effects

Whenever a person takes any medication, there is a risk of side effects. For people taking opioids, these include:

Addiction or misuse

People who take opioids for too long can develop an addiction to the drug. This means that they will start to experience a persistent urge to use the drug, despite any negative effects it may have.

Opioids also have the potential for misuse. Misuse happens if a person takes the drug to experience a high or does not follow the prescribed dosage.

It is also possible to develop a tolerance to the drug, meaning that a person needs more of it to feel its effects. This is why it is important for people to stop taking the drug before their tolerance increases.

Withdrawal symptoms

When a person stops taking opioids after taking them for a while, they might experience withdrawal symptoms, such as shaking and sweating.

Learn about the timeline for opioid withdrawal.


Taking a dosage of tramadol that is too high can result in an overdose. An overdose can cause respiratory depression, which is when a person’s breathing becomes dangerously slow and shallow. This can lead to death.

Learn how to recognize the signs of an opioid overdose and what to do.

Drug interactions

Tramadol is a drug that interacts with other medications and can cause fatal side effects if people do not take it properly. It is important to know what drugs are compatible with tramadol to avoid any complications.

A person should speak with a doctor about any current medications before they start taking tramadol.

Serotonin syndrome

Serotonin syndrome is a rare but potentially life threatening condition that occurs when the body produces too much serotonin, there is an interaction with another medication or substance, or both.

Serotonin syndrome can cause symptoms such as:

The liver is one of the most important organs in the body. It is responsible for transforming nutrients in food into substances that the body can use and for filtering toxins from the blood.

Many factors can affect the health of a person’s liver, such as genetics, diet, alcohol consumption, and lifestyle choices.

Liver health is important for the proper functioning of the whole body. There are many things that people can do to keep the liver healthy.

These include:

If the damage to the liver is not severe and doctors find it early, it can be reversible. However, if the damage is severe enough, it may be permanent.

Most of the time, taking tramadol will not cause liver damage. Additionally, because healthcare professionals regularly monitor people taking tramadol, they may notice any signs of liver damage early.

Blood tests can help healthcare professionals determine how well a person’s liver works. If the liver shows signs of damage, the doctor may lower the dosage of tramadol or prescribe an alternative medication.

Below are some frequently asked questions about tramadol and the liver.

Is tramadol hard on the liver and kidneys?

Long term use of tramadol may lead to liver and kidney damage. However, people can work with their doctor to monitor the effect of tramadol on their organs and ensure they do not overuse this medication.

Which painkiller is safe for the liver?

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be less likely to cause liver toxicity than painkillers containing acetaminophen painkillers, such as paracetamol (Tylenol, Panadol).

What organs does tramadol damage?

Overdose or extended use of tramadol may increase the risk of liver and kidney damage, heart problems, and other health conditions.

Tramadol can cause liver damage if a person does not take it according to the prescription.

People should always ensure that they take the proper dosage of tramadol and avoid taking other drugs that may interact with it.

A person should not take tramadol if they have any type of kidney or liver disease.