Tramadol

Date: May 2022, Version 2

What is it?

Tramadol is a painkiller used to treat moderate or severe pain and chronic (long-term) pain.

Benefits

What are the benefits of taking tramadol in pregnancy?

Tramadol is a reasonably strong painkiller and sometimes works where other painkillers have not.

Pregnant women who are taking tramadol should contact their midwife, GP or obstetrician as soon as possible. They will review whether tramadol is still needed and ensure that the dose is correct. Please do not stop taking tramadol or change the dose without speaking to a health care professional.

Risks

Are there any risks of taking tramadol during pregnancy?

Studies of pregnant women using tramadol do not, overall, suggest that it can cause miscarriage or birth defects in the baby.

Tramadol used around the time of delivery can affect the baby after birth. The baby may be ‘jittery’, have feeding problems, and initially need some help with breathing. These problems usually settle within the first few days.

Alternatives

Are there any alternatives to taking tramadol?

Possibly. Other medicines can be used to treat pain in pregnancy. However, if a doctor has offered tramadol this will be based on several factors, including which painkillers have already been tried, the likelihood of pain not being as well-controlled with another painkiller, and possible side effects if the medicine is changed. Women who have questions about a medicine that they are offered in pregnancy can speak to their doctor or midwife.

Chronic pain can sometimes be improved with talking therapies. However, this does not work for everyone and some people may need or prefer to take a medicine.

No treatment

What if I prefer not to take tramadol during pregnancy?

Severe and/or chronic pain can greatly affect quality of life. It can cause difficulty sleeping and mental health problems. Doctors may suggest taking tramadol in pregnancy if they think that the benefits of controlling the woman’s pain outweigh any possible risks to the baby.

Will I or my baby need any extra monitoring?

Women in the UK will be offered a very detailed scan at around 20 weeks of pregnancy as part of routine antenatal care. Taking tramadol in pregnancy is not expected to cause problems that would require any extra monitoring of the baby prior to birth.

Babies who were exposed to tramadol in the womb before delivery may be more closely monitored for a while after birth to ensure that they are breathing and feeding as normal.

Are there any risks to my baby if the father has taken tramadol?

We would not expect any increased risk to the baby if the father takes tramadol.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.