Tramadol is the generic version of the brand medication Ultram and is sold in 50-mg white, scored caplets. It is packaged in 30-, 60- or 90-pill bottles. How long a bottle lasts will depend on the dosage being taken.

How to Find the Right Dose

With pain medication, it’s always a good idea to consult with a doctor before deciding on a dose. It can be risky to take too much Tramadol, as doing so can lead to physical and psychological dependence. For people who have chronic pain and want to work up to the most effective Tramadol dose, doctors recommend the following schedule:

Start with 25 mg per day for 2 days.
If the starting dose does not provide enough pain relief, on the third day, increase to 25 mg twice a day, for 2 more days (total of 50 mg per day).
If 25 mg twice a day is not relieving the pain, after 2 more days, increase to 25 mg three times a day for 2 more days (total of 75 mg per day).
If 25 mg three times a day does not relieve pain, after 2 more days, increase to 25 mg four times a day (total of 100 mg per day).
If the 100-mg per-day dose is not causing side effects, then the total daily dose may be increased every 3 days after that by 50 mg. Watch for side effects and don’t go past 200 mg/day (i.e., 50 mg, four times a day).
After this maximum dose has been reached and tolerated, it should be safe to take Tramadol doses of 50- to 100-mg, as needed for pain relief, every 4 to 6 hours. Never take more than 400 mg/day.

This dosing process is complex and can take a few weeks to work through. But it’s a good idea to follow it closely since Tramadol does carry some risks of addiction as well as some bothersome side effects. For these reasons, it’s a good idea to take only as much Tramadol as is really needed to relieve pain, while watching closely for developing side effects. Individuals taking the smallest effective dose will be less likely to experience side effects.

Some patients may need to move up to a higher dosage more quickly. If the doctor decides that the benefits of a higher dose outweigh the risks, then 50 to 100 mg of Tramadol can be taken as needed from the start for pain relief every four to six hours. Again, the total dosage should never exceed more than 400 mg per day.

Tips on Managing Pain

Chronic pain can be very tough to treat, even with the best pain medication. It is often hard to pinpoint what causes pain and people react to pain and pain medication in different ways. One of the best steps to take when attempting to manage pain is to talk with a doctor.
Here are some things to think about before speaking with the doctor: Where do you feel pain? Does the location ever change?
What time of day do you feel pain? Is there any kind of pattern to your pain?
How would you describe your pain (for example, tingling, burning, numbing, dull or throbbing)?
How severe is your pain? Try to rate it on a scale of 1 to 10 (10 being extreme).
Do certain activities cause you to feel pain?
Does your pain keep you from doing your daily activities?
Is there anything you do that relieves your pain (such as deep breathing exercises)?

Discuss the answers to these questions with a doctor and work toward the right pain management solutions together.