Is Tramadol Safe in Pregnancy

Status

avoid Last reviewed: 2026-05-16 · Confidence: high

Reason

Pregnancy use is not usually recommended; FDA warns against breastfeeding use and neonatal withdrawal can occur.

Drug Information

Brand Name
Ultram
Generic Name
tramadol
Drug Class
opioid pain reliever
FDA Category
C
Rx Status
prescription

Safe Amount

Dosage must be determined by your provider based on individual risk/benefit.

Effects

Pregnancy
Tramadol crosses the placenta. Limited safety data in pregnancy. Late use can lead to newborn withdrawal.
Mother
May cause opioid side effects, dependence, and withdrawal if stopped suddenly after regular use. Use only with provider guidance.
Baby
Can cause neonatal opioid withdrawal after prolonged use in pregnancy; late-pregnancy use may affect the newborn. FDA also warns of serious breathing problems in breastfed infants.

Trimester Notes

1st Trimester
Limited human safety data. Use only if the provider decides benefit outweighs risk.
2nd Trimester
Limited safety data. Ongoing use should be reviewed by the prescriber.
3rd Trimester
Most concern near delivery. Prolonged use can cause neonatal opioid withdrawal. Use before or during labor only if benefits outweigh risks.

Risk-Benefit Note

If pain is severe, a prescriber may decide tramadol is needed, but the dose and duration should be reviewed carefully in pregnancy.

Conditions & Warnings

  • Consult OB/GYN or prescriber
  • Do not stop or continue without provider review
  • Higher concern near delivery
  • Breastfeeding is not recommended during treatment
  • If used for pain, provider should choose the lowest effective dose for the shortest time

Alternatives

  • Acetaminophen if your OB/GYN says it is appropriate
  • Non-medicine measures such as rest, ice, heat, or physical therapy if advised by your clinician

References

Black Box Warning: None specific to pregnancy; tramadol has opioid risks including misuse, addiction, and respiratory depression.
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