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tramadol is widely sold under the brand name ultram. it is an opioid medication that is useful in the treatment of mild to severe pain conditions. when you take its oral immediate-release formulation, the pain relief generally begins within an hour. the medication is also available as an injection. you can also buy tramadol online in combination with acetaminophen or longer-acting formulations. like other typical opioids, common side effects of tramadol include itchiness, constipation, and nausea. some severe side effects include decreased alertness, seizures, drug addiction, and an increased risk of serotonin syndrome. your prescribing doctor may recommend a change in dosage if you have kidney or liver problems. the medication is not recommended for those who are at risk of suicide or ladies who are pregnant.