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When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour. Tramadol, sold under the brand name Ultram among others, is an opioid pain medication used to treat moderate to moderately severe pain. As a recreational drug, it is typically smoked, but may be taken by mouth, snorted, or injected. Includes side effects, dosage guidelines, interactions and warnings Commonly reported side effects of tramadol include: pruritus, agitation, anxiety, constipation, diarrhea, hallucination, nausea, tremor, vomiting, and diaphoresis. 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