It may help improve mood and feelings of well-being, relieve anxiety and tension, help you sleep better, and increase your energy level. See also: duloxetine side effects in more detail. Tramadol may harm or cause death to other people who take your medication, especially children. Take tramadol exactly as directed. Usual Adult Dose for Pain. Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain. If you are taking the extended-release capsule, you may take it with or without food. Life-threatening respiratory depression and death have occurred in children who received tramadol [see Warnings and Precautions (5.4)]. It should not be taken with alcohol or other drugs unless directed by a healthcare provider. Look for an online pharmacy that requires a prescription from a licensed healthcare provider. Your doctor will probably decrease your dose gradually. Use with caution, particularly in patients >75 years of age. Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own.