Tramadol is now banned in-competition.
Tramadol is a high-strength opioid painkiller that has been on the World Anti-Doping Agency (WADA) monitoring list for 10 years. The World Anti-Doping Agency (WADA) added tramadol to the Prohibited List in 2024.
Having tramadol in your system during the in-competition period puts you at risk of a ban from sport.
Additionally, using tramadol within 24 hours of the in-competition period puts you at risk of a positive in-competition test.
The in-competition period usually starts at 11.59pm the night before your competition. It usually ends once the competition and its doping control processes is complete. Your competition or International Federation may have a different definition, so always check their rules carefully.
What to remember
- Tramadol use is banned in-competition.
- If you need to use tramadol during the in-competition period, you may need a TUE in advance. Check your TUE status.
- Using tramadol within 24 hours of a competition can lead to a positive test.
- If prescribed tramadol, ask for an alternative medication that is permitted in sport.
- Keep detailed medical notes relating to tramadol use in case you need to apply for a TUE retroactively.
Download the Tramadol factsheet for medical professionals
Tricky situations explained
Using tramadol during the in-competition period
Using tramadol during the in-competition period will be banned from 1 January 2024.
If you’re prescribed tramadol for use in-competition, you may need an approved TUE before you use the substance.
Your TUE status determines whether you need a TUE before you take a medication (in-advance) or only if you test positive (retroactive). Whatever your status, take care to save detailed medical notes from your medical professional.
Using tramadol out-of-competition
It is within the rules to use tramadol out-of-competition.
However, taking tramadol close to a competition means there’s a risk that you could test positive during the in-competition period. WADA advise that it takes 24 hours for tramadol to leave your system. We encourage athletes not to use tramadol for a minimum of 24 hours before a competition.
If you used tramadol out-of-competition, and you test positive in-competition, you will have the opportunity to as prescribed. You will need detailed medical notes from your medical professional.
If a TUE is not approved retroactively, you may face an anti-doping sanction.
No TUEs for out-of-competition tramadol use.
We understand that the possibility of returning a positive test in-competition means that some athletes would like a TUE in advance for out-of-competition tramadol use. However, using tramadol out-of-competition does not break anti-doping rules so we cannot provide a TUE in advance.
Instead, keep detailed medical records in case you need to apply for a retroactive TUE.
Do I need a TUE for tramadol?
Supporting a TUE application
To support any TUE application, you will need clear and comprehensive medical notes showing:
- a diagnosed medical condition supported by relevant clinical notes;
- that tramadol use will not produce any additional enhancement of performance beyond what might be anticipated by a return to the athlete's normal state of health; and,
- why tramadol was used over other permitted painkillers; or,
- previous attempts to control the diagnosis with other permitted
See WADA’s Checklist for TUE applications