Generic Name: Ultram Brand Name(s): Generics only. No brands available.

Uses

What is Ultram® (tramadol) used for?

Ultram® is a narcotic-like pain reliever.

Ultram® is used to treat moderate to severe pain.

The extended-release form of tramadol (Ultram® ER) is for around-the-clock treatment of pain.

Ultram® ER is not for use on an as-needed basis for pain.

How should I take Ultram® (tramadol)?

Take Ultram® exactly as prescribed. Follow all directions on your prescription label. Tramadol can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take Ultram® in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Tramadol may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Misuse of pain medication can cause addiction, overdose, or death, especially in a child or other person using the medicine without a prescription. Selling or giving away Ultram® is against the law.

Stop taking all other around-the-clock narcotic pain medications when you start taking Ultram®.

Ultram® can be taken with or without food, but take it the same way each time.

Do not crush, break, or open an extended-release tablet. Swallow the tablet whole to avoid exposure to a potentially fatal dose.

Never crush or break Ultram® tablet to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death.

If you use the extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Do not stop using this medicine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

How do I store Ultram® (tramadol)?

Ultram® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Ultram® in the bathroom or the freezer. There may be different brands of Ultram® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Ultram® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Ultram® (tramadol)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Ultram® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should not take Ultram® if you have:

  • Severe asthma or breathing problems
  • A blockage in your stomach or intestines
  • Recently used alcohol, sedatives, tranquilizers, or narcotic medications
  • Used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine)

Ultram® should not be given to a child younger than 12 years old. Ultram® ER should not be given to anyone younger than 18 years old.

Do not give tramadol to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.

Seizures have occurred in some people taking Ultram®. Talk with your doctor about your seizure risk, which may be higher if you have ever had:

  • A head injury, epilepsy or other seizure disorder
  • Drug or alcohol addiction
  • A metabolic disorder
  • Use certain antibiotics, antifungal medications, heart or blood pressure medications, or medicines to treat HIV or AIDS

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Ultram® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Ultram®. Ultram® is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Ultram® (tramadol)?

Get emergency medical help if you have signs of an allergic reaction to Ultram®: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Like other narcotic medicines, Ultram® can slow your breathing. Death may occur if breathing becomes too weak.

A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Call your doctor at once if you have:

  • Noisy breathing, sighing, shallow breathing
  • A slow heart rate or weak pulse
  • A light-headed feeling, like you might pass out
  • Seizure (convulsions)
  • Infertility, missed menstrual periods
  • Impotence, sexual problems, loss of interest in sex
  • Low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness
  • Severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Common side effects may include:

  • Headache, dizziness, drowsiness, tired feeling
  • Constipation, diarrhea, nausea, vomiting, stomach pain
  • Feeling nervous or anxious
  • Itching, sweating, flushing (warmth, redness, or tingly feeling)

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ultram® (tramadol)?

Ultram® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Other narcotic medications – opioid pain medicine or prescription cough medicine
  • Drugs that make you sleepy or slow your breathing – a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine
  • Drugs that affect serotonin levels in your body – medicine for depression, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting

Does food or alcohol interact with Ultram® (tramadol)?

Ultram® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ultram® (tramadol)?

Ultram® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • Liver or kidney disease
  • A stomach disorder
  • Mental illness, or suicide attempt
  • If you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others)

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Ultram® (tramadol).

What is the dose of Ultram® (tramadol) for an adult?

Usual Adult Dose for Pain:

Immediate-release: 50 to 100 mg orally every 4 to 6 hours as needed for pain.

Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain:

For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, tolerability can be improved by initiating slowly.

Immediate-Release (IR):

  • Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days to reach a dose of 50 mg four times a day.
  • Maintenance dose: After titration, 50 to 100 mg orally as needed for pain every 4 to 6 hours.
  • Maximum dose: 400 mg per day.

Extended-Release (ER):

  • Initial dose (tramadol-naive): 100 mg orally once a day.
  • Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions.
  • Maximum Dose: 300 mg orally per day.

Initial Dose for patients currently receiving IR tramadol: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day.

Initial Dose for those on Other Opioids: Discontinue all other around the clock opioid drugs; initiate with ER 100 mg orally once a day.

Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions.

Maximum Dose: 300 mg per day.

Usual Geriatric Dose for Pain:

Age: 75 years or older: Maximum dose: 300 mg per day.

Usual Geriatric Dose for Chronic Pain:

Age: 75 years or older: Maximum dose: 300 mg per day.

What is the dose of Ultram® (tramadol) for a child?

Usual Pediatric Dose for Pain:

17 years or older:

Immediate-release: 50 to 100 mg orally every 4 to 6 hours as needed for pain.

Maximum dose: 400 mg per day.

For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, tolerability can be improved by initiating slowly:

Immediate-Release:

  • Initial dose: 25 mg orally once daily; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days to reach a dose of 50 mg four times a day.
  • Maintenance dose: After titration, 50 to 100 mg orally as needed for pain every 4 to 6 hours.
  • Maximum dose: 400 mg per day.

How is Ultram® (tramadol) available?

Ultram® is available in the following dosage forms and strengths:

  • Tablet, coated: tramadol hydrochloride 50mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Ultram®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 2, 2017 | Last Modified: September 2, 2017

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