Ultram

Pronunciation: TRAM-a-dol
Generic Name: Tramadol
Brand Name: Ultram

Ultram is used for:

Treating moderate to moderately severe pain.

Ultram is an analgesic. It works in certain areas of the brain and nervous system to decrease pain.

Do NOT use Ultram if:

• you are allergic to any ingredient in Ultram


• you have had a severe allergic reaction (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue) to codeine or another opioid (eg, morphine)


• you have severe or persistent diarrhea caused by antibiotic use


• you have suicidal thoughts or actions, or have a history of alcohol or other substance abuse


• you are intoxicated with alcohol, opioids or narcotics (eg, codeine, morphine), or sedatives or sleeping medicines (eg, temazepam, zolpidem)


• you are taking carbamazepine, nefazodone, sodium oxybate (GHB), a thioxanthene (eg, thiothixene), or another product that contains tramadol

Contact your doctor or health care provider right away if any of these apply to you.

Before using Ultram:

Some medical conditions may interact with Ultram. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription (especially depression medicines) or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have liver, kidney, or thyroid problems; a blockage in the bladder; diabetes; heart problems (eg, cor pulmonale); high blood pressure; pancreas problems; prostate problems; or metabolism problems


• if you have or recently have had any head injury, brain injury or tumor, increased pressure in the brain, or infection of the brain or nervous system


• if you have a history of a recent stomach or bowel surgery, or any other stomach or bowel problems (eg, pain, inflammation, ulcers)


• if you have a history of lung or breathing problems (eg, asthma, chronic obstructive pulmonary disease [COPD]) or seizures (eg, epilepsy)


• if you drink alcohol; are going through withdrawal from alcohol or other substances; or have a history of alcohol or other substance abuse, mood or mental problems (eg, depression), or suicidal thoughts or actions

Some MEDICINES MAY INTERACT with Ultram. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Alpha-2 receptor blockers (eg, yohimbine), azole antifungals (eg, ketoconazole), linezolid, lithium, macrolide antibiotics (eg, erythromycin), monoamine oxidase inhibitors (MAOIs) (eg, phenelzine, selegiline), nefazodone, quinidine, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, paroxetine), serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine), St. John's wort, tricyclic antidepressants (eg, amitriptyline), or "triptans" (eg, sumatriptan) because the risk of seizures or serotonin syndrome may be increased


• Anorexiants (eg, phentermine), butyrophenones (eg, haloperidol), cyclobenzaprine, furazolidone, loxapine, certain medicines for mental or mood disorders (eg, olanzapine), molindone, opioid pain medicines (eg, codeine, hydrocodone), phenothiazines (eg, promethazine), sleeping medicines (eg, zolpidem), sodium oxybate (GHB), thioxanthenes (eg, thiothixene), or tiagabine because the risk of side effects, including excessive drowsiness, trouble breathing, liver problems, or seizures, may be increased


• Carbamazepine because it may decrease Ultram's effectiveness; the risk of seizures may also be increased


• Other products containing tramadol because they may increase the risk of Ultram's side effects


• Rifampin because it may decrease Ultram's effectiveness


• Anticoagulants (eg, warfarin) or digoxin because the risk of their side effects may be increased by Ultram

This may not be a complete list of all interactions that may occur. Ask your health care provider if Ultram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Ultram:

Use Ultram as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Ultram by mouth with or without food.


• If you miss a dose of Ultram and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Ultram.

Important safety information:

• Ultram may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Ultram with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Do not drink alcohol while you are using Ultram.


• Check with your doctor before you or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers, narcotic pain medicines) while you are using Ultram; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Ultram may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of this effect.


• Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.


• Ultram may increase your risk of seizures. Your risk may be greater if you also have certain medical conditions, use certain medicines, or if you use a lot of alcohol. Talk to your doctor to see if you may have a greater risk of seizures while taking Ultram.


• Tell your doctor or dentist that you take Ultram before you receive any medical or dental care, emergency care, or surgery.


• Serotonin syndrome is a possibly fatal syndrome that can be caused by Ultram. Your risk may be greater if you take Ultram with certain other medicines (eg, "triptans," MAOIs, antidepressants). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.


• Use Ultram with caution in the ELDERLY; they may be more sensitive to its effects, especially constipation, weakness or tiredness, severe light-headedness, and indigestion.


• Ultram should not be used in CHILDREN younger than 16 years; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Ultram has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Ultram while you are pregnant. Ultram is found in breast milk. Do not breast-feed while taking Ultram.

When used for long periods of time or at high doses, Ultram may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Ultram stops working well. Do not take more than prescribed.

Some people who use Ultram for a long time without a break may develop a physical need to continue taking it. This is known as physical DEPENDENCE.

If you suddenly stop taking Ultram, you may experience WITHDRAWAL symptoms, including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of Ultram:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; increased sweating; indigestion; mild itching; nausea; trouble sleeping; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); agitation; chest pain; confusion; difficult or painful urination; disorientation; excessive sweating; fainting; fast or irregular heartbeat; fever; hallucinations; loss of coordination; mood or mental changes (eg, depression); red, blistered, swollen, or peeling skin; seizures; severe dizziness or light-headedness; severe nausea, vomiting, or diarrhea; severe or persistent headache; slow or shallow breathing; suicidal thoughts or behaviors; tremor; vision problems.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Ultram side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center ( http://www.aapcc.org), or emergency room immediately. Symptoms may include bluish skin; cold, clammy skin; difficult, shallow, or slow breathing; drowsiness leading to unresponsiveness or coma; excessive sweating; limp muscles; pinpoint pupils; seizures; slow or irregular heartbeat.

Proper storage of Ultram:

Store Ultram at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Ultram out of the reach of children and away from pets.

General information:

• If you have any questions about Ultram, please talk with your doctor, pharmacist, or other health care provider.


• Ultram is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Ultram. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Ultram resources

• Ultram Side Effects (in more detail)
• Ultram Dosage
• Ultram Use in Pregnancy & Breastfeeding
• Drug Images
• Ultram Drug Interactions
• Ultram Support Group
• 145 Reviews for Ultram - Add your own review/rating

• Ultram Monograph (AHFS DI)


• Ultram Advanced Consumer (Micromedex) - Includes Dosage Information


• Ultram Consumer Overview


• Ultram Prescribing Information (FDA)


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• Ryzolt Consumer Overview


• Ryzolt Prescribing Information (FDA)


• Ultram ER Prescribing Information (FDA)

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