Ultram

Generic Name: tramadol (TRAM a dol)
Brand names: Rybix ODT, Ryzolt, Ultram

What is Ultram?

Ultram (tramadol) is a narcotic-like pain reliever.

Ultram is used to treat moderate to severe pain. Ultram extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock.

Ultram may also be used for other purposes not listed in this medication guide.

Important information about Ultram

You should not take Ultram if you have ever been addicted to drugs or alcohol.

Seizures (convulsions) have occurred in some people taking Ultram. You may be more likely to have a seizure while taking Ultram if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, or medicine for nausea and vomiting.

Seek emergency medical attention if you think you have used too much Ultram. A tramadol overdose can be fatal. Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma. Ultram may be habit-forming.

Tell your doctor if you feel that Ultram is not working as well in relieving your pain. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep Ultram in a place where others cannot get to it.

Ultram may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop using Ultram suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Do not crush the Ultram tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using Ultram by inhalation or injection can cause life-threatening side effects, overdose, or death.

Before taking Ultram

You should not take Ultram if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, if you have ever attempted suicide, if you are currently intoxicated (drunk), or if you have recently used any of the following drugs:

• alcohol;

• narcotic pain medicine;

• sedatives or tranquilizers (such as Valium);

• medicine for depression or anxiety;

• medicine for mental illness (such as bipolar disorder, schizophrenia); or

• street drugs.

Seizures have occurred in some people taking Ultram. Your risk of a seizure may be higher if you have any of these conditions:

• a history of drug or alcohol addiction;

• a history of epilepsy or other seizure disorder;

• a history of head injury;

• a metabolic disorder; or

• if you are also taking an antidepressant, muscle relaxer, or medicine for nausea and vomiting.

Talk with your doctor about your individual risk of having a seizure while taking Ultram.

If you have any of these other conditions, your doctor may need to adjust your Ultram dose or order special tests:

• kidney disease (or if you are on dialysis);

• cirrhosis or other liver disease;

• a stomach disorder; or

• a history of depression, mental illness, or thoughts of suicide.

FDA pregnancy category C. It is not known whether Ultram will harm an unborn baby. Ultram may cause serious or fatal side effects in a newborn if the mother uses the medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant while using Ultram. Tramadol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give Ultram to anyone younger than 18 years old without the advice of a doctor.

See also: Pregnancy and breastfeeding warnings in more detail

How should I take Ultram?

Take Ultram exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Do not take more than 300 milligrams of tramadol in one day.

Take this medicine with a full glass of water.

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

Do not crush the Ultram tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death. Do not crush, chew, break, or open a controlled-release, delayed-release, or extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

If you use the Ultram 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.

Ultram may be habit-forming. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor. Do not stop using Ultram suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Store Ultram at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle. Ultram is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An Ultram overdose can be fatal.

Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.

What should I avoid while taking Ultram?

Do not drink alcohol while you are taking Ultram. Alcohol may cause a dangerous decrease in your breathing when used together with tramadol. Ultram may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Ultram side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Ultram: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Ultram and call your doctor at once if you have any of these serious side effects:

• agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;

• seizure (convulsions);

• a red, blistering, peeling skin rash; or

• shallow breathing, weak pulse.

Less serious Ultram side effects may include:

• dizziness, drowsiness, weakness;

• nausea, vomiting, constipation, loss of appetite;

• blurred vision;

• flushing (redness, warmth, or tingly feeling); or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Ultram side effects (in more detail)

What other drugs will affect Ultram?

You may be more likely to have a seizure (convulsions) if you take Ultram while you are using certain other medicines. Do not take Ultram without telling your doctor if you also use any of the following medications:

• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or

• an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).

Cold or allergy medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by Ultram. Tell your doctor if you regularly use any of these medicines, or any other pain medication.

Tell your doctor about all other medicines you use, especially:

• carbamazepine (Tegretol);

• warfarin (Coumadin);

• digoxin (Lanoxin, Lanoxicaps);

• ketoconazole (Extina, Ketozole, Nizoral, Xolegel);

• erythromycin (E-Mycin, E.E.S., Ery-Tab);

• migraine headache medicine such as sumatriptan (Imitrex, Treximet);

• rifampin (Rifadin, Rimactane, Rifater);

• St. John's wort;

• quinidine (Quin-G); or

• drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety).

This list is not complete and other drugs may interact with Ultram. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Ultram.

• Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2010 Cerner Multum, Inc. Version: 12.01. Revision Date: 06/17/2010 6:10:15 PM.