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Ultracet

Generic Name: acetaminophen and tramadol (a SEET a MIN o fen and TRAM a dol)
Brand Names: Ultracet

Medically reviewed on April 3, 2018

What is Ultracet?

Ultracet contains a combination of tramadol and acetaminophen. Tramadol is an synthetic opioid pain medicine. Acetaminophen is a less potent pain reliever that increases the effects of tramadol.

Ultracet is used to treat moderate to severe pain.

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

Important Information

Do not take more Ultracet than your recommended dose. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

You should not use Ultracet if you have severe breathing problems, a blockage in your stomach or intestines, or if you have recently used an MAO inhibitor.

Ultracet is not for use in children younger than 12 years old, and is not for use in anyone under 18 who recently had surgery to remove the tonsils or adenoids.

Taking Ultracet during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use Ultracet with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Before taking this medicine

You should not use Ultracet if you are allergic to acetaminophen (Tylenol) or tramadol (Ultram), or if you have:

Ultracet is not approved for use by anyone younger than 12 years old.

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

Seizures have occurred in some people taking this medicine. Your risk of a seizure may be higher if you have ever had:

To make sure Ultracet is safe for you, tell your doctor if you have ever had:

  • liver disease, or if you drink alcohol;

  • kidney disease, urination problems;

  • problems with your pancreas, gallbladder, or thyroid; or

  • depression, mental illness, or a suicide attempt.

If you use Ultracet while you are pregnant, your baby could become dependent on tramadol. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant.

Do not breast-feed. Acetaminophen and tramadol can pass into breast milk and cause drowsiness, breathing problems, or death in a nursing baby.

How should I take Ultracet?

Take Ultracet exactly as prescribed by your doctor. Follow all directions on your prescription label. Never take this medicine in larger amounts, or for longer than prescribed. An overdose can damage your liver or cause death. Tell your doctor if you feel an increased urge to take more of this medicine.

The maximum amount of Ultracet is 2 tablets per dose, or 8 tablets per day. Do not take this medicine for longer than 5 days in a row.

Ultracet may be habit forming, even at regular doses. Never share it with another person. MISUSE OF NARCOTIC 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 this medicine is against the law.

You may take Ultracet with or without food, but take it the same way each time.

You should not stop using this medicine suddenly after long-term use. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat. Keep track of your medicine. Ultracet is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Since Ultracet is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of this medicine can be fatal, especially in a child or another person using the medicine without a prescription. Overdose can cause severe muscle weakness, pinpoint pupils, very slow breathing, extreme drowsiness, or coma.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

What should I avoid while taking Ultracet?

Do not drink alcohol. Dangerous side effects or death could occur.

See also: Ultracet and alcohol (in more detail)

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Ask a doctor or pharmacist before using any other medicine that may contain acetaminophen (sometimes abbreviated as APAP). Taking certain medications together can lead to a fatal overdose.

Ultracet side effects

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

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Like other narcotic medicines, tramadol 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.

Stop using Ultracet and 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);

  • chest pain;

  • liver problems - upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes); or

  • low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

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 Ultracet side effects may include:

  • dizziness, drowsiness;

  • stomach pain, nausea, loss of appetite;

  • diarrhea, constipation; or

  • sweating.

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: Side effects (in more detail)

What other drugs will affect Ultracet?

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • other narcotic medications - opioid pain medicine or prescription cough medicine;

  • a sedative like Valium - diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others;

  • other drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, tranquilizer, antidepressant, or antipsychotic medicine; or

  • drugs that affect serotonin levels in your body - medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with acetaminophen and tramadol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Ultracet only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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