Generic Name: acetaminophen and tramadol (a SEET a MIN o fen and TRAM a dol)
Brand Names: Ultracet
Medically reviewed by P. Thornton, DipPharm. Last updated on Dec 11, 2018.
What is Ultracet?
Ultracet contains a combination of tramadol and acetaminophen. Tramadol is an pain medicine similar to an opioid (sometimes called, a narcotic). 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.
MISUSE OF ULTRACET 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.
Do not give Ultracet to anyone younger than 12 years old, or 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 this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before taking this medicine
severe asthma or breathing problems;
a blockage in your stomach or intestines; or
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 tramadol. Your risk of a seizure may be higher if you have ever had:
a metabolic disorder;
if you have recently used sedatives, tranquilizers, or narcotic medications.
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.
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 the directions on your prescription label and read all medication guides. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to take more of this medicine.
Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine in a place where others cannot get to it. Selling or giving away this medicine is against the law.
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.
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 Ultracet at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it 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.
Ultracet dosing information
Usual Adult Dose of Ultracet for Pain:
Usual dose: 2 tablets orally every 4 to 6 hours as needed for pain
Maximum dose: 8 tablets per day
Maximum duration: 5 days
-Each tablet contains Tramadol 37.5 mg and Acetaminophen 325 mg. Maximum daily doses are Tramadol: 300 mg per day and Acetaminophen 2600 mg per day.
-Use of more than 1 product at time containing acetaminophen is not recommended.
-Due to the risks of addiction, abuse, and misuse, this drug is reserved for patients who have not been or are not expected to tolerate non-opioid pain medications or who have not obtained or are not expected to obtain analgesia with other pain management treatments.
Use: For the short-term (use should be limited to 5 days or less) management of acute pain, severe enough to require an opioid analgesic and for whom alternative treatments are inadequate.
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's almost time for your next 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.
Avoid driving or operating machinery until you know how Ultracet 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.
This medicine can slow or stop your breathing, and death may occur. 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 this medicine 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;
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:
stomach pain, nausea, loss of appetite;
diarrhea, constipation; or
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.
What other drugs will affect Ultracet?
You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.
Acetaminophen and tramadol can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:
cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic ("water pill");
medicines for motion sickness, irritable bowel syndrome, or overactive bladder;
other narcotic medications - opioid pain medicine or prescription cough medicine;
drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or
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 here.
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.
Copyright 1996-2019 Cerner Multum, Inc. Version: 11.02.
More about Ultracet (acetaminophen / tramadol)
- Side Effects
- During Pregnancy
- Dosage Information
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- Drug class: narcotic analgesic combinations
- FDA Alerts (4)