Generic Name: tramadol (TRAM a dol)
Brand Name: ConZip, Ultram, Ultram ER
Medically reviewed by Philip Thornton, DipPharm. Last updated on Jan 14, 2021.
What is Ultram?
Ultram (tramadol) is a narcotic-like pain reliever.
Ultram is used to treat moderate to severe pain.
The extended-release form of this medicine is for around-the-clock treatment of pain. This form of Ultram is not for use on an as-needed basis for pain.
You should not take Ultram if you have severe breathing problems, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others).
Ultram can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
Taking tramadol during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Fatal side effects can occur if you use tramadol with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before taking this medicine
You should not take Ultram if you are allergic to tramadol, or if you have:
severe asthma or breathing problems;
a stomach or bowel obstruction (including paralytic ileus);
if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications; or
if you have 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, or anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids. Ultram ER should not be given to anyone younger than 18 years old.
Avoid giving this medicine to children between 12 to 18 years of age who have conditions that may cause breathing problems.
Seizures have occurred in some people taking tramadol. 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; or
if you also use certain antibiotics, antifungal medications, heart or blood pressure medications, or medicines to treat HIV or AIDS.
If you use Ultram while you are pregnant, your baby could become dependent on the drug. 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 or plan to become pregnant.
Do not breastfeed while taking tramadol. This medicine can pass into breast milk and cause drowsiness, breathing problems, or death in a nursing baby.
To make sure this medicine is safe for you, tell your doctor if you have ever had:
breathing problems, sleep apnea;
liver or kidney disease;
problems with your gallbladder, pancreas, or thyroid;
a stomach disorder; or
mental illness, or suicide attempt.
How should I take Ultram?
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 this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Ultram 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 this medicine is against the law.
Stop taking all other around-the-clock narcotic pain medications when you start taking this medicine.
Ultram can be taken with or without food, but take it the same way each time.
Do not crush, break, or open an Ultram ER extended-release tablet. Swallow the tablet whole to avoid exposure to a potentially fatal dose.
Never crush or break a 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 Ultram ER 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.
Store at room temperature away from moisture and heat. Keep track of your medicine. Tramadol 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, mix the leftover medicine with cat litter or coffee grounds in a sealed plastic bag and throw the bag in the trash.
What happens if I miss a dose?
Since Ultram 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 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. A tramadol overdose can be fatal, especially in a child or other person using Ultram without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.
Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.
Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.
What should I avoid while taking Ultram?
Do not drink alcohol. Dangerous side effects or death could occur.
Rramadol may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Ultram side effects
Get emergency medical help if you have signs of an allergic reaction to Ultram (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin 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.
Tramadol can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or 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, breathing that stops during sleep;
a slow heart rate or weak pulse;
a light-headed feeling, like you might pass out;
missed menstrual periods;
impotence, sexual problems, loss of interest in sex; 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.
Common Ultram side effects may include:
constipation, nausea, vomiting, stomach pain;
dizziness, drowsiness, tiredness;
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 Ultram?
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.
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;
a sedative like Valium - diazepam, alprazolam, lorazepam, Xanax, Klonopin, Versed, and others;
drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or
drugs that affect serotonin levels in your body - a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.
This list is not complete. Other drugs may interact with tramadol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Ultram only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2021 Cerner Multum, Inc. Version: 21.01.
Tramadol generally starts to relieve pain within an hour in its fast-acting forms, which are used for short-term pain management. With slow-release or extended-release (ER) forms, the drug may take longer to start because it’s gradually released over 12 or 24 hours, but pain relief lasts longer. Continue reading
Symptoms of tramadol withdrawal can start 8-24 hours after the last dose. Untreated, withdrawal symptoms usually last for 4-10 days. Tramadol withdrawal is caused by stopping the drug suddenly. Continue reading
Tramadol has been linked to both high blood pressure and low blood pressure. But, neither adverse reaction is common when the medicine is taken as directed. Continue reading
No, Tramadol is not an anti-inflammatory drug or muscle relaxer. Because it’s not an anti-inflammatory drug, it likely won’t reduce any swelling you have when taken alone. Continue reading
Sleepiness is a common side effect of tramadol. Tramadol can also make you dizzy or lightheaded. Do not drive, operate heavy machinery, or participate in dangerous activities until you know how this drug affects you. Do not drink alcohol or take other CNS depressants with tramadol. Continue reading
Tramadol can have many serious (bad) side effects, including addiction, slowed or stopped breathing, overdose, and death. Talk to your doctor about tramadol before you start taking it to understand all of the possible serious side effects. Continue reading
Tramadol can cause constipation in 9% to 46% of patients. Stomach side effects in general are common with tramadol. Constipation is a well-known side effect of opioid pain treatment, and it should be addressed quickly to prevent further complications. Continue reading
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