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ULTRAM
ULTRAM ONLINE
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine
must be weighed against the good it will do. This is a decision
you and your doctor will make. For tramadol, the following should
be considered:
Allergies—Tell your doctor if you have ever
had any unusual or allergic reaction to tramadol or narcotic
analgesics. Also tell your health care professional if you are
allergic to any other substances, such as foods, preservatives, or
dyes.
Pregnancy—Although studies on birth defects
have not been done in pregnant women, tramadol has not been
reported to cause birth defects. In animal studies, there were
drug-related birth defects observed. Studies done in animals given
very high (toxic) doses resulted in lower than normal birth
weights and some deaths in the fetuses and birth defects in some
of the newborns.
Breast-feeding—Tramadol passes into breast
milk and may cause unwanted effects in nursing babies. It may be
necessary for you to take another medicine or to stop
breast-feeding during treatment. Be sure you have discussed the
risks and benefits of the medicine with your doctor.
Children—There is no specific information on
the relationship of age to the effects of tramadol in patients
less than 16 years of age.
Older adults—Studies in older adults show
that tramadol stays in the body a little longer than it does in
younger adults. Your doctor will consider this when deciding on
your doses.
Other medicines—Although certain medicines
should not be used together at all, in other cases two different
medicines may be used together even if an interaction might occur.
In these cases, your doctor may want to change the dose, or other
precautions may be necessary. When you are taking tramadol, it is
especially important that your health care provider know if you
are taking any of the following:
 | Carbamazepine (e.g., Tegretol)—May decrease the effects of
tramadol by decreasing the amount of medicine in the body |
| Central nervous system (CNS) depressants (medicines that
cause drowsiness)—Using these medicines with tramadol may
increase the chance of serious side effects or increase the
risk of convulsions (seizures) |
| Monoamine oxidase (MAO) inhibitor activity (isocarboxazid
[e.g., Marplan], phenelzine [e.g., Nardil], procarbazine
[e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine
[e.g., Parnate])—The chance of convulsions (seizures) may be
increased |
Proper Use of This Medicine
If you think that this medicine is not working as well after
you have been taking it for a few weeks, do not increase the
dose. Instead, check with your medical doctor or dentist.
Dosing—
The dose of tramadol will be different for different patients. Follow
your doctor's orders or the directions on the label. The
following information includes only the average doses of tramadol.
If your dose is different, do not change it unless your
doctor tells you to do so.
The number of doses you take each day, the time allowed
between doses, and the length of time you take the medicine depend
on the medical problem for which you are taking tramadol.
Take this medicine only as directed. Do not take more of it, do
not take it more often, and do not take it for a longer time than
your doctor ordered. Using too much of this medicine increases the
chance of unwanted effects.
| For pain:
| For oral dosage form (tablets):
| Adults—One-half to two 50-milligram (mg) tablets
every four to six hours as needed, no more than 8
tablets in a dayYour healthcare professional may want
you to break the tablets in half for the first dose
and increase your dose by half-tablets, up to a
maximum of 2 full tablets per dose. By starting at a
lower dose and slowly increasing the amount of
medicine you take, this will help you get used to the
medicine gradually.Your healthcare professional may
want you to take 2 tablets for the first dose if you
are having severe pain. This helps the medicine start
working a little faster.
| Children up to 16 years of age—Use and dose must
be determined by your doctor. |
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Missed dose—
If your medical doctor or dentist has directed you to take this
medicine according to a regular schedule and you miss a dose of
this medicine, take it as soon as possible. However, if it is
almost time for your next dose, skip the missed dose and go back
to your regular dosing schedule. Do not double doses.
Storage—
To store this medicine:
| Keep out of the reach of children.
| Store away from heat and direct light.
| Do not store tramadol tablets in the bathroom, near the
kitchen sink, or in other damp places. Heat or moisture may
cause the medicine to break down.
| Do not keep outdated medicine or medicine no longer needed.
Be sure that any discarded medicine is out of the reach of
children. |
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Precautions While Using This Medicine
This medicine will add to the effects of alcohol and other CNS
depressants (medicine that causes drowsiness). Some examples of
CNS depressants are antihistamines or medicine for hay fever,
other allergies, or colds; sedatives, tranquilizers, or sleeping
medicine; prescription pain medicine or narcotics; barbiturates;
medicine for seizures; muscle relaxants; or anesthetics, including
some dental anesthetics. Do not drink alcoholic beverages, and
check with your medical doctor or dentist before taking any of the
medicines listed above while you are using this medicine.
This medicine may cause some people to become drowsy, dizzy, or
lightheaded. Make sure you know how you react to this medicine
before you drive, use machines, or do anything else that could be
dangerous if you are dizzy or are not alert.
Dizziness, lightheadedness, or fainting may occur,
especially when you get up suddenly from a lying or sitting
position. Getting up slowly may help lessen this problem.
Nausea or vomiting may occur, especially after the first couple
of doses. This effect may go away if you lie down for awhile.
However, if nausea or vomiting continues, check with your medical
doctor or dentist. Lying down for a while may also help relieve
some other side effects, such as dizziness or lightheadedness,
that may occur.
Before having any kind of surgery (including dental surgery) or
emergency treatment, tell the medical doctor or dentist in charge
that you are taking this medicine. Taking tramadol together with
medicines that are used during surgery or dental or emergency
treatments may cause increased side effects.
If you think you or someone else may have taken an overdose
of tramadol, get emergency help at once. Signs of an overdose
include convulsions (seizures) and pinpoint pupils of the eyes.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some
unwanted effects. Although not all of these side effects may
occur, if they do occur they may need medical attention.
Get emergency help immediately if any of the following
symptoms of overdose occur:
| Convulsions (seizures); difficulty in breathing;
pinpointed pupils of the eyes |
Also, check with your doctor as soon as possible if any of the
following side effects occur:
| Less common or rare
| Blisters under the skin; blurred vision ;
change in walking and balance; convulsions
(seizures); difficult urination; dizziness or
lightheadedness when getting up from a lying or sitting
position; fainting; fast heartbeat;
frequent urge to urinate; loss of memory;
numbness, tingling, pain, or weakness in hands or feet;
seeing, hearing, or feeling things that are not there;
severe redness, swelling, and itching of the skin;
shortness of breath ; trembling and shaking of hands
or feet; trouble performing routine tasks |
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Other side effects may occur that usually do not need medical
attention. These side effects may go away during treatment as your
body adjusts to the medicine. However, check with your doctor if
any of the following side effects continue or are bothersome:
| More common
| Abdominal or stomach pain; agitation ;
anxiety; constipation ; diarrhea;
dizziness; drowsiness; dry mouth;
headache; heartburn; itching of the skin;
loss of appetite; loss of strength or weakness;
nausea ; nervousness; skin rash ;
sweating; unusual feeling of excitement;
vomiting |
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| Less common
| Confusion; depression; excessive gas;
flushing or redness of the skin; general feeling of
bodily discomfort; hot flashes; trouble in
sleeping |
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After you stop using this medicine, your body may need time to
adjust. The length of time this takes depends on the amount of
medicine you were using and how long you used it. During this
period of time check with your doctor if you notice any of the
following side effects:
| Anxiety; body aches; diarrhea; fast
heartbeat; fever, runny nose, or sneezing;
gooseflesh; high blood pressure; increased
sweating ; increased yawning; loss of appetite;
nausea or vomiting; nervousness, restlessness or
irritability; shivering or trembling; stomach
cramps; trouble in sleeping; unusually large
pupils; weakness |
Other side effects not listed above may also occur in some
patients. If you notice any other effects, check with your doctor.
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