ULTRAM

ULTRAM® ER is a 24-hour prescription medication approved by the FDA for the management of moderate to moderately severe chronic pain in adults who need around-the-clock treatment of their pain for an extended period of time. This medication is used to relieve moderate pain. It is similar to narcotic pain medications. It works on certain nerves in the brain that control how you experience pain.

Ultram

Generic Name: tramadol (TRAM a dol)
Brand Names: Ultram, Ultram ER

What is Ultram?

Ultram 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.

What is the most important information I should know about Ultram?

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.

Take Ultram exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Do not take more than 300 milligrams of Ultram in one day.

What should I discuss with my healthcare provider before taking Ultram?

• 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.

Before taking Ultram, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease;

• liver disease;

• a stomach disorder; or

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

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Ultram.

How should I take Ultram?

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

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

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

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?

Ultram side effects

• seizure (convulsions);

• a red, blistering, peeling skin rash; or

• shallow breathing, weak pulse.

Less serious 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. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

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).

Before taking Ultram, tell your doctor if you also use:

• carbamazepine (Tegretol);

• warfarin (Coumadin);

• digoxin (Lanoxin, Lanoxicaps);

• ketoconazole (Nizoral);

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

• rifampin (Rifadin, Rimactane, Rifater);

• St. John's wort;

• quinidine (Quinaglute, Quinadex, Cardioquin, Quinora); 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 there may be other drugs that can interact with Ultram. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Ultram.

• 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.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
• Copyright 1996-2009 Cerner Multum, Inc. Version: 9.05. Revision Date: 4/12/2009 4:41:51 PM.