Tramadol (Ultram)

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What Is Tramadol (Ultram)?

Tramadol is a medication used to treat acute or chronic pain. It is similar to narcotic pain relievers and may be used in its extended release form to treat chronic moderate to severe pain 24 hours a day.

Your doctor may also prescribe this medication to treat other conditions not listed in this information guide.

Important Facts about Tramadol

  • Do not take this medication if you are taking narcotics, including: tranquilizers or sedatives, medication for anxiety, depression, or mental illness, alcohol, or illegal drugs of any kind.
  • Do not take tramadol if you are suicidal or if you have attempted suicide in the past.
  • Do not take tramadol if you have a history of drug addiction or if you are addicted to drugs or alcohol now.
  • Do not take this medication if you have are allergic to tramadol.
  • Tramadol can cause convulsions or seizures in some patients. If you have ever experienced seizures, have sustained a head injury in the past, have a metabolic disorder, are taking narcotics, muscle relaxants, antidepressants, antipsychotic medication, or medication for vomiting or nausea, you have an increased risk of having seizures on this medication.
  • Take this medication by mouth in its whole pill form. Do not divide or crush tramadol tablets. This medication should never be injected, inhaled, or diluted in liquid. Doing so can lead to a fatal overdose.
  • This medication may be habit-forming and should only be used by the patient for which it was prescribed.
  • An overdose of tramadol can be fatal. Take only the amount prescribed by your physician, and contact emergency personnel if you believe you have taken more than the prescribed amount of this medication.

Important Considerations Before Taking Tramadol

Speak to your physician about the risks/benefits of taking this medication if you have a history of mental illness or depression, suicidal thoughts, kidney or liver disease, or gastrointestinal problems.

Ask your doctor about the risk of seizure if you have ever experienced: epilepsy or any seizure or convulsive disorder, a metabolic disorder, head injury, or alcohol or drug addiction. If you are taking narcotics, antidepressants, antipsychotics, muscle relaxants, or medication for vomiting or nausea, ask your doctor about the seizure risk associated with taking this medication.

This medication should not be taking by children under the age of 16 except on the advice of a physician.

People who have phenylketonuria (PKU) should not take the Rybix ODT form of tramadol, which may contain phenylalanine. Speak to your doctor about prescribing a different form of tramadol if you have PKU.

If you are pregnant, taking this medication could increase the risk of harm to your unborn baby. The Food and Drug Administration has rated tramadol as a category “C”, and it is not known what effects could occur from taking this medication during pregnancy. It is possible that this medication could cause birth defects or be fatal to your baby. Speak to your doctor about these risks if you are or become pregnant while taking this medication.

This medication may be passed into your breast milk and cause harm to your baby. Do not take tramadol if you are breast feeding.

Tramadol is habit-forming. Do not share this medication with anyone. Take only as prescribed by your doctor.

Potential Side Effects of Taking Tramadol

If you experience an allergic reaction to this medication, call 9-1-1, or get emergency assistance. Symptoms of a tramadol allergy may include: facial, mouth, throat, or tongue swelling, hives, or problems breathing.

Other serious side effects of this medication may include:

  • blisters, or a red rash on the skin that peels
  • weak pulse or shallow breathing
  • convulsions or seizures
  • hallucinations
  • fever
  • vomiting or nausea
  • extreme agitation
  • hyper-reactive reflexes
  • an increase in heart rate
  • diarrhea
  • fainting
  • lack of coordination

Stop taking tramadol, and contact your doctor if you experience any of these symptoms. Other, less serious symptoms of a possible side effect to this medication may include: dizziness, vertigo, headache, upset stomach, constipation, anxiety, nervousness, and drowsiness. These and other side effects may occur while you are taking tramadol. Speak to your doctor if you are concerned about side effects of taking this drug. You may also report side effects of this medication to the FDA at 1-800-FDA-1088.

Drug Interactions While Taking Tramadol

Speak to your doctor about other drugs you are taking before taking tramadol. Some drugs may interact negatively with this medication.

If you are taking MAO inhibitors, including isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam), or if you are taking antidepressant medication such as amitriptyline (Elavil, Vanatrip), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft), you may be at increased risk of developing seizures if you take tramadol.

Other medications that may interact negatively with tramadol include:

  • medications for HIV/AIDS, including atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra)
  • blood pressure or cardiac medication, including diltiazem (Cartia, Cardizem), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), or others
  • medications for headaches or migraines, including sumatriptan (Imitrex, Treximet)
  • medications for regulating heart rhythm, including amiodarone (Cordarone, Pacerone), flecainide (Tambocor), propafenone (Rythmol), or quinidine (Quin-G)
  • medications for cancer, including gefitinib (Iressa), imatinib (Gleevec), or nilotinib (Tasigna)

Some medications may increase the likelihood of experiencing sleepiness while on tramadol. These include: cold medications, allergy medications, seizure medication, muscle relaxants, sleeping pills, pain medications, and anxiety medications. Notify your physician if you take any of these medications on a regular basis or plan to take these medications while taking tramadol.

Speak to your doctor about any and all medications you are taking, including prescription or over-the-counter drugs, herbal medicines, vitamins, and mineral supplements. In addition to the medications listed here, there are many other medications that may interact with tramadol. Be sure to keep a list of your medications, and let your doctor know what medicines you are taking before being prescribed a new medication.

What to Avoid While Taking Tramadol

Drinking alcohol while taking tramadol can lead to decreased respiration and impaired judgment. Do not drink alcohol while taking this medication.

Taking tramadol can impair thinking and reactions. Use caution when operating a vehicle or heavy machinery while taking this medication.

How to Take Tramadol

Use this medication as prescribed by your physician. Follow dosing directions on the label carefully, and only take the amount prescribed. Speak to your physician if the amount prescribed does not appear to be working effectively, but never take more than the prescribed amount of this medication without speaking first to your doctor.

Keep tramadol tablets stored at room temperature and away from extreme heat or moisture.

Swallow tramadol pills whole. Never crush, divide, chew, inhale, or dissolve this medication for oral, inhaled, or injected use. Doing so could lead to an accidental overdose or death.

Tramadol may be taken with, or without food. Take this medication the same way each dose.

If you see portions of the tramadol capsule shell in your stool, do not be alarmed—this is normal. The medication has been absorbed correctly, and the shell may be expelled.

If taking Rybix OTD dissolving tablets, keep the pill in its blister pack until you are ready for your dose. Remove the pill with dry hands, and allow it to dissolve completely in your mouth. Do not chew or swallow the tablet. Allow it to fully dissolve, swallowing often or taking a sip of water if necessary to help the tablet dissolve.

If you plan to discontinue tramadol, speak to your doctor about how to taper off the drug. Withdrawing from this medication suddenly may cause undesirable side effects.

Keep this medication out of reach of others, and carefully monitor the amount of medication in the bottle to ensure that it is not being taken by anyone other than the person for whom it has been prescribed.

If You Miss a Dose of Tramadol

If you have missed a dose of tramadol, take your medication as soon as you recall the missed dose. If it is near time for your next scheduled dose, skip the missed dose, and take the medication at the next scheduled time. Do not double up on this medication in an attempt to make up for the skipped dose. Doing so could cause an overdose, which can be fatal.

What to Do if You Overdose on Tramadol

If you believe you may have taken too much tramadol, contact emergency services, or call the Poison Help Line at 1-800-222-1222 immediately, as an overdose of tramadol may be fatal.

Possible symptoms of an overdose include: shallow or difficult breathing, slow heartbeat, clamminess, cold skin, extreme drowsiness, muscle weakness, seizure, or passing out.

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