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| Generic Name: | tramadol |
| Pronounced: | TRAM a doll |
| Brand Name: | Ultram |
What is the most important information I should know about tramadol? |
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| Seizures have been reported as a rare side effect of treatment with tramadol. The risk of
seizures may be increased in patients who take more than the prescribed dose, have a history of
seizures or epilepsy, have head trauma, have a metabolic disorder, have a central nervous system
infection, are experiencing alcohol or drug withdrawal, or are taking certain medications. Talk to your
doctor about factors that may increase the risk of seizures during treatment. |
 | Do not drink alcohol while taking tramadol. Alcohol may cause a dangerous decrease in
breathing and/or liver problems when used during treatment with tramadol. |
|
 | Use caution when driving, operating machinery, or performing other hazardous activities.
Tramadol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these
activities. |
|
 | Do not take more of this medication than is prescribed for you. If the pain is not being
controlled, talk to your doctor. Taking more than the prescribed amount of this medication could result
in seizures or decreased breathing. |
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What is tramadol? |
| Tramadol is a pain reliever. Tramadol affects chemicals and receptors in the body that are
associated with pain. |
| Tramadol is used to relieve moderate to moderately severe pain. |
| Tramadol may also be used for purposes other than those listed in this medication guide. |
What should I discuss with my healthcare provider before taking tramadol? |
| Seizures have been reported as a rare side effect of treatment with tramadol. The risk of
seizures may be increased in patients who have any of the conditions or are taking any of the
medications listed below: Do not take tramadol without first talking to your doctor if you |
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have a history of seizures or epilepsy;
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have a head injury;
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have a metabolic disorder;
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have a central nervous system infection;
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are experiencing alcohol or drug withdrawal;
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are taking a tricyclic antidepressant such as amitriptyline
(Elavil), nortriptyline (Pamelor), doxepin (Sinequan), imipramine (Tofranil), clomipramine
(Anafranil), and others;
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are taking a monoamine oxidase inhibitor (MAOI) such as
isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);
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are taking a psychiatric medication such as chlorpromazine
(Thorazine), fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane), mesoridazine
(Serentil), perphenazine (Trilafon), thioridazine (Mellaril), thiothixene (Navane), and others;
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are taking a selective serotonin reuptake inhibitor (SSRI)
such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline
(Zoloft), or citalopram (Celexa);
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are taking a narcotic pain reliever such as codeine, fentanyl
(Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), hydrocodone (Vicodin, Lorcet,
Lortab, others), morphine (MS Contin, MSIR, RMS, Roxanol, others), oxycodone (Roxicodone,
Percocet, Percodan, others), propoxyphene (Darvon, Darvocet, others), and others;
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are taking promethazine (Phenergan) or prochlorperazine
(Compazine);
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are taking sibutramine (Meridia);
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are taking bupropion (Wellbutrin, Zyban); or
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are taking cyclobenzaprine (Flexeril).
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| Before taking tramadol, tell your doctor if you have |
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kidney disease;
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liver disease; or
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a history of alcohol or drug dependence.
|
| You may not be able to take tramadol, or you may require a dosage
adjustment or special monitoring during treatment if you have any of the conditions listed above. |
 | Tramadol is in the FDA pregnancy category C. This means that it is not known whether it
will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you
are pregnant. |
|
 | It is also not known whether tramadol passes into breast milk. Do not take tramadol
without first talking to your doctor if you are breast-feeding a baby. |
|
| If you are over 75 years of age, you may be more likely to experience side effects from
tramadol. The maximum daily dose of tramadol for people over 75 years of age is 300 mg. |
 | Tramadol is not approved by the FDA for use by children younger than 16 years of age. |
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How should I take tramadol? |
|
| Take tramadol exactly as directed by your doctor. If you do not understand these directions,
ask your pharmacist, nurse, or doctor to explain them to you. |
 | Take each dose with a full glass of water. |
|
| Tramadol can be taken with or without food. |
| Side effects from treatment with tramadol may be decreased by a slow increase in dose, as
directed by your doctor. The tablets can easily be broken in half at the score if needed. The maximum
dose of tramadol for an average healthy adult is 100 mg per dose, every 4 to 6 hours, up to 400 mg per
day. People over 75 years of age should not take more than 300 mg per day. People with liver or
kidney disease may need lower daily doses. Follow your doctor's directions. |
| Do not take more of this medication than is prescribed for you. If the pain is not being
controlled, talk to your doctor. Taking more than the prescribed amount of this medication could result
in seizures or decreased breathing. |
|
 | Store tramadol at room temperature away from moisture and heat. |
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What happens if I miss a dose? |
| Since tramadol is taken on an as-needed basis, missing a dose is usually not a problem. Take
the dose as soon as you remember, and do not take another dose for the amount of time prescribed by
your doctor. Do not take a double dose of this medication. |
What happens if I overdose? |
 | Seek emergency medical attention. |
|
| Symptoms of a tramadol overdose include difficulty breathing; shallow, weak breathing; and
seizures. |
|
What should I avoid while taking tramadol? |
| Do not drink alcohol while taking tramadol. Alcohol may cause a dangerous decrease in
breathing and/or liver problems when used during treatment with tramadol. |
|
| Use caution when driving, operating machinery, or performing other hazardous activities.
Tramadol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these
activities. |
|
| Avoid sleeping pills, tranquilizers, sedatives, and antihistamines except under the supervision of
your doctor. These drugs may increase drowsiness caused by tramadol. |
| Tramadol may increase the effects of other drugs that cause drowsiness, including
antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and
muscle relaxants. Dangerous sedation, dizziness, drowsiness, or decreased breathing may occur if
tramadol is taken with any of these medications. Tell your doctor about all medicines that you are
taking, and do not take any other prescription or over-the-counter medicines, including herbal
products, without first talking to your doctor during treatment with tramadol. |
What are the possible side effects of tramadol? |
|
| If you experience any of the following serious side effects, stop taking tramadol and seek
emergency medical attention or contact your doctor immediately: |
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an allergic reaction (difficulty breathing; closing of your throat;
swelling of your lips, tongue, or face; or hives); or
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seizures.
|
| Other, less serious side effects may be more likely to occur. Continue to
take tramadol and talk to your doctor if you experience |
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dizziness, drowsiness, or headache;
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nervousness, tremor, or anxiety;
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nausea, vomiting, constipation, or diarrhea; or
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itching, dry mouth, or sweating.
|
 | Tramadol is habit forming. Physical and/or psychological dependence
can occur, and withdrawal effects are possible if the medication is stopped suddenly after prolonged or
high-dose treatment. |
|
| Side effects other than those listed here may also occur. Talk to your doctor about any side
effect that seems unusual or that is especially bothersome. |
|
What other drugs will affect tramadol? |
| Tramadol may increase the risk of seizures especially in patients who have epilepsy or another
seizure disorder. Also, tramadol may increase the risk of seizures if you are taking any of the following
drugs: |
-
a tricyclic antidepressant such as amitriptyline (Elavil),
nortriptyline (Pamelor), doxepin (Sinequan), imipramine (Tofranil), clomipramine (Anafranil),
and others;
-
a monoamine oxidase inhibitor (MAOI) such as
isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);
-
an antipsychotic medication such as chlorpromazine
(Thorazine), fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane), mesoridazine
(Serentil), perphenazine (Trilafon), thioridazine (Mellaril), thiothixene (Navane), and others;
-
a selective serotonin reuptake inhibitor (SSRI) such as
fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or citalopram
(Celexa);
-
a narcotic pain reliever such as codeine, fentanyl
(Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), hydrocodone (Vicodin, Lorcet,
Lortab, others), morphine (MS Contin, MSIR, RMS, Roxanol, others), oxycodone (Roxicodone,
Percocet, Percodan, others), propoxyphene (Darvon, Darvocet, others), and others;
-
promethazine (Phenergan) or prochlorperazine
(Compazine);
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bupropion (Wellbutrin, Zyban); or
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cyclobenzaprine (Flexeril).
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| Do not take tramadol without first talking to your doctor if you are taking
any of the medicines listed above. |
| Before taking tramadol, tell your doctor if you are taking any of the following medicines: |
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carbamazepine (Tegretol);
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quinidine (Quinaglute Dura-Tabs, Cardioquin, Quinora,
others);
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warfarin (Coumadin); or
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digoxin (Lanoxin, Lanoxicaps).
|
| You may not be able to take tramadol, or you may require a dosage
adjustment or special monitoring during treatment if you are taking any of the medicines listed above. |
| Tramadol may increase the effects of other drugs that cause drowsiness, including
antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety
medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not
take any other prescription or over-the-counter medicines, including herbal products, without first
talking to your doctor during treatment with tramadol. |
| Drugs other than those listed here may also interact with tramadol. Talk to your doctor and
pharmacist before taking any prescription or over-the-counter medicines, including herbal products. |
Where can I get more information? |
| Your pharmacist has more information about tramadol written for health professionals that you
may read. |
What does my medication look like? |
| Tramadol is available with a prescription under the brand name Ultram. Other brand or generic
formulations may also be available. Ask your pharmacist any questions you have about this medication,
especially if it is new to you. |
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Tramadol 50 mg--white, capsule-shaped, film-coated tablets.
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| Remember, keep this and all other medicines out of the reach of children, never share your
medicines with others, and use this medication only for the indication prescribed. |
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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.
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