Before taking long-acting tramadol, tell your doctor or pharmacist if you are allergic to it; or to other narcotics (e.g., codeine); or if you have any other allergies.
Ultram ER (tramadol er) should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe breathing problems (e.g., respiratory depression, hypercapnia), intoxication with drugs that depress the nervous system or your breathing (CNS/respiratory depressants such as alcohol or tranquilizers/sedatives), certain mental/mood conditions (e.g., thoughts of suicide), abuse of drugs/alcohol.
Before using Ultram ER (tramadol er), tell your doctor or pharmacist your medical history, especially of: certain bowel diseases (paralytic ileus), brain disorders (e.g., seizures, increased intracranial pressure), conditions that increase the risk of seizures (e.g., head injury, brain tumors, meningitis, metabolic disorders, alcohol/drug withdrawal), adrenal gland problem (e.g., Addison's disease), difficulty urinating (e.g., due to enlarged prostate, urethral narrowing), heart problems (e.g., irregular heartbeat), personal or family history of regular use/abuse of drugs/alcohol, kidney disease, liver disease, lung diseases (e.g., chronic obstructive pulmonary disease-COPD, hypoxia), disease of the pancreas (e.g., pancreatitis), mental/mood conditions (e.g., major depression, toxic psychosis), a certain spinal problem (kyphoscoliosis), stomach/intestinal problems (e.g., gallbladder disease), underactive thyroid (hypothyroidism).
Ultram ER (tramadol er) may make you dizzy or drowsy. Use caution while driving, using machinery, or doing any activity that requires alertness. Avoid alcoholic beverages because they may increase the risk of Ultram ER (tramadol er)'s side effects.
To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
Before having surgery, tell your doctor or dentist that you are using Ultram ER (tramadol er).
Caution is advised when using Ultram ER (tramadol er) in the elderly because they may be more sensitive to its effects, especially slow/shallow breathing and drowsiness.
During pregnancy, Ultram ER (tramadol er) should be used only when clearly needed. It is not recommended for use for long periods or in high doses late in pregnancy because of possible serious harm to your baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using Ultram ER (tramadol er) for an extended time may have seizures or withdrawal symptoms such as irritability, abnormal/persistent crying, or diarrhea. Tell your doctor immediately if you notice any of these symptoms in your newborn.
Ultram ER (tramadol er) passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.
IMPORTANT NOTE: The preceding information is intended to heighten awareness of health information and does not suggest diagnosis or treatment. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.
Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.
Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
IMPORTANT NOTE: The preceding information is intended to heighten awareness of health information and does not suggest diagnosis or treatment. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.
Take Ultram ER (tramadol er) by mouth, either always with food or always without food, usually once daily or as directed by your doctor. If nausea occurs, consult your doctor or pharmacist about ways to decrease it (e.g., antihistamines, lying down for 1 to 2 hours with as little head movement as possible).
Swallow Ultram ER (tramadol er) whole. Do not crush, chew, or split the tablet. Doing so would release the tramadol into your bloodstream all at once, possibly causing serious (sometimes fatal) side effects.
The dosage is based on your medical condition and response to treatment. To reduce the risk of side effects, your doctor may tell you to gradually increase your dose when starting long-acting tramadol. The maximum recommended dose is 300 milligrams a day.
If you have severe kidney disease (e.g., on dialysis) or severe liver disease (e.g., cirrhosis), regular-release tramadol is recommended instead of the long-acting form.
Pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
Follow your doctor's or pharmacist's instructions for the safe use of non-narcotic pain relievers (e.g., acetaminophen, ibuprofen). Ask your doctor or pharmacist for more details regarding your treatment.
Ultram ER (tramadol er) may cause dependence, especially if it has been used regularly for an extended time or if it has been used in high doses. In such cases, withdrawal reactions (e.g., anxiety, sweating, sleeplessness, shaking, diarrhea, rapid breathing) may occur if you suddenly stop Ultram ER (tramadol er). To prevent withdrawal reactions when stopping extended, regular treatment with Ultram ER (tramadol er), gradually reduce the dosage as directed. Also, if you are taking regular doses of narcotic medications for ongoing pain (e.g., cancer pain), starting tramadol may cause a withdrawal reaction. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.
Rarely, abnormal drug-seeking behavior (addiction) is possible with Ultram ER (tramadol er). Do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed.
When used for an extended period, Ultram ER (tramadol er) may not work as well and may require different dosing. Talk with your doctor if Ultram ER (tramadol er) stops working well.
Tell your doctor if your pain does not decrease or if it worsens.
IMPORTANT NOTE: The preceding information is intended to heighten awareness of health information and does not suggest diagnosis or treatment. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.
Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, headache, or weakness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you are taking tramadol regularly, it may be useful to start using a laxative right away instead of waiting until you become constipated. Consult your pharmacist for details regarding the correct use of laxatives (e.g., stimulant-type with stool softener).
Remember that your doctor has prescribed Ultram ER (tramadol er) because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using Ultram ER (tramadol er) do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes, unusual/extreme stiffness in the muscles, shaking (tremor), severe stomach/abdominal pain, change in the amount of urine, vision changes.
Tell your doctor immediately if any of these rare but very serious side effects occur: slow/shallow breathing, seizures, fever/flu-like symptoms.
A very serious allergic reaction to Ultram ER (tramadol er) (which may occur as early as the first dose) is rare. However, seek immediate medical attention if you notice any of the following symptoms: rash, itching, swelling (especially of the lips, tongue, or throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Click HERE to learn more about Ultram ER side effects.
IMPORTANT NOTE: The preceding information is intended to heighten awareness of health information and does not suggest diagnosis or treatment. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.
If you miss a dose of Ultram ER (tramadol er), take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
IMPORTANT NOTE: The preceding information is intended to heighten awareness of health information and does not suggest diagnosis or treatment. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
Ultram ER (tramadol er) should not be used with the following medications because very serious (possibly fatal) interactions may occur: MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine).
Avoid taking MAO inhibitors within 2 weeks before, during, and after treatment with tramadol.
If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting tramadol.
Before using Ultram ER (tramadol er), tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: carbamazepine, SNRI antidepressants (e.g., venlafaxine, duloxetine), SSRI antidepressants (e.g., fluoxetine, paroxetine), sibutramine, other narcotic medications.
Also report the use of drugs that might increase seizure risk when combined with tramadol such as isoniazid (INH), phenothiazines (e.g., thioridazine, chlorpromazine, promethazine), theophylline, or tricyclic antidepressants (e.g., amitriptyline), among others. Consult your doctor or pharmacist for details.
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as certain antihistamines (e.g., diphenhydramine), anti-anxiety drugs (e.g., diazepam), anti-seizure drugs (e.g., phenytoin), medicine for sleep (e.g., zolpidem), muscle relaxants (e.g., cyclobenzaprine).
Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
IMPORTANT NOTE: The preceding information is intended to heighten awareness of health information and does not suggest diagnosis or treatment. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.