What is Ultram ER (Tramadol)?

Tramadol is a narcotic-like pain reliever.
Tramadol is used to treat moderate to severe pain. Tramadol extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock.
Tramadol may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking Ultram ER (Tramadol)?

You should not take tramadol if you have ever been addicted to drugs or alcohol, if you are currently intoxicated (drunk), or if you have recently used any of the following drugs:

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

• kidney disease
• liver disease
• a stomach disorder; or
• a history of depression, mental illness, or suicide attempt

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tramadol may also cause serious or fatal side effects in a newborn if the mother uses the medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
Tramadol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Tramadol should not be given to a child younger than 18 years of age.

Ultram ER Side Effects

What are the possible side effects of Ultram ER (Tramadol)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using tramadol and call your doctor at once if you have any of these serious side effects:

• agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting
• 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. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ultram ER Interactions

What other drugs affect Ultram ER (Tramadol)?

You may be more likely to have a seizure (convulsions) if you take tramadol while you are using certain other medicines. Do not take tramadol 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 tramadol, 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 tramadol. 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.

What should I avoid while taking Ultram ER (Tramadol)?

Do not drink alcohol while you are taking tramadol. Alcohol may cause a dangerous decrease in your breathing when used together with tramadol.
Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tramadol. Tell your doctor if you regularly use any of these other medicines.
Tramadol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Ultram ER Dosage

How should I take Ultram ER (Tramadol)?

Take tramadol 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 tramadol in one day.
Take this medication with a full glass of water.
Tramadol can be taken with or without food, but take it the same way each time.
Do not crush the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.
Do not crush, chew, break, or open a controlled-release, delayed-release, or extended-release tablet or capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.
If you use the tramadol 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.
Tramadol may be habit-forming. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor.
Do not stop using tramadol suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
Store tramadol at room temperature away from moisture and heat.
Keep track of how many pills have been used from each new bottle of this medicine. Tramadol is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I overdose on Ultram ER (Tramadol)?

Seek emergency medical attention if you think you have used too much of this medicine. A tramadol overdose can be fatal.
Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.

What happens if I miss a dose of Ultram ER (Tramadol)?

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.
Edited from everydayhealth.com