the generic version of Ultram, is a synthetic analgesic medication. The exact mode of action of tramadol is unknown but it is said to work like morphine.
Tramadol binds to opioid receptors in the brain -- receptors that
transmit the sensation of pain throughout the body. Here are 10 things
you should know about tramadol to ensure its safe use.
Why is this medication prescribed?
Tramadol
is used to relieve moderate to moderately severe pain. Tramadol
extended-release tablets are only used by people who are expected to
need medication to relieve pain around-the-clock for a long time.
Tramadol is in a class of medications called opiate agonists. It works
by changing the way the body senses pain.
How should this medicine be used?
Tramadol
comes as a tablet and an extended-release (long-acting) tablet to take
by mouth. The regular tablet is usually taken with or without food every
4-6 hours as needed. The extended-release tablet should be taken once a
day. Take the extended-release tablet at about the same time of day
every day, and either always take it with food or always take it without
food. Take tramadol exactly as directed. Do not take more medication as
a single dose or take more doses per day than prescribed by your
doctor. Taking more tramadol than prescribed by your doctor may cause
serious side effects or death.
Your doctor may start you on a low
dose of tramadol and gradually increase the amount of medication you
take, not more often than every 3 days if you are taking the regular
tablets or every 5 days if you are taking the extended-release tablets.
Swallow
the extended-release tablets whole; do not split, chew, or crush them.
Do not snort (inhale powder from crushed tablet) or inject the dissolved
extended-release tablets. Taking this medication in a way that is not
recommended may cause serious side effects or death.
Tramadol can
be habit-forming. Do not take a larger dose, take it more often, or take
it for a longer period of time than prescribed by your doctor. Call
your doctor if you find that you want to take extra medication or if you
notice any other unusual changes in your behavior or mood.
Do
not stop taking tramadol without talking to your doctor. Your doctor
will probably decrease your dose gradually. If you suddenly stop taking
tramadol you may experience withdrawal symptoms such as nervousness;
panic; sweating; difficulty falling asleep or staying asleep; runny
nose, sneezing, or cough; numbness, pain, burning, or tingling in your
hands or feet; hair standing on end; chills; nausea; uncontrollable
shaking of a part of your body; diarrhea; or rarely, hallucinations
(seeing things or hearing voices that do not exist).
Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking tramadol,
- tell
your doctor and pharmacist if you are allergic to tramadol or other
opiate pain or cough medications such as meperidine (Demerol), morphine
(Avinza, Kadian, MS Contin), codeine (in some pain medications and cough
syrups), hydrocodone (in Vicodin), hydromorphone (Dilaudid), oxycodone
(OxyContin, in Percocet), propoxyphene (Darvon, Darvon N, in Darvocet),
any other medications, or any of the ingredients in tramadol tablets or
extended-release tablets. Ask your pharmacist for a list of ingredients
in tramadol tablets or extended release tablets.
- tell
your doctor and pharmacist what other prescription and nonprescription
medications, vitamins, and nutritional supplements you are taking. Be
sure to mention any of the following: antifungal medications such as
ketoconazole (Nizoral); digoxin (Lanoxin); erythromycin (E.E.S.,
E-Mycin, Erythrocin); monoamine oxidase (MAO) inhibitors, including
isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl,
Emsam, Zelapar), and tranylcypromine (Parnate); medications for anxiety,
mental illness, nausea, and pain; medications for seizures, such as
carbamazepine (Tegretol); muscle relaxants such as cyclobenzaprine
(Flexeril); promethazine (Phenergan); quinidine; rifampin (Rifadin,
Rifamate, Rimactane, others); sedatives; sleeping pills; selective
serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa),
fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil),
and sertraline (Zoloft); tranquilizers; tricyclic antidepressants such
as amitriptyline (Elavil), amoxapine (Asendin), clomipramine
(Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan),
imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline
(Vivactil), and trimipramine (Surmontil);and warfarin (Coumadin). Many
other medications may also interact with tramadol, so be sure to tell
your doctor about all the medications you are taking, even those that do
not appear on this list. Your doctor may need to change the doses of
your medications or monitor you carefully for side effects.
- tell your doctor what herbal products you are taking, especially St. John's wort.
- tell
your doctor if you have or have ever had seizures; an infection in your
brain or spine; a head injury, a brain tumor, a stroke, or any other
condition that caused high pressure inside your skull; depression or
thoughts about harming or killing yourself or planning or trying to do
so; diabetes; breathing problems or lung disease; or kidney or liver
disease. Also tell your doctor if you drink or have ever drunk large
amounts of alcohol, use or have ever used street drugs, or have overused
prescription medications.
- tell your doctor if you are
pregnant, plan to become pregnant, or are breast-feeding. If you become
pregnant while taking tramadol, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol.
- you
should know that this medication may make you drowsy and may affect
your coordination. Do not drive a car or operate machinery until you
know how this medication affects you.
- talk to your doctor
about the safe use of alcohol while you are taking this medication.
Alcohol can make the side effects from tramadol worse.
- you
should know that tramadol may cause dizziness, lightheadedness, and
fainting when you get up from a lying position. To avoid this, get out
of bed slowly, resting your feet on the floor for a few minutes before
standing up.
What special dietary instructions should I follow?
Talk to your doctor about drinking grapefruit juice while you are taking this medication.
What should I do if I forget a dose?
If
your doctor has told you to take tramadol regularly, take the missed
dose as soon as you remember it. However, if it is almost time for the
next dose, skip the missed dose and continue your regular dosing
schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
Tramadol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- dizziness
- weakness
- sleepiness
- difficulty falling asleep or staying asleep
- headache
- nervousness
- agitation
- uncontrollable shaking of a part of the body
- muscle tightness
- changes in mood
- drowsiness
- heartburn or indigestion
- nausea
- vomiting
- diarrhea
- constipation
- itching
- sweating
- chills
- dry mouth
Some
side effects can be serious. If you experience any of these symptoms or
those listed in the SPECIAL PRECAUTIONS section , call your doctor
immediately:
- seizures
- sores on the inside of your mouth, nose, eyes, or throat
- flu-like symptoms
- hives
- rash
- difficulty swallowing or breathing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
- hallucinations (seeing things or hearing voices that do not exist)
If
you experience a serious side effect, you or your doctor may send a
report to the Food and Drug Administration's (FDA) MedWatch Adverse
Event Reporting program online [at
http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
Tramadol may cause other side effects. Tell your doctor if you have any unusual problems while you are taking this medication.
What storage conditions are needed for this medicine?
Keep
this medication in the container it came in, tightly closed, and out of
reach of children. Store it at room temperature and away from excess
heat and moisture (not in the bathroom). Throw away any medication that
is outdated or no longer needed. Talk to your pharmacist about the
proper disposal of your medication.
In case of emergency/overdose
In
case of overdose, call your local poison control center at
1-800-222-1222. If the victim has collapsed or is not breathing, call
local emergency services at 911.
Symptoms of overdose may include:
- decreased size of the pupil (the black circle in the center of the eye)
- difficulty breathing
- extreme drowsiness
- unconsciousness
- coma
- seizure
- heart attack
What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It
is important for you to keep a written list of all of the prescription
and nonprescription (over-the-counter) medicines you are taking, as well
as any products such as vitamins, minerals, or other dietary
supplements. You should bring this list with you each time you visit a
doctor or if you are admitted to a hospital. It is also important
information to carry with you in case of emergencies.
