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 purposes other than those listed in this medication guide.
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 each dose 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 inhlation or injection can cause
life-threatening side effects, overdose, or death.
Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is
specially made to release medicine slowly in the body. Breaking the pill would 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 this medication suddenly without talking to your doctor. You may need
to gradually reduce the dose. Withdrawal symptoms may occur when you stop using tramadol.
Withdrawal symptoms include anxiety, sweating, nausea, diarrhea, tremors, chills,
hallucinations, trouble sleeping, or breathing problems. Call your doctor at once if you have any
of these withdrawal symptoms after you stop using tramadol.
Store tramadol at room temperature away from moisture and heat.
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:
seizure (convulsions);
a red, blistering, peeling skin rash; or
shallow breathing, weak pulse.
Continue taking tramadol and talk to your doctor if you have any of
these less serious side effects:
dizziness, drowsiness, weakness;
nausea, vomiting, constipation, loss of appetite;
blurred vision;
flushing (redness, warmth, or tingly feeling); or
sleep problems (insomnia).
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.
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:
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).
If you are using any of these drugs, you may not be able to use
tramadol or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect 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.
Do not drink alcohol while you are taking tramadol. Alcohol may cause a dangerous
decrease in your breathing when used together with tramadol.
Avoid using drugs that make you sleepy (such as cold medicine, other pain medications,
muscle relaxants, and medicine for seizures, depression or anxiety). These drugs may slow your
breathing or increase drowsiness when used together with tramadol.
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.
Seek emergency medical attention if you think you have used too much of this
medicine. A tramadol overdose can be fatal.
Symptoms of a tramadol overdose may include drowsiness, shallow breathing, slow
heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.
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.
You should not take tramadol if you have ever been addicted to drugs or alcohol.
Take tramadol exactly as it was prescribed for you. Do not take it in larger doses or for
longer than recommended by your doctor. Do not take more than 300 milligrams of tramadol in
one day.
Do not stop using this medication suddenly without talking to your doctor. You may need
to gradually reduce the dose. Withdrawal symptoms may occur when you stop using tramadol.
Withdrawal symptoms include anxiety, sweating, nausea, diarrhea, tremors, chills,
hallucinations, trouble sleeping, or breathing problems. Call your doctor at once if you have any
of these withdrawal symptoms after you stop using tramadol.
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 inhlation or injection can cause
life-threatening side effects, overdose, or death.
Seizures (convulsions) have occurred in some people taking tramadol. You may be more
likely to have a seizure while taking tramadol if you have a history of seizures or head injury, a
metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle
relaxers, or medicine for nausea and vomiting.
Seek emergency medical attention if you think you have used too much of this
medicine. A tramadol overdose can be fatal. Symptoms of a tramadol
overdose may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or
clammy skin, feeling light-headed, fainting, or coma.
While you are taking tramadol, do not drink alcohol or use drugs that make you
sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for
seizures, depression or anxiety). These drugs may slow your breathing or increase drowsiness
when used together with tramadol.
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.
You should not take tramadol if you have ever been addicted to drugs or alcohol.
Do not take tramadol if you are 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; or
a metabolic disorder.
Talk with your doctor about your individual risk of having a seizure
from this medicine.
Before taking tramadol, tell your doctor if you are allergic to any drugs, or if you have:
kidney disease;
liver disease;
a stomach disorder; or
a history of depression, mental illness, or suicide attempt.
If you have any of these conditions, you may not be able to use
tramadol, or you may need a dosage adjustment or special tests during treatment.
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.
Older adults may be more sensitive to the effects of tramadol. If you are over 65,
your doctor may recommend a lower dose.
Tramadol should not be given to a child younger than 16 years of age.
Tramadol is available with a prescription under the brand names Ultram and Ultram ER.
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.
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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or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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