How to Take Ultram
Doses of Ultram work differently in different people. The dose should therefore be made on an individual basis, weighing the possible benefit of a higher dose with possible side effect risks.
It may be helpful to keep track of your pain using a migraine jounral each day when you first begin taking Ultram. Record the intensity of your pain, and the symptoms you are experiencing. This will help you know if Ultram or Ultram ER is working for you at the dose you are taking.
Studies have shown that starting at the lowest possible dose and increasing gradually will results in fewer side effects.
Ultram Dosage in Adults (17 years of age and over)
- Starting Dose: Ultram should be started at 25 mg per day and increased in 25 mg increments as separate doses every 3 days to reach 100 mg per day (25 mg, 4 times a day). After that, the total daily dose may be increased by 50 mg every 3 days to reach 200 mg per day (50 mg, 4 times a day).
- Maximum Dose: Ultram 50 to 100 mg can be taken as needed for pain relief every 4 to 6 hours not to exceed 400 mg per day.
Ultram Dosage in Adults With Kidney Problems
If you have kidney problems (creatinine clearance less than 30 mL/min),it is recommended that you take Ultram at 12 hour intervals and do not take more than 200 mg a day.
Ultram Dosage in Adults With Liver Problems
If you have liver cirrhosis, the recommended dose of Ultram is 50 mg every 12 hours.
Ultram Dosage in Older Adults
Older adults should consider a lower Ultram starting dose due to greater frequency of liver, kidney and heart problems and the increase in other existing conditions existing and medications taken. If you are over 75 years old your dose should not exceed 300 mg per day.
In studies, 30% of people over 75 years of age had gastrointestinal side effects compared to 17% of those under 65 years of age. Constipation caused 10% of people over 75 to stop taking Ultram.
Ultram ER Dosage
Do not take Ultram ER if you have:
- Kidney problems (creatinine clearance less than 30 mL/min)
- Liver damage
Ultram ER must be swallowed whole and must not be chewed, crushed, or split
Ultram ER Dosage in Adults (18 years of age and over)
If You Are Not Currently on Ultram Immediate-Release Products:
- Starting dose: 100 mg once daily and increased by 100 mg every five days as necessary .
- Maximum dose: Do not exceed 300 mg per day.
If You Are Currently on Ultram Immediate-Release Products:
- Starting dose: Talk to your doctor. You may not be able to switch to Ultram ER.
Ultram ER should not be used with other tramadol products.
Ultram ER Dosage in Older Adults
Older adults should consider a lower Ultram ER starting dose due to greater frequency of liver, kidney and heart problems and the increase in other existing conditions existing and medications taken. If you are over 75 years old your dose should not exceed 300 mg per day.
Work with your doctor to determine the best dose to start at for your individual needs.
Ultram is not recommended for you if you:
- Are allergic to tramadol or any of the ingredients in Ultram or opioids
- Are intoxicated with alcohol, hypnotic drugs, narcotic drugs, pain relievers, opioid drugs or psychotropic drugs
- Suicidal or prone to addiction
Use Ultram with caution if you
- Are taking tranquilizers or antidepressant drugs
- Drink alcohol excessively and suffer from emotional problems or depression
Ultram and Ultram ER Use in Children:
The safety and efficacy of Ultram in children under 16 years of age have not been established. The use of Ultram in children is not recommended.
Learn more about Ultram and Ultram ER and the potential benefits and risks by visiting Ultram and Ultram ER Precautions and Warnings.
Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010. Click the References Link below for a complete list of references.