Ultram (tramadol) Precautions and Warnings

Ultram and Ultram ER Precautions and Warnings Overview

Ultram and Ultram ER can have drug interactions with other medicines or not be good drugs for you if you have certain medical conditions, such as abdominal conditions, liver or kidney disease. It’s important to know all of the medicines that you or your family member takes. Use the migraine journal to keep a list of all medicines to share with your doctor. Only your doctor can prescribe prescription medicines for you. Do not stop taking any medicine without speaking to your doctor.

You should talk to your doctor about whether you should take the drug Ultram and Ultram ER if you have any condition associated with:

  • Abdominal conditions (such as vomiting, diarrhea, loss of appetite, indigestion)
  • Liver disease
  • Kidney disease

Liver disease, such as cirrhosis, makes it difficult for your body to absorb Ultram and Ultram ER. Kidney disease makes it difficult for your body to get rid of Ultram and Ultram ER. If you have either of these conditions your dose of Ultram or Ultram ER may need to be reduced since these conditions increase the amount of time Ultram and Ultram ER stay in your body.

Additional Ultram and Ultram ER Warnings

  • Ultram may cause seizures and/or serotonin syndrome when taken along with serotonergic agents (such as SSRIs, SNRIs, and triptans) or drugs that significantly reduce the rate at which Ultram leaves your body
  • Ultram may decrease your ability to perform potentially dangerous mental or physical tasks such as driving a car or operating machinery
  • Ultram should not be taken with alcohol
  • Ultram should be used with caution when taking medications such as tranquilizers, hypnotic drugs or other opiate containing pain relievers. Use of these medicines may increase your risk of breathing difficulties, decreased rate of breathing, decreased heart rate, and loss of consciousness that could possibly lead to coma or death.

Tell your doctor if you are pregnant, think you might become pregnant, or are trying to become pregnant.

Follow your doctor’s instructions for the amount of Ultram or Ultram ER to take each day, and be sure to allow the appropriate amount of time between doses. Exceeding the maximum dose of Ultram or Ultram ER per day or taking your next dose too soon increases your risk of breathing difficulties, seizures and death.


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.


Ultram and Ultram ER Use 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 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 and Ultram ER and Drug Abuse and Dependence

Addiction to Ultram or Ultram ER can occur. When taken regularly, even for a short period of time, Ultram can build up in your body. Your body then becomes used to the drug and stops feeling the medicine’s effects at the recommended dosage. This causes some people to take the medicine more often or in higher doses. This is dangerous and can lead to physical and psychological dependence.

If you feel you have become dependent on Ultram or Ultram ER you may have a problem. Signs of dependence may include:

  • Constant thoughts of how to get and take the drug
  • Strong drug cravings
  • Inability to control your use of the drug
  • Using Ultram or Ultram ER for non-medical purposes
  • Continuing to use Ultram or Ultram ER despite harm or risk of harm

Being addicted to Ultram or Ultram ER can result in painful withdrawal symptoms that may include:

  • Sweating
  • Yawning
  • Nausea
  • Vomiting
  • Cold flashes
  • Muscle and bone pain
  • Agitation
  • Irritability
  • Insomnia
  • Restlessness
  • Depression

Breaking an addiction to Ultram or Ultram ER can be dangerous and should be done under the supervision of a doctor. This is especially true for those who have been using Ultram or Ultram ER for long periods of time.


Ultram and Ultram ER and Alcohol and Drug Abuse

Ultram and Ultram ER when used along with alcohol, other opioid drugs, or illegal drugs that cause central nervous system depression (like low heart rate or difficulty breathing) can increase the effects of all of the drugs and alcohol.

Remember: Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if you are taking a medication and don’t know its effect. To learn more about a medicine and whether it will interact with alcohol, talk to your pharmacist or doctor.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010. Click the References Link below for a complete list of references.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010.
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