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ULTRAM® (tramadol hydrochloride) tablets is a centrally acting analgesic. The chemical name for tramadol hydrochloride is (±)cis-2-[(dimethylamino)methyl]-1-(3methoxyphenyl) cyclohexanol hydrochloride. Its structural formula is: 

The molecular weight of tramadol hydrochloride is 299.8. Tramadol hydrochloride is a white, bitter,

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, crystalline and odorless powder,

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. It is readily soluble in water and ethanol and has a pKa of . The n-octanol/water log partition coefficient (logP) is at pH 7. ULTRAM® tablets contain 50 mg of tramadol hydrochloride and are white in color. Inactive ingredients in the tablet are pregelatinized corn starch, modified starch (corn), hypromellose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol,

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polysorbate 80, sodium starch glycolate, titanium dioxide and carnauba wax.  Tramadol belongs to the class of drugs known as opiate agonists,

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. Primarily, tramadol works by changing the way the body senses pain. Some people mistakenly believe that tramadol is an NSAID (nonsteroidal anti-inflammatory drug), but it is not. Tramadol 50mg may be prescribed as an immediate release tablet.  Tramadol 100mg, Tramaodl 200mg, Tramadol 300mg are Prescribed as an extended release tablets.  For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, the tolerability of ULTRAM® can be improved by initiating therapy with the following titration regimen: ULTRAM® should be started at 25 mg/day qAM and titrated in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg q.i.d.). Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg q.i.d.). After titration, ULTRAM® 50 to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day. For the subset of patients for whom rapid onset of analgesic effect is required and for whom the benefits outweigh the risk of discontinuation due to adverse events associated with higher initial doses, ULTRAM® 50 mg to 100 mg can be administered as needed for pain relief every four to six hours, not to exceed 400 mg per day.

Tramadol is a narcotic-like pain reliever,

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. 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 regularly. Tramadol,

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the generic version of Ultram,

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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. The Cochrane Review stated that when tramadol is taken for up to 3 months,

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there may be decreased pain, improvements in function and stiffness and overall well-being. However,

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tramadol can cause side effects that are significant enough to require that the patient must stop taking the medication. Risks outweigh benefits for many people who have tried tramadol.

Tramadol has mu-opioid agonist activity. ULTRAM can be abused and may be subject to criminal diversion.

Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. Drug addiction is characterized by behaviors that include one or more of the following: what is the medication soma for, impaired control over drug use, compulsive use,

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, use for non-medical purposes, and continued use despite harm or risk of harm, and craving,

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. Drug addiction is a treatable disease,

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utilizing a multidisciplinary approach, but relapse is common.

“Drug-seeking” behavior is very common in addicts and drug abusers. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated “loss” of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating physician(s). “Doctor shopping” to obtain additional prescriptions is common among drug abusers and people suffering from untreated addiction.

Abuse and addiction are separate and distinct from physical dependence and tolerance. Physicians should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of ULTRAM® can occur in the absence of true addiction and is characterized by misuse for non-medical purposes,

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, often in combination with other psychoactive substances. Concerns about abuse and addiction should not prevent the proper management of pain,

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. However all patients treated with opioids require careful monitoring for signs of abuse and addiction,

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because use of opioid analgesic products carries the risk of addiction even under appropriate medical use.

Be aware of the following possible Tramadol drug interactions: 


Carbamazepine reduces the effect of tramadol

Quinidine increases the concentration of tramadol by 50% to 60%

Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects.

Tramadol side effects are usually temporary

Get emergency medical help if you have any of these signs of an allergic reaction to tramadol: hives; difficulty breathing;

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; swelling of your face,

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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 tramadol side effects may include:



dizziness, drowsiness, weakness;

nausea, vomiting,

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constipation, loss of appetite;

blurred vision;

flushing (redness, warmth, or tingly feeling); or

sleep problems (insomnia).

Risk of Overdosage

Patients taking tramadol should be warned not to exceed the dose recommended by their physician. Tramadol products in excessive doses, either alone or in combination with other CNS depressants, including alcohol, are a cause of drug-related deaths,

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. Patients should be cautioned about the concomitant use of tramadol products and alcohol because of potentially serious CNS additive effects of these agents,

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. Because of its added depressant effects, tramadol should be prescribed with caution for those patients whose medical condition requires the concomitant administration of sedatives, tranquilizers, muscle relaxants,

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antidepressants, or other CNS depressant drugs. Patients should be advised of the additive depressant effects of these combinations.

Serious potential consequences of overdosage with ULTRAM® (tramadol hydrochloride) tablets are central nervous system depression, respiratory depression and death. Some deaths have occurred as a consequence of the accidental ingestion of excessive quantities of tramadol alone or in combination with other drugs. In treating an overdose, primary attention should be given to maintaining adequate ventilation along with general supportive treatment.

What your doctor should tell you about Tramadol ?



Patients should be informed that ULTRAM® may cause seizures and/or serotonin syndrome with concomitant use of serotonergic agents (including SSRIs, SNRIs, and triptans) or drugs that significantly reduce the metabolic clearance of tramadol.

ULTRAM® may impair mental or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery.

ULTRAM® should not be taken with alcohol containing beverages.

ULTRAM® should be used with caution when taking medications such as tranquilizers, hypnotics or other opiate containing analgesics.

The patient should be instructed to inform the physician if they are pregnant, think they might become pregnant, or are trying to become pregnant.

The patient should understand the single-dose and 24-hour dose limit and the time interval between doses, since exceeding these recommendations can result in respiratory depression, seizures and death.Before you use tramadol, you must know following information: 
Before Using

In deciding to use a medicine,

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, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine,

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the following should be considered: 

Allergies 

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. 

Pediatric 

There is no specific information on the relationship of age to the effects of tramadol tablets in patients less than 16 years of age, and tramadol extended-release tablets in patients less than 18 years of age . 

Geriatric 

Studies in older adults show that tramadol stays in the body a little longer than it does in younger adults. Your doctor will consider this when deciding on your doses. 

Pregnancy

  Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breastfeeding 

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. 

Drug Interactions 

Using this medicine with any of the following medicines is not recommended,

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. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. 



Rasagiline

Selegiline

2 - Tramadol is available in immediate release and extended release formulations.

Tramadol may be prescribed as an immediate release tablet (50 mg.) or as an extended release tablet (100,

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, 200, or 300 mg.). The extended release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment. Your doctor will determine the appropriate dosage schedule for you.  

3 - Tramadol extended release tablets must be taken whole,

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not split, chewed or crushed. 

It is important to take tramadol properly and to follow prescribing instructions,

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. If taken improperly or in a way that is not recommended,

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serious side effects and even death can result.  

4 - Tramadol can be habit-forming for some people. 

Do not take more tramadol than has been prescribed for you. Taking more tramadol or taking it more often can cause dependency on it. You should also not stop taking tramadol without first consulting your doctor. You may experience withdrawal symptoms if you stopped it suddenly. You doctor will likely decrease your dose of tramadol gradually.  

5 - Drug interactions are possible with tramadol. 

Be aware of the following possible drug interactions:  



Carbamazepine reduces the effect of tramadol

Quinidine increases the concentration of tramadol by 50% to 60%

Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects.

 Tramadol is a synthetic analog of the phenanthrene alkaloid codeine and,

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, as such, is an opioid and also a prodrug (codeine is metabolized to morphine, tramadol is converted to O-desmethyltramadol). Opioids are chemical compounds which act upon one or more of the human opiate receptors. The euphoria and respiratory depression are mainly caused by the ?1 and ?2 receptors; the addictive nature of the drug is due to these effects as well as its serotonergic/noradrenergic effects,

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. The opioid agonistic effect of tramadol and its major metabolite(s) are almost exclusively mediated by the substance's action at the ?-opioid receptor,

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. This characteristic distinguishes tramadol from many other substances (including morphine) of the opioid drug class, which generally do not possess tramadol's degree of subtype selectivity.

Once you notice that you have difficulty in breathing or tightness of the chest, swelling of eyelids, face or lips, develop rash or hives, then it is high time that you tell your doctor about it the soonest possible time,

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. It is also important that you avoid alcohol when taking tramadol. Meanwhile, women who are planning on becoming pregnant must consult it first with a doctor so he can discuss the benefits and risks of using tramadol during pregnancy. Tramadol is excreted in breast milk so it is only logical for women to avoid breastfeeding while taking tramadol. 

The dosage of tramadol or any change in the prescription should only be done after consulting with your doctor. If you notice any unpleasant side effects caused by this drug, then you need to talk to your doctor about it,

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. It is better to be honest about any adverse reactions of your present medication so that immediate remedy can be provided. 

The most commonly reported adverse drug reactions are nausea, vomiting, sweating and constipation. Drowsiness is reported, although it is less of an issue than for non-synthetic opioids,

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. Patients prescribed tramadol for general pain relief with or without other agents have reported withdrawal symptoms including uncontrollable nervous tremors, muscle contracture, and 'thrashing' in bed (similar to restless leg syndrome) if weaning off the medication happens too quickly. Anxiety, 'buzzing', 'electrical shock' and other sensations may also be present, similar to those noted in Effexor withdrawal. Anecdotally, tramadol is widely regarded by chronic pain sufferers as being among the most difficult of the pain medications to stop after prolonged administration, as withdrawal from both the serotonergic/noradrenergic and the mu-opioid effects is present. Respiratory depression, a common side-effect of most opioids, is not clinically significant in normal doses,

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. By itself,

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it can decrease the seizure threshold. When combined with SSRIs, tricyclic antidepressants, or in patients with epilepsy, the seizure threshold is further decreased. Seizures have been reported in humans receiving excessive single oral doses (700 mg) or large intravenous doses (300 mg). However, there have been several rare cases of people having grand-mal seizures at doses as low as 100–400 mg orally.

Tramadol can also be taken in combination with Carbamazepine and it is normally prescribed for the treatment of epilepsy and bipolar disorder,

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. Carbamazepine also lessens the effect of tramadol. However, you should be careful about drug interactions as it can lead to unwanted side effects or prevent the medicine in easing your pain,

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. When this happens,

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you need to consult a health care professional if you have questions on drug interactions with tramadol. 




Tramadol is great for pain,

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, but there are things people need to know before taking it.

If you are suffering from a great deal of pain and have no way to stop it, you may want to consider shopping online at a pharmacy, instead of waiting for a doctor,

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. When you cannot get it from a hospital due to the fact that the doctor takes too long to approve it,

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or they don’t believe you are in pain,

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you can order online. This means you will be shopping sometimes from overseas, but many times you will be shopping from your own country. When you order tramadol online you will receive it at your door,

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. Gone are the days of having to wait for hours in line at a pharmacy, only to find out you can’t get your medicine that day, or to have it close before you get to the counter. Thousands upon thousands of people order tramadol online each day. The fact that people can get discounts on the internet is great as well,

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. Many hospitals and pharmacies in the traditional sense do not give any discounts,

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. After you order a certain amount of medicine from an online pharmacy you may begin receiving great coupons! You will also never have to worry about getting a cheaper quality medicine,

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. The medicine you receive will be the same each time, even if the pill looks a bit different. The dosage will not mysteriously change all of a sudden. The price is also extremely less than normal, sometimes by half or more. This means you are getting more of what you need for less money.

This medicine is also FDA approved. This means it is not illegal to have in your home, has been proven to work, and is readily available at almost any pharmacy,

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. You will not be in trouble for owning this medicine. This medicine is used to treat pain ranging from mild to severe. The tablets can be taken every four to six hours, but should never be taken more frequently. Due to the fact that it has similar reactions as morphine people can easily become addicted. By using the medicine only as directed a person can avoid this,

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. Some of the common side effects of tramadol are migraines,

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sleepiness, insomnia, nausea,

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and vomiting. If you experience these more than normally you should consult a doctor immediately.

Tramadol is known as Ultram in some places, but it is scientifically known as tramadol hydrochloride. This is a medicine available in many places. Sometime a certain state of country will classify it as a controlled substance, but in many places there is not regulation on it,

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. The only reason it can be controlled is due to the fact that it is highly addictive and the abuse potential is high. Tramadol simply affects the nerve endings inside of the brain and spinal cord,

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. This relieves pain like morphine done by binding certain receptors.

There are many other medicines that give similar effects as tramadol. These are ones that affect the reuptake of chemicals such as serotonin,

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. Another chemical is affects is norepinephrine. These chemicals are both ones that are used in the process of transferring certain signals from the brain to nerve endings. The signal travels through the brain and body and releases serotonin. This is why we feel the pain, but also the reason we do not feel pain while taking tramadol,

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. It essentially blocks the normal process the body goes through when pain is happening.
There are side effects in most medications. Some of the main ones that will regularly happen are constipation,

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nausea,

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migraines and headaches,

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dizziness and vertigo, sleeplessness or insomnia, and also loss of appetite. Any side effect of Tramadol can easily be treated by the patient and does not require and professional medical attention. The side effects on the more serious side are so rare that they are virtually not there at all,

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. However, before you take tramadol you should always speak to your doctor or physician,

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. This is due to the fact that many problems a person has can cause adverse effects when coupled with tramadol. Some of the things to inform your doctor about if you experience them are epilepsy, seizures, cirrhosis, hepatitis,

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renal failure,

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kidney disease, liver disease, lung disease, and alcohol or drug addiction. If you have ever had an injury to the head, or swelling to the head,

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severe pain in the abdomen, or have allergies to foods or colorings,

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you should speak with a doctor as well. Women who are breastfeeding should not take tramadol as it can transfer to the child. Alert the doctor to any current medications or vitamins you are taking to prevent adverse reactions.

When you are taking tramadol you must always remember to take it at the same time each day,

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. This is because many people forget they have taken the medicine already and will take it again,

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. This can cause an overdose and can be harmful,

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. In the event of not being sure if you took the medicine or not, you should not take it until the regular time comes again. This is to ensure your safety. The age of a person,

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as well as other health disorders may change dosage for tramadol. If you have a bad reaction to a certain dosage you may not be able to take as much, or if you have other medicines which don’t react well with tramadol you may not be able to take it.

There are many different things that people take that should not be paired with tramadol. Some of these things are alcohol,

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, dextromethorphan, painkillers,

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antidepressant, antipsychotics,

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anxiety medicines, sleeping pills, herbal supplements, and antihistamines. If you are not sure that your medication will react in a damaging way with tramadol you should ask a doctor. Do not take anything else with the medicine until you are sure it is safe.




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