|
Tramadol
What is tramadol?
(TRAM a doll)
Ultram |
|
• |
Tramadol is a pain reliever. Tramadol affects chemicals and
receptors in the body that are associated with pain. |
|
• |
Tramadol is used to relieve moderate to moderately severe pain. |
|
• |
Tramadol may also be used for purposes other than those listed in
this medication guide. |
What is the most important information I should know about tramadol?
|
|
• |
Seizures have been reported as a rare side effect of treatment with
tramadol. The risk of seizures may be increased in patients who take
more than the prescribed dose, have a history of seizures or epilepsy,
have head trauma, have a metabolic disorder, have a central nervous
system infection, are experiencing alcohol or drug withdrawal, or are
taking certain medications. Talk to your doctor about factors that may
increase the risk of seizures during treatment. |
|
• |
Do not drink alcohol while taking tramadol. Alcohol may cause a
dangerous decrease in breathing and/or liver problems when used during
treatment with tramadol. |
|
• |
Use caution when driving, operating machinery, or performing other
hazardous activities. Tramadol may cause dizziness or drowsiness. If you
experience dizziness or drowsiness, avoid these activities. |
|
• |
Do not take more of this medication than is prescribed for you. If
the pain is not being controlled, talk to your doctor. Taking more than
the prescribed amount of this medication could result in seizures or
decreased breathing. |
|
• |
Seizures have been reported as a rare side effect of treatment with
tramadol. The risk of seizures may be increased in patients who have any
of the conditions or are taking any of the medications listed below: Do
not take tramadol without first talking to your doctor if you |
| |
· |
have a history of seizures or epilepsy; |
| |
· |
have a metabolic disorder; |
| |
· |
have a central nervous system infection; |
| |
· |
are experiencing alcohol or drug withdrawal; |
| |
· |
are taking a tricyclic antidepressant such as amitriptyline (Elavil),
nortriptyline (Pamelor), doxepin (Sinequan), imipramine (Tofranil),
clomipramine (Anafranil), and others; |
| |
· |
are taking a monoamine oxidase inhibitor (MAOI) such as
isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate); |
| |
· |
are taking a psychiatric medication such as chlorpromazine (Thorazine),
fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane),
mesoridazine (Serentil), perphenazine (Trilafon), thioridazine (Mellaril),
thiothixene (Navane), and others; |
| |
· |
are taking a selective serotonin reuptake inhibitor (SSRI) such as
fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil),
sertraline (Zoloft), or citalopram (Celexa); |
| |
· |
are taking a narcotic pain reliever such as codeine, fentanyl (Duragesic),
hydromorphone (Dilaudid), meperidine (Demerol), hydrocodone (Vicodin,
Lorcet, Lortab, others), morphine (MS Contin, MSIR, RMS, Roxanol,
others), oxycodone (Roxicodone, Percocet, Percodan, others),
propoxyphene (Darvon, Darvocet, others), and others; |
| |
· |
are taking promethazine (Phenergan) or prochlorperazine (Compazine); |
| |
· |
are taking sibutramine (Meridia); |
| |
· |
are taking bupropion (Wellbutrin, Zyban); or |
| |
· |
are taking cyclobenzaprine (Flexeril). |
|
• |
Before taking tramadol, tell your doctor if you have |
| |
· |
a history of alcohol or drug dependence. |
|
• |
You may not be able to take tramadol, or you may require a dosage
adjustment or special monitoring during treatment if you have any of the
conditions listed above. |
|
• |
Tramadol is in the FDA pregnancy category C. This means that it is
not known whether it will be harmful to an unborn baby. Do not take this
medication without first talking to your doctor if you are pregnant. |
|
• |
It is also not known whether tramadol passes into breast milk. Do
not take tramadol without first talking to your doctor if you are
breast-feeding a baby. |
|
• |
If you are over 75 years of age, you may be more likely to
experience side effects from tramadol. The maximum daily dose of
tramadol for people over 75 years of age is 300 mg. |
|
• |
Tramadol is not approved by the FDA for use by children younger than
16 years of age. |
How should I take tramadol?
|
|
• |
Take tramadol exactly as directed by your doctor. If you do not
understand these directions, ask your pharmacist, nurse, or doctor to
explain them to you. |
|
• |
Take each dose with a full glass of water. |
|
• |
Tramadol can be taken with or without food. |
|
• |
Side effects from treatment with tramadol may be decreased by a slow
increase in dose, as directed by your doctor. The tablets can easily be
broken in half at the score if needed. The maximum dose of tramadol for
an average healthy adult is 100 mg per dose, every 4 to 6 hours, up to
400 mg per day. People over 75 years of age should not take more than
300 mg per day. People with liver or kidney disease may need lower daily
doses. Follow your doctor's directions. |
|
• |
Do not take more of this medication than is prescribed for you. If
the pain is not being controlled, talk to your doctor. Taking more than
the prescribed amount of this medication could result in seizures or
decreased breathing. |
|
• |
Store tramadol at room temperature away from moisture and heat. |
What happens if I miss a dose?
|
|
• |
Since tramadol is taken on an as-needed basis, missing a dose is
usually not a problem. Take the dose as soon as you remember, and do not
take another dose for the amount of time prescribed by your doctor. Do
not take a double dose of this medication. |
What happens if I overdose?
|
|
• |
Seek emergency medical attention. |
|
• |
Symptoms of a tramadol overdose include difficulty breathing;
shallow, weak breathing; and seizures. |
What should I avoid while taking tramadol?
|
|
• |
Do not drink alcohol while taking tramadol. Alcohol may cause a
dangerous decrease in breathing and/or liver problems when used during
treatment with tramadol. |
|
• |
Use caution when driving, operating machinery, or performing other
hazardous activities. Tramadol may cause dizziness or drowsiness. If you
experience dizziness or drowsiness, avoid these activities. |
|
• |
Avoid sleeping pills, tranquilizers, sedatives, and antihistamines
except under the supervision of your doctor. These drugs may increase
drowsiness caused by tramadol. |
|
• |
Tramadol may increase the effects of other drugs that cause
drowsiness, including antidepressants, alcohol, other antihistamines,
pain relievers,
anxiety medicines, seizure medicines, and muscle relaxants.
Dangerous sedation, dizziness, drowsiness, or decreased breathing may
occur if tramadol is taken with any of these medications. Tell your
doctor about all medicines that you are taking, and do not take any
other prescription or over-the-counter medicines, including
herbal products, without first talking to your doctor during
treatment with tramadol. |
What are the possible side effects of tramadol?
|
|
• |
If you experience any of the following serious side effects, stop
taking tramadol and seek emergency medical attention or contact your
doctor immediately: |
| |
· |
an allergic reaction (difficulty breathing; closing of your throat;
swelling of your lips, tongue, or face; or hives); or |
|
• |
Other, less serious side effects may be more likely to occur.
Continue to take tramadol and talk to your doctor if you experience |
| |
· |
dizziness, drowsiness, or headache; |
| |
· |
nervousness, tremor, or anxiety; |
| |
· |
nausea, vomiting, constipation, or diarrhea; or |
| |
· |
itching, dry mouth, or sweating. |
|
• |
Tramadol is habit forming. Physical and/or psychological dependence
can occur, and withdrawal effects are possible if the medication is
stopped suddenly after prolonged or high-dose treatment. |
|
• |
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. |
What other drugs will affect tramadol?
|
|
• |
Tramadol may increase the risk of seizures especially in patients
who have epilepsy or another seizure disorder. Also, tramadol may
increase the risk of seizures if you are taking any of the following
drugs: |
| |
· |
a tricyclic antidepressant such as amitriptyline (Elavil),
nortriptyline (Pamelor), doxepin (Sinequan), imipramine (Tofranil),
clomipramine (Anafranil), and others; |
| |
· |
a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan),
phenelzine (Nardil), or tranylcypromine (Parnate); |
| |
· |
an antipsychotic medication such as chlorpromazine (Thorazine),
fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane),
mesoridazine (Serentil), perphenazine (Trilafon), thioridazine (Mellaril),
thiothixene (Navane), and others; |
| |
· |
a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine
(Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft),
or citalopram (Celexa); |
| |
· |
a narcotic pain reliever such as codeine, fentanyl (Duragesic),
hydromorphone (Dilaudid), meperidine (Demerol), hydrocodone (Vicodin,
Lorcet, Lortab, others), morphine (MS Contin, MSIR, RMS, Roxanol,
others), oxycodone (Roxicodone, Percocet, Percodan, others),
propoxyphene (Darvon, Darvocet, others), and others; |
| |
· |
promethazine (Phenergan) or prochlorperazine (Compazine); |
| |
· |
bupropion (Wellbutrin, Zyban); or |
| |
· |
cyclobenzaprine (Flexeril). |
|
• |
Do not take tramadol without first talking to your doctor if you are
taking any of the medicines listed above. |
|
• |
Before taking tramadol, tell your doctor if you are taking any of
the following medicines: |
| |
· |
carbamazepine (Tegretol); |
| |
· |
quinidine (Quinaglute Dura-Tabs, Cardioquin, Quinora, others); |
| |
· |
warfarin (Coumadin); or |
| |
· |
digoxin (Lanoxin, Lanoxicaps). |
|
• |
You may not be able to take tramadol, or you may require a dosage
adjustment or special monitoring during treatment if you are taking any
of the medicines listed above. |
|
• |
Tramadol may increase the effects of other drugs that cause
drowsiness, including antidepressants, alcohol, antihistamines,
sedatives (used to treat
insomnia), other pain relievers, anxiety medicines, and muscle
relaxants. Tell your doctor about all medicines that you are taking, and
do not take any other prescription or over-the-counter medicines,
including herbal products, without first talking to your doctor during
treatment with tramadol. |
|
• |
Drugs other than those listed here may also interact with tramadol.
Talk to your doctor and pharmacist before taking any prescription or
over-the-counter medicines, including herbal products. |
Where can I get more information?
|
|
• |
Your pharmacist has more information about tramadol written for
health professionals that you may read. |
|
|