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Tramadol is a strong pain medication used to treat moderate to severe pain that is not being relieved by other types of pain medicines. Tramadol is a synthetic opioid and acts in the brain and spine (central nervous system) to reduce the amount of pain you feel.
The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.
Taking tramadol during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before taking this medicine
You should not take tramadol if you are allergic to it, or if you have:
- severe asthma or breathing problems;
- a stomach or bowel obstruction (including paralytic ileus);
- if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications; or
- if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine).
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Tramadol should not be given to a child younger than 12 years old. Ultram ER should not be given to anyone younger than 18 years old.
Do not give this medicine to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.
Seizures have occurred in some people taking tramadol. Your seizure risk may be higher if you have ever had:
- a head injury, epilepsy or other seizure disorder;
- drug or alcohol addiction; or
- a metabolic disorder.
How should I take tramadol?
Take tramadol exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Never use tramadol in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to take more of this medicine.
Never share tramadol with another person, especially someone with a history of drug addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine where others cannot get to it. Selling or giving away this medicine is against the law.
Stop taking all opioid medications when you start taking tramadol.
Tramadol can be taken with or without food, but take it the same way each time.
Swallow the capsule or tablet whole to avoid exposure to a potentially fatal overdose. Do not crush, chew, break, open, or dissolve.
Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon).
Never crush or break a tramadol tablet to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death.
You may have withdrawal symptoms if you stop using tramadol suddenly. Ask your doctor before stopping the medicine.
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Store at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.
Do not keep leftover tramadol. Just one dose can cause death in someone using it accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, mix the leftover medicine with cat litter or coffee grounds in a sealed plastic bag throw the bag in the trash.
Dosing information
Usual Adult Dose for Pain:
Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain
-For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days
Maximum dose: 400 mg per day.Usual Adult Dose for Chronic Pain:
Extended-Release (ER):
18 years or older (tramadol-naive): 100 mg orally once a day
-Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions
-Maximum Dose: 300 mg/dayFor patients CURRENTLY receiving Immediate-Release (IR) Tramadol:
Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a dayConversion from other Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy
-Initial dose: 100 mg ER orally once a day
-Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions
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