Doctors' Answers to "Frequently Asked Questions" - Ultram


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 09/13/2000]
Question: History: As a teenager my husband was a heroine addict for about five years. He cleaned himself up for a few years, then began using heroine again. When he seen the "old life" coming back to haunt him, he turned to methadone to stay away from street drugs. While on methadone he started suffering from anxiety, so his doctor started prescribing him xanax, which he has been on for about five or six years (almost as long as the methadone). Trying to regain his life, once again, my husband (and hero) has gone through a rapid detox off of methadone. He has not had a dose in two and a half weeks and his withdrawls are nothing, compared to going cold turkey. Now my question, after my husband has been suffering from mild withdrawls the doctor prescribed him "a mild pain reliever" Ultram. According to the research (from the manufactures) anyone who has had an additiction to an opiate should not be given this medicine, however his doctor prescribed 50 mg every 4 to 6 hours for pain, should he be taking this? Could he become dependent/addicted to this medication? And with taking the Xanax, could he have seizures because there are warning with mixing Ultram and psycotropic medication. Thank you for your help!

Answer: Not unless he wishes to become readdicted. He will probably become dependent, this is an ill advised drug in a previous narcotic addict. Xanax is also habit forming, did he try one of the SSRI antidepressants? Paxil, Prozac etc.?

[posted 08/20/2000]
Question: I have been taking Ultram for approximately 3 years now. My Doctors that performed my back and neck surgeries but me on it after battling with narcotic addiction. I recently stopped taking the drug, and am suffering severe withdrawal sysmtems. I stopped 6 days ago, in those past 6 days I have slept approximatetly 20 hours. I feel like jumping out of my skin, very anxious and very shaky. My leg twitches at night would be worthy of a black belt in karate!! When will these symtems lessen? I feel like I am going crazy and am sooooo tired but can not sleep. It's all I can do to not go find a Dr. to prescribe what I need to feel better. Is there life after Ultram?

Answer: You are having narcotic withdrawal to the ultram-very similar to any narcotic. Like narcotic withdrawal, it will take about 10 days to 2 weeks to be gone completely-with the worst over in 3-5 days.

[posted 06/28/2000]
Question: I have been reading your postings on the drug ultram and i want to add my two cents. I experienced major head injury(tripod fracture)in 1992. I have implants and fixation plates and screws and the headaches i have experienced for years have only gotten worse. I have tried those migrane drugs like immitrex but they did little, Motrin which destroyed my stomach, and other things. Drs dont want to prescribe narcotics, other then occasionally, because of reasons that i cant understand. THANK GOD FOR ULTRAM. i am not a drug abuser and i am not drug dependant and i take them when i need them and i get relief from very bad pain. so dispite the bad stuff previously posted about ultram and the concern others have about dependency, i am glad i can be treated like a responsible adult and have a real tool to manage my pain. thanks

Answer: Ultram is a very useful medication, but like most medications-there is no free lunch. Thanks.

[posted 04/9/2000]
Question: I need a long term prescription for ultram. I recently had to change doctors and I am having a hard time getting my medication. For the past three years I have taken 300 mg of ultram a day for the pain in my left leg. A physician with Kaiser Permanente started me on the medication in june of 1998 after determining that a degenerating disc was the cause of my pain. I work in a large warehouse on concrete floors and without the medication the pain is almost unbearable. Of all the pain relievers I have used, ultram is the best. I get the pain relief without the side effects that you get with most pain medications. However my current doctor will not give me a precription. I have read a lot about this drug and its addictive potential, but I have not had any adverse side effects from it. Can you help?

Answer: You need a conversation with your md. If he/she is unwilling, they may refer you to a pain specialist. In the meantime, ask around for doctors who understand the nature of long term chronic pain. Your community will have some who understand how and why to prescribe appropriate pain treatments. Then switch to them as your primary.

[posted 03/27/2000]
Question: I have undergone Microvascular Decompression for the 9th and 10th cranial nerves to treat glossopharylyngual neuralgia.It has helped the pain somewhat. After the operation, I've had severe acid-reflux,nausea, vomiting. I am still on Zoloft and Klonopin for the atypical pain. Also Utram for pain due to the post-operative skull pain. Not always, however, sometimes, I go into severe vomiting after taking the Ultram.
Is this a drug reaction or a symptom of the head pain? My Doctors aren't sure and I'd love to know your opionion. Thank you.

Answer: Some patients do have nausea/vomiting after taking Ultram since the narcotic type receptor can affect your stomach like a traditional narcotic.

[posted 03/24/2000]
Question: I have been taking Ultram for migraine headaches when they do not respond to Maxalt-MLT. Since approximately March of 1999 I have been taking Ultram more frequently for tension and sinus/allergy related headaches with good results. I have two questions regarding Ultram first, are there any side effects such as ear pain or damage from prolonged use? Second, I am aware of (and have unfortunately experienced) the potential for effects on sexual performance - specifically the ability to achieve orgasm. Is there anyway to prevent this side effect AND still continue to take the medication? For example, if the effects of the medication last for anywhere from 4 to 8 hours, can you gauge the time last taken so that the effects (or side effects) will not interfere with sexual activity? Perhaps skip the dose until after sex with the hope of not having the unpleasant interference of the medication and sexual performance? Or are the effects of Ultram more long-lasting and more time would be required in order for the medication to clear your system and not interfere with sexual performance? If the latter is the case, how much time should be allowed for the effects of the medication to be gone in order to not interfere with sex? I would like to continue taking Ultram as needed for pain since it has worked well for me however, recently it has interfered consistently with my sexual enjoyment and would consider either stopping the medication or changing to another one in order to eliminate the side effect. Thank you for your response!

Answer: This is extremely variable and you will need to experiment. Since Ultram works in a similar manner to mild narcotics, the sexual depression varies. Some have no sexual depression, others have major problems. You are aware that this is a potential addictive drug? Sometimes viagra with the meds will be helpful.

[posted 03/11/2000]
Question: Will the new drug known as Ultram, which is supposed to be a non-narcotic, show up positive for opiods on a drug screening?

Answer: Probably not since the structure is different and it affects the receptors in a similar manner. But, I have no direct information.

[posted 02/29/2000]
Question: I HAVE BURNING AND SLIGHT CRAMPING IN MY CALFS AND FEET FOR ABOUT A YEAR 3/99. I STARTED WEARING INSERTS AND THAT WITH SOME OF THE PAIN IN THE BOTTOM OF MY FEET. I HAVE BEEN TAKING ULTRAM FOR A YEAR NOW ABOUT 2 PILLS A DAY.
IF I DONT TAKE IT THE BURNING GETS UNSLEEPABLE. I HAVE HAD OF BLOOD WORK AN MRI OF THE BACK PLUS.I AM WONDERING IF THE ULTRAM IS CAUSING THE BURNING? I HAVE TRIED TO STOP FOR 2 OR 3 DAYS BUT THE BURNING AND CRANPING IS TO GREAT.

Answer: The burning is not the Ultram since it predated the Ultram, probably a peripheral neuropathy-but other possibilities. What does your md think it is? There are much cheaper narcotic like analgesics to take that would work like ultram if it is a chronic condition.

[posted 02/28/2000]
Question: Can you use the medicine ultram while pregnant ? I use this medicine for migrane headaches.

Answer: Possibly, but I would stick to other narcotics with long term track records in pregnancy like Darvon, or codeine.

[posted 02/15/2000]
Question: I am a 28 year old female, very healthy and athletic. (Used to run 3 miles a day)
I was in a car accident,hit head on and dislocated and fractured my hip.
I also crushed the left knee on the dashboard. All of the bones in the knee have joined
and seem to be working fine, yet there is no cartilidge left.
The hip has no signs of avascularneuclorosis (sorry about spelling)
yet has very little cartlidge as well. I have done physical therapy and continue feeling the pain may subside,
but it has not. The alternatives now that have been suggested are the three drugs already mentioned (vioxx, lodine, relafen).
Each of these left side effects that were awful. Between the dierrhea, nausea, and "fog" like state, I was miserable. The idea suggested now is "ULTRAM."
What I have read on it does not sound good for someone looking to be on it from age 28 on. Are there any other suggestible options? How about the ULTRAM, what about the addicitve tendencies I am reading about,
and have there been any long term studies? My family has a long history of alcoholism and a small history of drug addiction. I have been very cautious all of my life and have never been on any drug before.
I am open to any suggestions.

Answer: Ultram does have mild addiction potential. But, the option is some other drug(and you've failed the usual ones) or taking some addiction. Accupuncture or a TENS unit would be the only other options to narcotics of some variety. But, I suspect you will need long term narcotics. I'd personally use Tylenol \\#2 or \\#3 prior to Ultram since they're a lot cheaper and about the same addiction potential(maybe less).

[posted 02/2/2000]
Question: My doctor just prescribe Ultram for chronic pain. I get terrible fibromylgia attacks where it is hard to get out of bed without help, walk or move. Accompaning with them comes migraines. The only thing that works is an injection of demerol with medication for nausea. My doctor wanted me to try this but when I did I experenced increased heart rate, felt like blood pounding in my ears, nerousness (I felt "wired", insomnia and my skin itched. If felt like hot pin pricks. Have you heard of this reaction? Also what do I do for chronic pain? HELP

Answer: The skin itching is fairly common with narcotic and narcotic like medications. The others are reported but less common. A good treatment for chronic pain currently eludes us. You would be advised to see a pain specialist if you have not, or a specialist in fibromyalgia.

[posted 01/20/2000]
Question: I had a dentist appt. at 4:00 pm yestereday afternoon & had to premidicate with Trimox at 3:00 due to having Mitrel Valve Prolapse. At approx 2:30 I took 50mg of Ultram for back pain at 3:00 I took 2000mg of Trimox. At 3:15 I started having severe stomach pain and soon after started getting very hot. By 3:30 I knew it was a drug reaction & it was pointed out by my co-workers that I was bright red from head to toe (and extremely uncomfortable because now I was even more hot & had started sweating. Once in the ambulance they started a Benadryl drip and not long after we got to the hospital (about 10 min.)I started shivering and became extremely cold. They gave me Prednazone,Thyamine,Visteril & Pepsid. I've never in my life had an allergic reaction to ANY medication including antibiotics. I believe the reaction was caused by the combination of the 2 drugs and though the doctors didn't seem to think that was the case they wouldn't rule it out 100%. I can't find enough info on Ultram to prove or disprove my theory. Is there any info that you have that can shed any light on what really caused this?

Answer: No. But, an adverse reaction form needs to filed with the FDA to document the problem. Available in the hospital pharmacy and commonly ignored by physicians.

[posted 11/21/1999]
Question: I weaned myself off Prozac this past summer after being on it for 5 years. I was taking 20 mg/day during the winter and 10 mg/day during the spring/summer/fall months. I live in N WI and have SAD to some extent, but my job was the primary cause of my depression, which I have since "gotten rid of" due to downsizing. Although I have been "arming" myself with St. John's Wort, Mega B Stress Vitamins, and other vitamins(chewable) and minerals(liquid,) I suffered through a bad week and then was asked to be put on Effexor. I am starting on 37.5 mg and working my way up to 75 mg after the first week. I am also taking Ultram 50 mg
(50-300 mg/day) for back pain. Will the Effexor lessen the effect of the Ultram? If I don't respond well to the Effexor, would it be ok to ask for Ritalin or DextrStat PLUS the Effexor with my hypertension? I have a bad case of "white coat syndrome" where my blood pressure is normal
(120/80) at home, but goes up (150/90) in the doctor's office. I am also a heavy coffee drinker. I have a mini-espresso machine, so am used to drinking double lattes. I don't consume alcohol nor smoke. Please respond with your opinions. Thank you.

Answer: Why not go back to the Prozac if it was working? The Effexor should have minimal effect on the Ultram other than possible sedation -it will not lessen the effect, if anything help to decrease the dosage of the Ultram. I would avoid Ritalin with your blood pressure, especially if the Prozac did work.

[posted 11/24/1999]
Question: I take 100mg of Sinequan a day, is it safe to take Ultram while on the Sinequan?

Answer: Wouldn't expect a problem, except possibly some sedation.

[posted 08/23/1999]
Question: I have been taking Ultram on and off for about 2 years now for undiagnosed noncardiac chest pain and back pain. When I take it I only take 1 50mg tablet a day. I have had no adverse side effects except increased alertness. A few months ago I took one and it made me a bit nausous, and another time I got light headed and nausous but diodn't pass out. This morning however I took one and lost consciousness I think. I found myself sitting on the floor in front of the chair I was sitting on and my mind was racing until I eventually came around. Is this a seizure? Why would I suddenly have such a reaction after being on it for so long? I am taking Neurontin but have taken Ultram many times in addition to Neurontin w/out such a reaction. Any ideas? Should I stop taking the Ultram?

Thanks!

Answer: Could be a seizure, but there are other causes for syncope(passing out). Do you have a pre-existing seizure disorder? I would stop the Ultram in any case.

[posted 10/19/1999]
Question: I need more information on Tramadol Hydrochloride before I start to take this drug.

Answer: This drug goes by the brand name Ultram. It is a synthetic analgesic and appears to bind in some manner to opioid receptors in the brain. However, the mode of action is not completely known. It causes similar side effects to narcotics, but generally less depression. It does appear to increase seizure risk and should not be used with MAO inhibitors, neuroleptics or other drugs that could affect the seizure threshold. It should not be taken with alcohol or sedatives unless under close supervision. Withdrawal occurs if the drug is abruptly stopped, similar to narcotic addiction. The most common side effects are dizziness, nausea, constipation, headache, pruritus and vomiting. A pretty good pain pill if used for short durations, but pricey.

[posted 08/15/1999]
Question: Dear Doctor,

Two years ago I developed bursitis in both hips. I was prescribed Ultram for several months and recived cortisone shots in the hips. I also have recuring lower back pain.
The Ultram works wonderful, but I know that I am now taking it for the "Good" feeling it gives me also. I am too emabarassed to talk to my Doctor about this. I have actually been buying generic ultram off the internet because I dont want the Doctor to know I am feeling addicted to this drug and using it still.. I dont have any physical withdrawl symtoms when I run out of the drugs other than just wanting it to feel good. I am in a quandry.....The Ultram really keeps the pain away.....but I KNOW I am abusing it too! What should I do?
Thank You

Answer: This won't get better until you face the need to be off this drug. This is an addicting drug in most patients-similar to any other narcotic.

[posted 08/13/1999]
Question: I read the Ultram FAQ. I am an attorney. I do employment class actions on the plaintiff side. I find it frankly unbelieveable that McNeil did not know of the addictive potential of Ultram. It had been used in Germany for 14 years before it was approved in the US. I do not sue doctors, and I do not waste taxpay money on frivolous litigation. The types of cases I handle involve systematic and blatant discrimination, not the wishy washy variety. From what I read, it is a virtual certainty that McNiel has correspondence with German distributors and doctors reporting side effects not made known to the FDA durring approval. Small, severely monitored populations, used to test for FDA are not going to mimic the behavior of those who can pretty much get as much Ultram as they want (the FAQ suggests that's not far off). More sinister, although pure conjecture, is whether McNiel concealed the addictive potential so that doctors would be more generous with it than, eg, narcotics, thereby generating more profit. If you know of anyone who has legitimately been injured by McNiels failure to warn of the abuse potential, if they are angry and would feel better knowing they are doing something, like finding out what McNiel actually knew, I would be willing to speak to them. You have my email address.

Answer: I basically agree with your comment, and your letter is posted on our net site.

[posted 08/10/1999]
Question: I recently started taking Vioxx 25mg once a day for back pain. Doctor also prescribed Ultram 50mg 3 times a day. I haven't been taking Ultram because it seems to bother my stomach. Questions:
1. Will stomach distress eventually not occur?
2. I have a history of seizures. The first one occured when I was 40 which was 20 years ago. I had a total of about 5 seizures, but have not had one for about 13 years. Is Ultram contraindicated in my case. If so, is there a substitute for it?

Answer: It will probably persist. As to the seizures, it is a relative contraindication-especially if taken with SRI antidepressants, tri-cyclic antidepressants, opiates, MAO inhibitors,or neuroleptics.

[posted 08/8/1999]
Question: My mother has been taking the prescription drug Ultram for her arthritis pain. When she runs out she appears to go into some type of withdrawal symptoms, especially insomnia.She has been on this drug for at least 3 yrs. Any information would be appreciated. Thank you, S.P

Answer: Ultram is a potentially addicting medication used for chronic /acute pain. When it first came out, the potential addicting possibilities were less appreciated. Now it's pretty clear that it is mildly addicting. However, if she needs it for the pain and doesn't have significant side effects-so what? Pain is generally more debilitating than most people appreciate.

Addiction to Ultram [posted 1/14/99]
Question: I am strongly addicted to Ultram and have been for three years. I have consistently been taking six pills a day for two years. The pills run my life! I have to have them to even be able to function during the day. When I have tried to withdraw myself from them, I cannot sleep at night. I have perspiration pour all over me and I feel like bugs are climbing on my body. It has been a total nightmare. I have been telling my doctor for a year what I have been going through, but he has ignored it up until now. He continued to tell me that it was not addictive and that it was all in my head. Well now they are putting me in a drug rehab to withdraw me from it. I don't know who to blame. Who is at fault? McNeil Pharmaceutical told my doctor that it was NOT addictive so he was going by what they said. Now that my doctor has discussed my situation with them, they are saying that there is a small percentage that are becoming addicted to it. This is very upsetting to me as I have suffered dearly. I don't know who to blame. Should my doctor have known? My pharmacist at two different locations told me that I was taking too many of those pills and they were addictive. Do you have information on Ultram that you can send me or can you direct me somewhere where I can get all the ends and outs of Ultram. Please help me any way possible.

Answer: This drug was advertised by McNeil as not being addictive, but usage has demonstrated otherwise. As to the blame, that's a legal problem. I'd focus on getting into rehab and off the medications. I've had the same problem with the drug although I don't have anyone who needs rehab. What information are you looking for on Ultram? Legal? You know its addictive capacity.

Ultram Information [posted 10/28/98]
Question: Could you send me some general info on this Rx. For instance: What class does this drug belong to (Narcotics?) and what is the dependency chance with this new medication? If any, is it physical or psychological dependency? thank you

Answer: Well, it is semi-synthetic centrally acting analgesic that appears to work at the opioid receptors in some fashing currently not completely understood. The initial information from the company showed no dependence;but, clinically, we see patients who have physical dependence on this drug. It is not currently classed as a narcotic.

Concerns About Vertigo on Ultram [posted 10/28/98]
Question: My doctor has just prescribed Ultram to handle the pain I have with Fibromylgia. I also take Zoloft (100 mg) daily, use Imitrax for migraine headaches, take Estrace for hormone and cyclobenzapr (10 mg) nightly. It works great for the pain. I have noticed that when I wake up during the night after taking it that I have a real problem with vertigo. Also I have a rash all over my face and neck. Have you had any reports of Ultram causing this?

Answer: Vertigo more commonly than the rash, both are listed as possible side effects.

Ultram Concerns [posted 10/9/98]
Question: For my real bad headaches, I sometimes receive narcotics, such as darvocet-N 100s, or hydrocodone containing pills, such as Vicoden, at other times, sence my headaches come from stress and are tension headaches I have taken fiorinal, and other barbiturates. My doctors don't want me taking the same drug because of addictive potential of some of them, so they experiment with different ones to relieve my pain. Now they gave me a drug called Ultram, and my question is can taking one drug somehow effect they way another drug could work or used to work? what I mean is, that if I take this Ultram, and it don't work as well, so I go back to Darvocet, or something that worked better before, could the Ultram chemically change the way the other drug would work, because it binds to the same receptors (opiods receptors), or does the brain have many receptors for each, or any drug for that matter?

Answer: Not usually unless you develop co-tolerance, possible with narcotics.

Very Happy With Ultram [posted 10/9/98]
Question: I have a comment to make about "ULTRAM". Thank you, McNeil Pharmaceuticals! I've had pain in mymal t hand for 10 years. I have had all the nerve conduction tests, fusion between 6 and 7, carpal tunnel surgery, and surgery @ the left elbow. Tried acupuncture and most medications for pain. Until my Dr. recently prescribed "Ultram",50mg, for daytime use, and "Hydrocodine", for evenings, with "Etodolac" 400mg (twice daily), I had just about given up on the possibilities of any relief from this pain! I have had no ill side effects from either of these medications, but have experienced a really "GOOD", feeling. Maybe, as suggested by others, that good feeling is no more than the subdued pain. Anyway, just wanted to say, "THANK YOU", to McNeil and my Dr. If you're looking into "Ultram", this a positive review !

Answer: Thanks for the input.

Ultram Side Effects [posted 8/5/98]
Question: The listed side effects of Ultram include urinary problems. Does this include problems getting and maintaining an erection and/or achieving orgasm? I have chronic back and hip pain and Ultram has worked very well, but the side effect above is my concern now.

Answer: Yes, an occasional problem.

Ultram [posted 7/30/98]
Question: My husband has been using ultram every since it came out. His doctor put him on it, and he wanted to wean him off of narcotics. My husband had a injury at work and then a car wreck three weeks after his surgery. That wreck re-injured his back, and he had to go in for another surgery on his lower back in 1995. In 1996 someone in a car was on top of a hill on our side of the road and hit our car. That wreck re-injured his lower back again. He needs to have a back fusion done, but due to the car insurance resistance he is having to wait until the mess can be straightened out. He has had so much bad luck with his back, they don't know what part of it is their responsibility even though the doctor has explained it. I wanted to let you know the situation before I told you my reason for writing. When they started him out on ultram, they didn't want him back on any narcotics. The doctors said the effects of this drug were good because it was not addictive. Now they come out saying it is addictive and can cause seizures, just by taking it with no other medicine. We did not know any of this until three weeks ago. He had a seizure in 1996, and no one could figure out why. Since then he has not had any. These doctors gave him a prescription with 12 refills and 240 pills a month. He has been addicted to them for over a year. I've seen it the whole time, but my husband did not believe me. Neither did the doctor who gave it to him. He gets very hateful after the effects of the medicine wear off. His concentration is always shot when he is on it. I have to watch out for him. They do not want you to take narcotics, afraid you will get addicted to them. So what is the option for people who are in constant pain? Why did the makers of this drug not alert us to this problem sooner? Is there any way that a person can get compensated for their mistake? I know if the person taking it could see the problems they should quit, but when they get attached to something like that, they cannot see it. Sometimes people do not argue with a doctor because you would think they knew everything about the medicine they are prescribing. If there is any information about the new releases on ultram, please let me know. It's hard to find any information on this when they are trying to keep it quiet.

Answer: The manufacturers of this drug tried to represent it as a non-narcotic alternative. Many physicians, including myself, took this in, in the early days of the drug. I think if you look at earlier questions in this column you will see that I addressed a similar problem on Ultram -corrected by a reader - as a non-narcotic alternative. I have a lot of ethical problems with the way that the drug was marketed and I suspect someone will take them to court for this approach. However, if your husband has not seen a pain specialist it needs to happen. Unfortunately, the only way to hold most pain is through narcotics. This leads to potential addiction. However, there is often no choice for the patient in marked pain. If your doctor is not understanding about the need to abolish your husband's pain, I would look for additional medical help.

Ultram [posted 7/16/98]
Question: Are they going to change Ultram to a narcotic?

Answer: Do you mean change the schedule? I doubt this and haven't heard of a change.

Ultram for Fatigue
Question: I have been taking a drug called Ultram for the past year for aching muscles and fatigue. This drug is usually prescribed for pain, which my physician prescribed for headaches, but I found it to be so effective for my lack of mental energy, muscle aching and general fatigue that I take it once every day and it works like a miracle. Can you tell me why? Also, do you know of any long term side effects?

Answer: There are no obvious long term side effects to date, although it has only been available for 5 years or so. I have several patients who take it for Restless Leg Syndrome and it really helps their sleep patterns, possibly the reason you are having the increased mental alertness. I doubt the drug itself would have this effect unless it affected some other part of your metabolism/sleep cycle.

Ultram
Question: My doctor has started me on a medication called Ultram. I am taking it for chronic headaches. It seems to help really well. Can you tell me more about this medication?

Answer: Ultram goes by the generic name tramadol, and it is an analgesic, or pain reliever, that has several reported possible mechanisms of action. In part, this medication works by effecting the brain's metabolism of two chemicals known as serotonin and norepinephrine. In addition, it also likely has some effect at an opioid center in the brain. The body clears this drug via the urinary tract and its half life (or, time it takes for the body to remove 50% of the drug) is 6-8 hours. This medication has proven to be effective in the treatment of pain, but it has several side effects that you should be aware of. It should, firstly, not be used in conjunction with narcotics, alcohol, or psychotropic drugs (medications used for conditions such as schizophrenia, depression, mania, bipolar disorder, etc.). There is a risk of patients on this medication experiencing seizures. This risk is increased in patients taking the drugs just mentioned, as well as in those who already have some form of seizure condition. Allergic reactions are rare but have been reported and can be severe. Therefore, any individual with a history of allergy to this medication or any narcotic should take this medication only after a thorough discussion with their health care provider. There are several other side effects which are also not common but include low blood pressure, anxiety, confusion, insomnia, nausea and/or vomiting, headache, constipation, dry mouth, heartburn due to acid reflux, urinary symptoms, rash, liver problems, and mild anemia. Overuse or abuse of this medication can obviously be very harmful. The typical dosing of this medication is 50mg to 100mg every 4 to 6 hours, not to exceed 400mg per day. This limit is reduced to 300mg per day in the elderly. As is always the case, when you are on any medication prescribed by your health care provider, regular follow up is the best way to ensure that the medication is not only successfully treating the condition for which it was intended, but also to ensure that no harmful side effects are occurring.

Ultram Side Effects
Question: I would like to know about the drug ultram. Is it habit forming and does it have side effects.

Answer: Ultram(tramadol hydrochloride) is a centrally acting analgesia which is different from opiates. However, it appears to have affinity for opiate receptors in the brain and possibly in the body as well. Vertigo, constipation, headache, confusion, nausea are the most common side effects. Currently, it is not thought to be addictive.




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