Side effects
Tramadol may cause serious allergic reactions including anaphylaxis which can be life-threatening. Anaphylaxis requires immediate medical attention. Contact your doctor immediately if you have the following symptoms:
Patients taking tramadol may experience dizziness, lightheadedness, or fainting especially suddenly getting up from a lying or sitting position. Slowly getting up can possibly help with this problem.
There have been reports that taking tramadol with antidepressants known as selective serotonin reuptake inhibitor can lead to serotonin syndrome, this adverse effect is potentially life threatening. Seek medical attention if you have symptoms of serotonin syndrome which include changes in mental status, agitation, tremor, over responsive reflexes, tachycardia, and muscle twitching.
Cautions
Make sure to tell your doctor about all the other medicines you are using. It is also important to inform the doctor whether you have had an unusual reaction to tramadol or any other drugs. Other allergies, such as to foods, dyes, preservatives, or animals should also be mentioned.
The extended-release tablets are for oral use only and should be swallowed whole. They should not be chewed, crushed, or split.
Tramadol potentiates the effects CNS depressants such as alcohol and certain drugs. Examples of these are sedatives, tranquilizers, anticonvulsants, muscle relaxants, sleeping pills, and some antihistamines. Patients are therefore advised to avoid alcohol while taking tramadol, they should also check with their doctors before taking any medicines that may affect their level of alertness.
Tramadol may increase the side effects of some medicines that are used during surgery or emergency treatments. Always tell the health professional in charge that you are taking tramadol before having any kind of surgery or emergency treatment.
Tramadol must be used with caution in patients with history of seizures or those with a reduced seizure threshold due to certain medications, including: MAO inhibitors, tricyclic antidepressants, other tricyclic compounds (i.e. cyclobenzaprine, promethazine), neuroleptic drugs, selective serotonin reuptake inhibitors (SSRIs), and others.
Seizures can occur with tramadol, particularly if taken high doses or if used with medicines that reduce seizure threshold. Tramadol may also increase the risk of seizures in epileptic patients or those who with seizure risk.
Tramadol should not be discontinued without the doctor's advice. Decreasing the dosage gradually may be recommended to prevent a possible worsening of the condition and to reduce the risk of withdrawal symptoms such as headache, nausea, anxiety, difficulty with sleeping, tremors, or diarrhea
Contraindications
Tramadol is contraindicated in patients who previously had an allergic reaction to the drug or other opioids.
Tramadol should not be given to patients with acute intoxication from alcohol or drugs such as hypnotics, narcotic analgesics, or psychotropics because it can increase the effects of these agents.
Tramadol is contraindicated in patients with a past or present history of narcotic dependence.
If you are taking tramadol, you should not drive a car, operate machinery, or perform any other activities that require alertness until you know how the drug affects you.
Drug interactions
Various drugs have been found to interact with tramadol. Some interaction involve changes in metabolism. Carbamazepine, for example, reduces the effect of tramadol by increasing its metabolism. There following classes of drugs increase the risk of seizure when taken with tramadol:
Taking tramadol with the any of following drugs increases certain certain side effects. The doctor may change the dose or the frequency of use of one or both of the drugs.
These are just few of the drugs that may affect tramadol. Tell your doctor about all the medications, vitamins, minerals, herbal products you use to find out whether it is safe to take them with tramadol.
• If you are 65 or older, use this medicine with caution. You could have more side effects.
• This medicine may be habit-forming with long-term use.
• If you have a history of drug or alcohol addiction, talk with healthcare provider.
• If you have kidney disease, talk with healthcare provider.
• If you have liver disease, talk with healthcare provider.
• If you have PKU, talk with healthcare provider. Some products do contain phenylalanine.
• If you have seizures, talk with healthcare provider.
• If you have attempted suicide, talk with healthcare provider.
• Check medicines with healthcare provider. This medicine may not mix well with other medicines.
• You may not be alert. Avoid driving, doing other tasks or activities until you see how this medicine affects you.
• Avoid alcohol (includes wine, beer, and liquor) or other medicines and natural products that slow your actions and reactions.
• Tell healthcare provider if you are pregnant or plan on getting pregnant.
• Feeling lightheaded, sleepy, having blurred vision, or a change in thinking clearly. Avoid driving, doing other tasks or activities that require you to be alert or have clear vision until you see how this medicine affects you.
• Feeling dizzy. Rise slowly over several minutes from sitting or lying position. Be careful climbing.
• Headache.
• Nausea or vomiting. Small frequent meals, frequent mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
• Constipation. More liquids, regular exercise, or a fiber-containing diet may help. Talk with healthcare provider about a stool softener or laxative.
• If you suspect an overdose, call your local poison control center or emergency department immediately.
• Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.
• Severe dizziness or passing out.
• Difficulty breathing.
• Signs or symptoms of depression, suicidal thoughts, nervousness, emotional ups and downs, abnormal thinking, anxiety, or lack of interest in life.
• Significant change in thinking clearly and logically.
• Seizures.
• Poor pain control.
• Severe nausea or vomiting.
• Severe constipation.
• Feeling extremely tired or weak.
• Any rash.
• No improvement in condition or feeling worse.
• This medicine does not mix well with some medicines. Serious reactions may occur. Check all medicines with healthcare provider.
• If you have an allergy to tramadol or any other part of this medicine.
• Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other symptoms involved.
• If you are addicted to drugs.
• If you are an alcohol drinker or take any alcohol-containing medicines.
• If you have lung disease.
• If you are breast-feeding.
• Tramadol binds to brain receptors, relieving pain. It decreases the feeling of pain and a person's response to pain.
• Take this medicine with or without food. Take with food if it causes an upset stomach.
• Ultram® ER: Always take with food or always take on an empty stomach.
• Long-acting products: Swallow whole. Do not chew, break, or crush.
• Oral-disintegrating tablet:Do not push tablet through foil when opening. Use dry hands to remove from foil. Place on tongue and let dissolve. Water is not needed. Do not swallow whole. Do not chew, break, or crush.
• Drink plenty of noncaffeine-containing liquid unless told to drink less liquid by healthcare provider.
• Take a missed dose as soon as possible.
• If it is almost time for the next dose, skip the missed dose and return to your regular schedule.
• Do not take a double dose or extra doses.
• Many times this medicine is taken on an as needed basis.
• Change in condition being treated. Is it better, worse, or about the same?
• Keep a diary of pain control.
• Bowel movements.
• Follow up with healthcare provider.
• Store at room temperature.
• Protect from moisture. Do not store in a bathroom or kitchen.
Created: 2006-10-13 16:06:20.0
Modified: 2010-07-15 09:30:13.0
Lexi-PALS TM © (1977)-(2007) Lexi-Comp, Inc. All rights reserved.
• If you have a life-threatening allergy, wear allergy identification at all times.
• Do not share your medicine with others and do not take anyone else's medicine.
• Keep all medicine out of the reach of children and pets.
• Most medicines can be thrown away in household trash after mixing with coffee grounds or kitty litter and sealing in a plastic bag.
• Keep a list of all your medicines (prescription, natural products, supplements, vitamins, over-the-counter) with you. Give this list to healthcare provider (doctor, nurse, nurse practitioner, pharmacist, physician assistant).
• Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or in Canada to Health Canada's Canada Vigilance Program at 1-866-234-2345.
• Talk with healthcare provider before starting any new medicine, including over-the-counter, natural products, or vitamins.
Tramadol is an opioid analgesic. Its exact mechanism of action is not yet completely understood, but it is thought to alter pain perception by binding to receptors in the brain that are important in transmitting the sensation of pain from the body.
(TRA ma dole)
