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The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine /paroxetine, SNRIs such as duloxetine / venlaine ), among others. The risk of serotonin syndrome /toxicity increases if you are also taking other drugs that increase serotonin.
COMMON BRAND NAME(S): Ultram GENERIC NAME(S): Tramadol.
In the US.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
If someone accidentally swallows this drug, get medical help right away. Keep this medicine in a safe place to prevent theft, misuse, or abuse.
Ask your pharmacist for help in selecting a laxative (such as a stimulant type with stool softener ). To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise.
Make sure laboratory personnel and all your doctors know you use this drug. This medication may interfere with certain laboratory tests (including amylase / lipase levels), possibly causing false test results.
You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. Call your doctor for medical advice about side effects.
Discuss the risks and benefits with your doctor. During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. (See also Warning section.).
Before using this medication, l your doctor or pharmacist your medical history, especially of: brain disorders (such as head injury, tumor, seizures ), breathing problems (such as asthma, sleep apnea, chronic obstructive pulmonary disease - COPD ), kidney disease, liver disease, mental/ mood disorders (such as confusion, depression, suicidal thoughts), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), stomach /intestinal problems (such as blockage, constipation, diarrhea due to infection, paralytic ileus), difficulty urinating (such as due to enlarged prostate ), gallbladder disease, disease of the pancreas ( pancreatitis ).
Check the labels on all your medicines (such as allergy or cough -and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
If you wait until the pain has worsened, the medication may not work as well. Pain medications work best if they are used as the first signs of pain occur.
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However, get medical help right away if you notice any of the following symptoms: rash, itching /swelling (especially of the face/ tongue /throat), severe dizziness, trouble breathing. A very serious allergic reaction to this drug is rare.
Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, or headache may occur. Some of these side effects may decrease after you have been using this medication for a while. If any of these effects persist or worsen, l your doctor or pharmacist promptly.
Canada residents can call a provincial poison control center. If the person is awake and has no symptoms, call a poison control center right away. US residents can call their local poison control center at. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, give them naloxone if available, then call 911. Symptoms of overdose may include: slow breathing, slow/ irregular heartbeat, coma, seizure.
Examples include quinidine, azole antifungals (such as itraconazole ), HIV drugs (such as ritonavir ), macrolide antibiotics (such as erythromycin ), rifamycins (such as rifampin ), drugs used to treat seizures (such as carbamazepine ), among others. Other medications can affect the removal of tramadol from your body, which may affect how tramadol works.
See also Warning section.
This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Though it helps many people, this medication may sometimes cause addiction. Ask your doctor or pharmacist for more details. Take this medication exactly as prescribed to lower the risk of addiction.
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Older adults may be more sensitive to the side effects of this drug, especially confusion, dizziness, drowsiness, and slow/shallow breathing.
Do not increase your dose, take the medication more frequently, or take it for a longer time than prescribed. If you are older than 75 years, the maximum recommended dose is 300 milligrams per day. Follow your doctor's instructions carefully. Properly stop the medication when so directed. The dosage is based on your medical condition and response to treatment. The maximum recommended dose is 400 milligrams per day. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose.
The risk for severe breathing problems is higher when you start this medication and after a dose increase, or if you take the wrong dose/strength. See also Drug Interactions section. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/ dizziness, difficulty waking up. Also, other medications can affect the removal of tramadol from your body, which may affect how tramadol works. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems may cause very serious side effects, including death. Be sure you know how to take tramadol and what other drugs you should avoid taking with it.
It is against the law. Do not share this medication with others.
This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome /toxicity. The risk increases if you are also taking other drugs that increase serotonin, so l your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea / vomiting / diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.
Consult your doctor before breast -feeding. This medication passes into breast milk and may rarely have undesirable effects on a nursing infant. l the doctor right away if your baby develops unusual sleepiness, difficulty feeding, or trouble breathing.
With WebMD's Medicine Cabinet, you can check interactions with drugs.
Do not use it later for another condition unless told to do so by your doctor. This medication has been prescribed for your current condition only. A different medication may be necessary in that case.
Take this medication by mouth as directed by your doctor, usually every 4 to 6 hours as needed for pain relief. You may take this drug with or without food. If you have nausea, it may help to take this drug with food. Ask your doctor or pharmacist about other ways to decrease nausea (such as lying down for 1 to 2 hours with as little head movement as possible).
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In that case, this medication might be used for sudden (breakthrough) pain only as needed. Other pain relievers (such as acetaminophen, ibuprofen ) may also be prescribed. If you have ongoing pain (such as due to arthritis ), your doctor may direct you to also take long-acting opioid medications. Ask your doctor or pharmacist about using tramadol safely with other drugs.
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Do not start, stop, or change the dosage of any medicines without your doctor's approval. This document does not contain all possible drug interactions. Drug interactions may change how your medications work or increase your risk for serious side effects. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist.
When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.
See also How to Use section for more information about addiction. Tramadol has a risk for abuse and addiction, which can lead to overdose and death. To lower your risk, your doctor should have you take the smallest dose of tramadol that works, and take it for the shortest possible time. Tramadol may also cause severe, possibly fatal, breathing problems.
To prevent withdrawal reactions, your doctor may reduce your dose gradually. This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as restlessness, watering eyes, runny nose, nausea, sweating, muscle aches) may occur if you suddenly stop using this medication. Consult your doctor or pharmacist for more details, and report any withdrawal reactions right away.
This medication is used to help relieve moderate to moderay severe pain. It works in the brain to change how your body feels and responds to pain. Tramadol is similar to opioid ( narcotic ) analgesics.
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Before having surgery, l your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
See also Warning section.
You may report side effects to Health Canada at. In Canada - Call your doctor for medical advice about side effects.
Some products that may interact with this drug include: certain pain medications (mixed opioid agonist-antagonists such as pentazocine, nalbuphine, butorphanol), opioid antagonists (such as naltrexone ).
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This drug may make you dizzy or drowsy. Avoid alcoholic beverages. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.
If you notice other effects not listed above, contact your doctor or pharmacist. This is not a complete list of possible side effects.
l your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes (such as agitation, confusion, hallucinations ), severe stomach / abdominal pain, difficulty urinating, signs of your adrenal glands not working well (such as loss of appetite, unusual tiredness, weight loss ).
Not applicable. Ask your doctor or pharmacist if you should have naloxone available to treat opioid overdose. Teach your family or household members about the signs of an opioid overdose and how to treat it.
Talk to your pharmacist for more details. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Before taking tramadol, l your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
Ask your doctor when to start or stop taking this medication. Avoid taking MAO inhibitors ( isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine ) during treatment with this medication. Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication.
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Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Consult your pharmacist or local waste disposal company.Information last revised January 2017. Properly discard this product when it is expired or no longer needed. 2017 First Databank, Inc.
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l your doctor or pharmacist if you are taking other products such as other opioid pain or cough relievers (such as codeine, hydrocodone ), alcohol, drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine ), or antihistamines (such as cetirizine, diphenhydramine ). The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/ dizziness ) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems.
If you have any questions, ask your doctor or pharmacist. Read the Medication Guide provided by your pharmacist before you start taking tramadol and each time you get a refill.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else.
Get medical help right away if any of these rare but seriousfainting, seizure, slow/shallow breathing, severe drowsiness/difficulty waking up.
Keep all medications away from children and pets. Store at room temperature away from light and moisture.
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To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who use this drug for a long time may develop severe (possibly fatal) withdrawal symptoms. Before using this medication, women of childbearing age should talk with their doctor(s) about the risks and benefits. l the doctor right away if you notice any symptoms in your newborn baby such as crying that doesn't stop, slow/shallow breathing, irritability, shaking, vomiting, diarrhea, poor feeding, or difficulty gaining weight. It may slightly increase the risk of birth defects if used during the first two months of pregnancy. l your doctor if you are pregnant or if you plan to become pregnant. To lessen the risk, take the smallest effective dose for the shortest possible time. Also, using it for a long time or in high doses near the expected delivery date may harm the unborn baby.
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l your doctor if your pain persists or worsens.Tramadol