WHAT ARE THE INDICATIONS?
It is an analgesic which helps in relieving moderate to severe pain. Tramadol is used to treat dental, cancer, and acute musculoskeletal pain, post-operative pain and in osteoarthritis (used with NSAIDS).
HOW DOES IT ACT?
Tramadol is an opioid receptor agonist. It inhibits the release of neurotransmitters responsible for pain like substance P, GABA, dopamine, acetylcholine and noradrenaline. It also blocks the reuptake of norepinephrine and serotonin in the Central Nervous System, which inhibits pain transmission to the spinal cord. This leads to inhibition of pain.
WHAT IS THE DOSAGE?
Follow the dosage plan prescribed by your doctor. Always start with low dose which is 25 mg/day. Separate doses of 25 mg should be given for 3 days to reach 100 mg/day (25 mg four times a day). After that dose is titrated slowly to get the desired effects. Total daily dose should not exceed 400 mg.
ULTRAM (tramadol) 50 mg to 100 mg can be given for every four to six hours to get quick analgesic effect.
HOW TO TAKE?
Follow the instructions of doctor for using ULTRAM. Do not take in amounts more than that prescribed by doctor. Take it with a glass of water. Swallow the tablet whole to prevent exposure to a potentially fatal dose. Do not crush or break an ULTRAM tablet.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine. It can lead to over dosage and poisoning.
WHAT TO DO IN CASE OF OVERDOSE?
Symptoms of overdose are slow heart rate, severe drowsiness, shallow breathing, excessive sweating, cold and clammy skin, fainting. Seek immediate medical attention in case of overdose.
WHAT ARE THE SIDE EFFECTS?
Common side effects like Headache, tiredness, drowsiness, abdominal upset (constipation) can be experienced by users. These are not serious and subside with time. There exist some side effects chances of whose occurrence is very rare but once they occur require immediate medical attention. These are:
1. Allergic reaction manifested as difficulty in breathing or irregular breathing, swelling of lips/face/throat, redness of skin, rashes.
2. Seizures (convulsions)
3. Tachycardia (fast heart rate)
4. Pain in stomach
5. Vomiting, diarrhoea, loss of coordination, fainting
6. Skin reaction resulting in fever, pain of skin, sore throat, peeling, burning and itching of eyes, purple rash on skin, blistering skin.
7. Anxiety or nervousness
8. Excessive sweating and flushing
WHAT ARE THE CONTRAINDICATIONS?
Ultram should not be used in any of the following cases:
1. If you have allergy to ULTRAM /tramadol or any other inactive ingredient of the product.
2. If you have asthma or any other respiratory disease. (ULTRAM can worsen your condition)
3. Patient of chronic constipation.
4. Patient with kidney and/or liver dysfunction
5. Patient of mood disorder like confusion, depression
6. Have had heart attack or stroke in the past 6 months or suffering from pancreatic disease.
7. Patients with enlarged prostate who have difficulty in urination.
WHAT ARE THE PRECAUTIONS?
1. Pregnant women should consult a doctor before using ultram.
2. ULTRAM passes through breast milk, take ULTRAM with doctor’s advice if you are a nursing mother.
3. Drowsiness is the main side effect of ULTRAM. Do not drive or avoid doing any work that requires alertness after you have taken this medicine.
4. If you are taking ULTRAM and drugs like muscle relaxants, anti-anxiety, anti-depressant, sleep inducers or anti epileptics (drugs for seizures) discuss it with your doctor.
5. Do not use ULTRAM in larger amounts, or for longer than prescribed because it can affect your breathing.
6. ULTRAM has serious withdrawal symptoms; do not stop using ULTRAM suddenly if you are not getting any benefit. Ask your doctor.
7. Do not drink alcohol with ULTRAM because it will lead to serious consequences.
8. ULTRAM causes addiction and dependence, should be used by the person for whom it is not prescribed.
9. ULTRAM should not be prescribed for children below 16 years of age.
WHAT ARE THE DRUG INTERACTIONS?
Drugs having potential to interact with ULTRAM are:
1. fluoxetine, paroxetine and amitriptyline
2. Serotonergic Drugs MAOIs
3. linezolid (an antibiotic which is a reversible non-selective MAOI)
Note: Some other drugs can interact with ULTRAM. So, before using ULTRAM tell your doctor about the drugs which you are using concomitantly.
WHAT SHOULD BE THE STORAGE CONDITIONS?
It should be placed in cool, dry place away from the sunlight. Store it in a place not reachable to children and pets.
We provide Ultram to the patient from 50mg to 200mg. The maximum dose of Ultram should be 400mg per day and should never increase as the overdose may cause serious problem to the user. If the patient is suffering from moderate to severe chronic pain then the initial dose should be 25mg per day and then if required should be increased to 50mg per day after 3 days. In case still the patient needs more dose then Ultram dose can be increased from 50mg to 100mg for every 4 to 6 hours. However, in any case the dose should not be more than 400mg per day.
The recommended dose for the patient having creatinine clearance less than 30 ml per min should be 200mg daily with an interval of 12 hours. Dialysis patient should take regular dose as during haemodialysis, very negligible amount of Ultram is removed from the body. The dose for cirrhosis patient should be 50mg for every 12 hours. It is suggested that the dose for Ultram should not be more than 300 mg per day in case of patient above the age of 75 years.
Ultram is white coloured tablet, bitter in taste and appear as crystalline powder that is odourless. The inactive ingredients present in Ultram includes modified starch, pregelatinizes corn starch, polyethylene glycol, polysorbate 80, sodium starch glycolate, titanium dioxide, carnauba wax, microcrystalline cellulose, lactose and hypromellose. This Ultram is soluble in water and ethyl alcohol and have molecular weight 299.8. Ultram is kept in tight and sealed container and should be stored at temperature ranging from 15°C -30°C.
Not all user of Ultram will have side effect of the drug. It depends on the physical condition and immune system of the individual. Some user of Ultram might not have any side effect while taking this tablet or even after that while others may have problem in taking Ultram.
However, this side effect is for short period of time and is well tolerated by the patient. Some of the common side effects exhibited by the patients are constipation, headache, nausea, dizziness, drowsiness and vomiting. Few patients can have itching, sweating, diarrhoea, rash on skin and mouth become dry. Ultram can cause pain in abdomen, rash on skin, frequent urination, improper vision, lose in weight, hallucinations, problem in breathing, etc.
If the patient is suffering from any allergy, they must reveal about this to the doctor prior taking Tramadol. Sometimes the inactive ingredients present in the Ultram may cause allergic reaction or some other problem to the user.
If a patient is having any medical record, must talk to the doctor about this, so that dose can be adjusted accordingly. Patients with disease related with kidney, liver, mental disorder should consult their medical advisor before taking Ultram.In case, the user is suffering from any intestinal problem, infection, paralysis, constipation, diarrhoea, etc. should consult to the doctor before taking this medicine.
Two people with same type of sign and symptoms of the disease should also not be given Ultram if one person is already using it. It may cause serious problem to the other person.