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In this Article

• What is tramadol (Ultram ER)?
• What are the possible side effects of tramadol (Ultram ER)?
• What is the most important information I should know about tramadol (Ultram ER)?
• What should I discuss with my healthcare provider before taking tramadol (Ultram ER)?
• How should I take tramadol (Ultram ER)?
• What happens if I miss a dose (Ultram ER)?
• What happens if I overdose (Ultram ER)?
• What should I avoid while taking tramadol (Ultram ER)?
• What other drugs will affect tramadol (Ultram ER)?
• Where can I get more information?

What happens if I miss a dose (Ultram ER)?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Ultram ER)?

Seek emergency medical attention if you think you have used too much of this medicine. A tramadol overdose can be fatal.

Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.

What should I avoid while taking tramadol (Ultram ER)?

Do not drink alcohol while you are taking tramadol. Alcohol may cause a dangerous decrease in your breathing when used together with tramadol.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tramadol. Tell your doctor if you regularly use any of these other medicines.

Tramadol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What other drugs will affect tramadol (Ultram ER)?

You may be more likely to have a seizure (convulsions) if you take tramadol while you are using certain other medicines. Do not take tramadol without telling your doctor if you also use any of the following medications:

• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or
• an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).

Before taking tramadol, tell your doctor if you also use:

• carbamazepine (Tegretol);
• warfarin (Coumadin);
• digoxin (Lanoxin, Lanoxicaps);
• ketoconazole (Nizoral);
• erythromycin (E-Mycin, E.E.S., Ery-Tab);
• rifampin (Rifadin, Rimactane, Rifater);
• St. John's wort;
• quinidine (Quinaglute, Quinadex, Cardioquin, Quinora); or
• drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety).

This list is not complete and there may be other drugs that can interact with tramadol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about tramadol.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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