ULTRAM may cause addiction and serious breathing problems. It can also cause death if taken by a child who has not been prescribed it. Do not take this medication with other drugs that slow or stop your breathing (including alcohol, sedatives/tranquilizers, and some MAO inhibitors such as isocarboxazid, linezolid, methylene blue injection, rasagiline, selegiline, and tranylcypromine).

Keep this medicine away from children and never share it with others. Properly dispose of unused or expired medication by asking your pharmacist about drug take-back programs or calling your local environmental agency.


While the development of addiction to opioid analgesics in properly managed patients is rare, concern about abuse and diversion should not deter healthcare professionals from prescribing these medications. ULTRAM ER (tramadol hydrochloride) extended-release tablets are Schedule IV controlled substances, and careful record-keeping of prescriptions, dispensing, and renewals is strongly advised. As with other opioids, a patient-specific tapering plan is appropriate for patients who have been physically dependent on opioids; abrupt discontinuation can lead to unpleasant symptoms and potentially life-threatening withdrawal.

This medication may interact with certain MAO inhibitors, antidepressants, cold or allergy medicines, sedatives, narcotic pain relievers, barbiturates, alcohol, other drugs that affect the central nervous system, and migraine headache medicine. Tell your doctor or pharmacist about all the medicines you use, including dietary supplements and herbal products.


ULTRAM ER can cause birth defects if used during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant. ULTRAM ER may interact with other medications, including MAO inhibitors, antidepressants, cold or allergy medicines, sleeping pills, muscle relaxers, medicine for seizures or anxiety, or HIV/AIDS medicines. Tell your doctor about all the medicines you take.

ULTRAM can increase the risk of life-threatening side effects if taken with other drugs that depress respiration or affect blood pressure. Examples of such drugs include phenytoin, nephrotoxic antibiotics, nonsteroidal anti-inflammatory agents, alcohol, and other opioids. ULTRAM can also cause sedation or confusion and may increase the risk of accidents or falls in elderly patients.

Misuse of this medication can cause addiction, overdose, and death. Keep this medication in a secure place where others cannot get it. Do not sell it or give it to anyone. Keep leftover medicine out of the reach of children. Ask a pharmacist where to find a drug take-back program. If there is no take-back program, mix the medicine with cat litter or coffee grounds in a sealed plastic bag and throw away.

Some people may feel agitated or have thoughts about suicide while taking ULTRAM. Tell your doctor if you or anyone in your family has ever tried to kill yourself, or if you have had suicidal thoughts or attempts. Your doctor will recommend getting naloxone (a medicine to reverse the effects of an opioid overdose) and keeping it with you at all times.


Ultram is a pain medicine that acts in the central nervous system. It is used to treat moderate to severe pain in adults. It is sometimes combined with other medicines to treat certain conditions. This medication is not for everyone. It can cause breathing problems in some people. It may also be habit-forming. Do not take this medication if you have a history of drug or alcohol addiction, or if you have ever had brain disorders (such as head injury, tumor, seizures). Do not use it if you have a blockage in your stomach or intestines. Do not take this medication if you are taking any other drugs that can affect your breathing or make you drowsy, including sedatives, tranquilizers, and narcotic medications. This medication should not be used during pregnancy unless it is clearly needed. It can cause life-threatening withdrawal symptoms in the newborn. Do not breast-feed if you take this medication.

If you are using the immediate-release tablet form of this medication, take it by mouth as directed by your doctor, usually every 4 to 6 hours as needed for pain relief. Swallow the tablets whole; do not chew, crush, or split them. If you have nausea, it may help to take this medication with food. If you are on dialysis, ULTRAM ER may be given through a vein (dialysis). Talk to your doctor about this.

If you are using the extended-release tablet, a dose of 100 mg once daily is usually started and then increased by 100-mg increments every 5 days to the desired level of pain relief. The maximum daily dose is 300 mg. Your doctor may recommend that you get naloxone (a medication that can reverse opioid overdose) and keep it with you at all times. This way, if you have a reaction to this medication and stop breathing or don’t wake up, the person helping you will be able to give you the naloxone right away.

Side effects

For the best results, this medication should be used exactly as prescribed by your doctor. Do not increase your dose without permission, as doing so can increase the risk of side effects. Your doctor may start you on a low dosage and gradually increase your dose, depending on your response to the medication and your condition.

This medication can cause addiction, abuse, and diversion (see WARNINGS). Keep this medication in a secure place where others cannot get to it. Do not sell or give it to anyone else, even if they have symptoms similar to yours. This medication is a controlled substance and has been assigned a schedule IV rating by the Food and Drug Administration.

Taking ULTRAM ER with other opioids or certain other drugs can cause life-threatening side effects such as respiratory depression, seizures, and serotonin syndrome. This includes alcohol, sedatives, tranquilizers, other central nervous system depressants, and certain antidepressants. ULTRAM ER should be taken only with a prescription from your doctor.

This medicine can cause drowsiness. If you are affected, do not drive or operate machinery. This medication should also not be taken if you are pregnant, planning to become pregnant or breastfeeding. It can pass into breast milk and can harm a nursing infant. It is recommended that you tell your doctor if you are breast-feeding.

Suddenly stopping this medication can cause withdrawal. Withdrawal symptoms include anxiety, sweating, trouble sleeping, tremors, diarrhea, nausea, vomiting and changes in your mood or behavior. Your doctor may decrease your dose slowly to help prevent withdrawal when this medication is no longer needed for pain relief. Withdrawal is more likely if this medication has been used for a long time or in high doses.


While marketed as less habit-forming than opiate medications, Ultram (tramadol) can be highly addictive for some people. Its pleasurable and euphoric side effects can overshadow the drug’s pain-relieving properties, leading some users to use it for recreational purposes. This abuse can cause addiction and other negative side effects, such as withdrawal symptoms.

To avoid an overdose, never take more than the prescribed dose. Always follow the directions on your prescription label and read all medication guides. Never share this medicine with other people, especially if they have a history of addiction or if they are taking another opioid medication. If used improperly, this drug can cause a fatal overdose. Symptoms of overdose include slow or stopped breathing, and unconsciousness. If these symptoms occur, call emergency medical help right away. If you have a risk of overdose, your doctor may recommend that you carry the medicine naloxone (a medicine that can reverse an opioid overdose) with you at all times. Make sure that any person who cares for you knows where you keep it, and how to administer it if needed.

Overdose can lead to seizures and brain damage, and the risk is highest within 3 days of starting or increasing your dose. It can also be dangerous if taken with other drugs that depress the central nervous system, such as alcohol.

A complete rehabilitation program includes detox to clear the drug from your body, followed by a treatment program that addresses your chemical dependency and psychological issues related to it. Your treatment will include psychotherapy, and you’ll learn how to cope with chronic pain without relying on drugs or alcohol. In addition, you’ll be introduced to methods such as yoga, hypnotherapy and massage that can help reduce stress and physical pain.