TRAMADOL DRUG INFO

IMPORTANT NOTE: The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

TRAMADOL - ORAL (TRAH-muh-dall)

COMMON BRAND NAME(S): Ultram

USES: Tramadol is used for pain relief.

HOW TO USE: Take Tramadol by mouth as prescribed. It is usually taken every 4 to 6 hours as needed. Use Tramadol exactly as prescribed. Do not increase your dose, use it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for an extended period of time, do not suddenly stop using Tramadol without your doctor's approval. When used for extended periods, Tramadol may not work as well and may require different dosing. Consult your doctor if the medication stops working well.

SIDE EFFECTS: Tramadol may cause dizziness, weakness, incoordination, nausea or vomiting, stomach upset, constipation, headache, drowsiness, anxiety, irritability, dry mouth, or increased sweating. If any of these effects persist or worsen, inform your doctor. Notify your doctor if you develop any of these serious effects while taking Tramadol: chest pain, rapid heart rate, skin rash or itching, mental confusion, disorientation, seizures, tingling of the hands or feet, trouble breathing. In the unlikely event you have an allergic reaction to Tramadol, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, breathing trouble. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Tell your doctor your medical history, especially of: kidney disease, liver disease, seizure disorder, lung disease, history of drug or alcohol dependency, any allergies you may have. Limit alcohol as it may add to the dizziness or drowsiness effects caused by the medication. Because Tramadol may make you dizzy/drowsy, use caution performing tasks requiring alertness such as driving. Tramadol should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Tramadol is excreted into breast milk. Because the effects on a nursing infant are not known, consult your doctor before breast- feeding.

DRUG INTERACTIONS: Before you buy Tramadol, tell your doctor of all prescription and nonprescription medications you may use, especially of: carbamazepine, narcotic pain relievers (e.g., codeine), drugs used to aid sleep, antidepressants (e.g., SSRI-types such as fluoxetine or fluvoxamine), MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine), psychiatric medicine (e.g., nefazodone), "triptan"-type drugs, anti-anxiety drugs (e.g., diazepam), sibutramine. Also, report use of certain antihistamines (e.g., diphenhydramine) which are also present in many cough-and-cold products. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: The maximum dosage for Tramadol in any form is 400 mg per day. Certain manufacturers or formulations have lower maximum doses. For example, Ultracet (37.5 mg/325 mg tramadol/APAP tablets) is capped at 8 tablets per day (300 mg/day). Ultram ER is available in 100, 200, and 300 mg/day doses and is explicitly capped at 300mg/day as well.

If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include cold and clammy skin, low body temperature, slowed breathing, slowed heartbeat, drowsiness, dizziness, lightheadedness, deep sleep, loss of consciousness, or seizures.

PHYSICAL DEPENDENCE AND WITHDRAWL
Tramadol is associated with the development of a physical dependence and a severe withdrawal syndrome. Tramadol may cause typical opiate-like withdrawal symptoms as well as atypical withdrawal symptoms including seizures. Atypical withdrawal effects may be related to Tramadol's effect on serotonin and norepinephrin reuptake. Symptoms may include anxiety, anquish, depression, severe mood swings, electric-shock sensations throughout body, pins and needles, sweating, palpitations, restless legs syndrome, sneezing, insomnia, tremors, among others. In most cases, Tramadol withdrawal can set in 12 to 20 hours after the last dose, but may vary. It is recommended that patients physically dependent on pain killers take their medication regularly to prevent onset of withdrawal symptoms and this is particularly relevent to Tramadol because of its SSRI and SNRI properties. When the time comes to discontinue the use of Tramadol, do so gradually over a period of time that will vary according to the individual patient and dose and length of time on the drug.

NOTES: Do not share Tramadol with others.

MISSED DOSE: If you miss a dose, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store Tramadol at room temperature between 59 and 86 degrees F (15 to 30 degrees C) away from heat and light. Do not store in the bathroom. Keep this and all medications out of the reach of children.



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