Overview

Ultram is a new type of pain reliever. Although it appears to work in part by blocking opioid recepters, it is not considered a narcotic.

It is prescribed for moderate to moderately severe pain, and is approximately as potent as Darvocet.

Side Effects and Interactions

Ultram may cause side effects such as dizziness, nausea, constipation, headache, drowsiness, vomiting and itching.

Agitation and anxiety, weakness or fatigue, sweating, indigestion, dry mouth or diarrhea may also occur.

It is important to recognize that Ultram may affect a person's coordination or impair their judgment, so that driving or operating machinery would be hazardous.

Report any symptoms or suspected side effects to your physician promptly.

Ultram is less effective when taken in conjunction with the anticonvulsant Tegretol, and a larger dose may be needed.

MAO inhibitor drugs, on the other hand (Eldepryl, Nardil, Parnate) appear to increase Ultram levels and may, therefore, increase the risk of seizures.

Check with your doctor and pharmacist to make sure this medicine is safe in combination with any other drugs you take.

Special Precautions

Large doses of Ultram carry a risk of seizures.

People with kidney disease or cirrhosis may need a lower dose of Ultram, as may the elderly.

Taking the Medicine

Ultram may be taken with or without meals, every four to six hours.

Maximum dose is 400 mg daily, except in those over 75 years, who should be limited to 300 mg per day or less.

If you would like to know more about tramadol (Ultram, Ultracel) and its side effects and potential for dependence as well as withdrawal symptoms, check out this Q&A.

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  1. Private
    Pennsylvania
    Reply

    Contrary to what doctors may say, this drug is very addictive. Use it sparingly and carefully. There is a small percentage of people who seem to be able to stop this drug cold turkey and not experience withdrawal. They are very lucky. More and more it’s becoming recognized that tramadol is an addictive drug and causes terrible withdrawal for many. The worst of it will last anywhere from 2 days to 2 weeks and then, depending on how long you’ve been taking the drug, you may continue to experience withdrawal symptoms for months afterward. I can’t even begin to explain how bad the withdrawal is. If you look it up, you will find numerous reports and testimonials from others who are trying to get off this drug and can’t because the wd is so bad, or who are going through/went through the wd and can vouch for the hellaciousness of it. For me the worst physical symptom was constant restless legs. Emotionally I was extremely depressed and had zero energy. Just lifting my arm felt like a huge effort. Going up and down the stairs put me out of breath. My internal thermostat was totally out of whack. I was hot one minute, and cold the next. My hair and clothes would get drenched from night sweats. The list goes on and on. I don’t EVER want to go through that kind of withdrawal again. I’m not saying don’t take this drug. But do be careful and try to stay on it for only as short a length of time as possible. Oh, I should also note I had a seizure while withdrawing from tramadol, which is not uncommon when coming off this drug.

  2. Phil
    Reply

    I have been taking Tramadol 50 mg for over 5 years now for chronic back pain (degenerative disc disease). The pain relieving properties are very good,no doubt about that. But as my body continues to build tolerance to this drug, I find myself taking more just to ease the pain.
    Is this something that I should go see my doctor about? Also I found that when I go 2 or 3 days without taking a dose, and I can say with confidence that it is withdrawal symptoms. I would develop severe anxiety, hot and cold flashes, brain zaps, depression, insomnia and just a feeling of doom enveloping me.
    I’ve taken oxycodone and hydrocodone many times and have never had the withdrawal effects like I have with Tramadol. It’s literally terrifying, and it seems I need to stay on them just to avoid the withdrawal symptoms.
    Id like to slow down on the intake but I would need a doctor’s professional help in doing so. I have heard that a drug” Suboxone can ease these effects. Any input would be greatly appreciated. Thanks, P.J.

  3. kenny o
    Reply

    I took tramadol for NECK pain BECAUSE OF A PINCHED NERVE and I could not sleep and was not tired for 3 days I had to stop taking it to sleep but it did kill all the pain. I then seen a surgeon who told me I needed surgery for my neck bones to take off the arthritis spurs I haven’t had surgery yet but every time I take tramadol I cant sleep till it wears off.

  4. jp
    Reply

    I have chronic arthritis degenerative disc dis herniatiins stenisis etc my knees and ankles were fine after taking tramadol my tendon in ankle is killing me as well as knee pain. I refuse anti inflammatories because of stomach pain secere they cause ulcers now only take oxy 4x day 15 mg it dulls the pain no side effects tramadol is titally addictive w more side effects than narcotics no tylenol either. I will find natural herb based anti inflammatories instead you are much better off w oxycodone believe me.

  5. VR
    Reply

    I found these comments both interesting and rather curious. I took Tramadal (Ultram) for 7 years for chronic back pain which was the result of being electrocuted. I find these claims of addictiveness and withdrawals to be rather suspicious, as I never suffered any such effects, even though I took 400 mg per day. My pain ended over time, so I quit taking the tramadols, and suffered NO withdrawals whatsoever.
    In fact, I had originally been taking Oxycodones AND Tramadols, and the Tramadols allowed me to get off the oxycodones which DID cause withdrawals whenever I tried to quit without taking Tramadols. By taking Tramadols, I suffered no withdrawals from the oxycodones, and then was later able to quit the Tramadols with no problems.

  6. Trish
    Reply

    I was given Tramadol for knee pain. I don’t like taking med’s so when I took the first dose I bit off half and took at bed time. The other half I took in the morning. I woke up with asthma attack of sorts. Anyone else have this type of side effect? If so does it go away?
    PEOPLE’S PHARMACY RESPONSE: Please tell your doctor about this reaction. Bronchospasm can be a side effect of tramadol and it could be serious.

  7. EJ
    Reply

    I woke up with severe pain in my right leg 3 months ago. Ended up in the emergency room, diagnosed with IT band syndrome and was prescribed tramadol and 2 weeks rest. 50mg pills, directions 1 to 2 tablets every 6 to 8 hours.
    The Tramadol relieved the pain and I was so glad to have the pain gone. Well I went to an orthopedist and they disagreed with the IT band syndrome diagnosis, sent me to a P Therapist. The PT was able to find that it was a ruptured disc and got all the pain out of my leg and into my back. I began a couple months of aggressive exercise therapy, all the while continuing to be prescribed the Tramadol and taking the recommended dosage.
    Eventually, I noticed that the pain was not returning when it was time to take the Tramadol. I decided to stop taking it. After about 18 hours I went into what I finally realized were severe withdrawal symptoms. I stood it for about 24 hrs and then caved and took the Tramadol. Now I was faced with what to do? I have apparently healed my back injury to the point that I don’t need the Tramadol for pain relief but I cant stop taking it because I have become physically dependent!
    So what I did was start to wean myself off of it. Went from 2 pills every 6 hours to 2p every 8 hours for a couple days then 1 pill every 8 hours a couple days then 1 pill every 10 hours a couple days then I just stopped. The withdrawal symptoms started again on cue after about 18 hours, though not quite as severe as before.
    Let me say that withdrawal is about the worst hell you can imagine. I am currently at about 60 hours since my last pill and hope I am through the worst of it which was last night. I wonder how long it takes to get through this and I would suggest to others not to take this drug, certainly not for more than a few days. Also, the tapering off may have worked better if I drug it out longer but I was just so ready to get this crap out of my system.

  8. Somebodyishome
    Reply

    I was prescribed Tramadol for severe leg, back pain and subsequent multi level spinal fusion surgery and have been taking it since early 2011. At times the dosage was 800 mg a day. This past two months I have been reducing the Tramadol by one pill a week. I will take the last pill this Sunday and am so glad to be off this drug. I will never take it again. Each time I have been on it my soft tissues in my body start to degenerate.
    I currently have trouble with the tendons at the heels of my feet, ankles, knees, shoulders, fingers and hands. My hands are so bad, I can hardly do anything with them. I have had to get cortisone shots for trigger fingers and carpal tunnel to help with the pain, numbness and swelling and am scheduled for more shots next week. Each night my fingers swell and my hands and arms go numb. During the day, my ankle swells and hurts very bad, to the point where they must be elevated for hours for just some of the swelling to go down.
    I am hoping that once my body rids itself from the medication, all the soft tissue problems will get better, but I have some reservations that it won’t. My Mother-In-Law was on Tramadol for years and all of her soft tissues and muscles completely wasted way until she was literally skin and bones. She ultimately passed away from a fall that broke her hip. Be very careful with this medication and at the first signs of adverse effects, ween yourself off, either by one pill a week, or if that is too quickly then do a half a pill per week.

  9. Lori
    Reply

    I was prescribed Tramadol years ago for neck/back pain. It started out fine, taking the prescribed dosage, but then I began to notice that I would get sick, like I had the flu. I had no idea what this was, until years later when I became a full fledged DRUG ADDICT, addicted to the non-narcotic, non-controlled TRAMADOL. I would get dope sick when I didn’t have it, and got to the point where I was ordering it from online pharmacies, and doctor shopping for prescriptions. It was a nightmare.
    I lost my state job, my dignity, and the respect of my family & friends. I was even arrested for calling-in fake prescriptions. Tramadol made my life a living nightmare, and I do not recommend this drug to anyone. I NEVER took drugs, or even drank hardly, and now, years later, I am recovering from this addiction. Judge me if you want, but I know what I am talking about.

  10. Paula
    Reply

    I’ve taken 150mg Tramadol 8am and noon for the past year and love it! It’s non-symptomatic for me and relieves my chronic pain very well. In the early evening I take a anti-inflammatory with a 12hour duration (Nabumetone). This combo treats my fibromyalgia extremely well.

  11. CC
    Reply

    I’ve been prescribed Tramadol for nerve pain for the last 3 1/2 years. I’m trying to switch to herbal pain relievers and reducing the Tramadol. I can’t seem to do it. I get very fatigued, disoriented and depressed. Almost a suicidal depression. I was told by it was not narcotic, but it is acting like one. I feel trapped into taking it.
    And I got the nerve pain damage from a cortisone shot in my lumbar. Something that I was told would not hurt me but did. I was on no medication at that point.

  12. dgb
    Reply

    I take 50 mg of tramadol daily for help in my neuropathic (non-diabetic) pain in my feet. In combination with cymbalta and lyrica, I find much more relief. I ignored one neurologist’s claim that it would be addictive. The pain relief is so much better that I really don’t care about addiction at this point in my life. My own doc prescribes it so I am not worried. It is quality of life that is so important.

  13. MD
    Reply

    I am a 60-yr-old male who has worked fairly dangerous manual labor most of my life. I have so many injuries that I am in constant pain, if I don’t take about 50 mg of Tramadol twice a day. I have always had some other odd pains with stiffness, disorientation, extreme fatigue, and a host of other unpleasant symptoms.
    Tried most every med for the past 26 years, with no success, except that Naproxen helped for a few weeks before losing its effectiveness. I should mention here that I have never liked being dependent upon meds to function, but have to use levothyroxine, as well.
    Have used Tramadol for about 6 years – before then, I lost several jobs because of the nightmarish restlessness and pain that prevented getting anything but fleeting, fatigue-induced sleep. I have tried to stop (and even reduce the dose) of Tramadol – I suffer way too much and would rather be dead than to return to the ugly symptoms without the Tramadol.
    I keep hoping something else will come available to do the same as the T. I have used every natural remedy and treatment that you could name, as far as I know. When Ephedra capsules were legally obtainable – I used about a quarter capsule twice to 3 times a day to keep moving. I finally realized one day, that the increased energy (metabolic rate?) actually made my muscle and joint pain and stiffness almost disappear! Ephedra sinica stems are illegal now, but even so – I think that it could present a danger in the long run, as it seems to “wear out” the heart and other organs after a while.
    I am just presenting my scenario, so that others may find that they have similar results, and perhaps someone will link cases to some common cause and remedy.

  14. JW
    Reply

    My sis has suffered constant unrelenting severe pain in shoulders & knees for over a year now, can’t sleep, can no longer drive, can hardly walk or use hands to do anything. She was on zocor, wishes she had ignored the PA’s ignorant insistence that she MUST stay on that drug. She has been off it for 7 months now, & pain has not eased. The doc has been giving her things like arthritis tylenol, naprosen, etc. which have not touched this crippling pain.
    He has just called in tramadol, & recommended a rheumatologist, who says they can’t see her for at least 2 months to try to diagnose her & do something about this pain. Her hands & feet are swollen. Does this sound like rhabdomyolysis from zocor to you? It’s not her joints (bones), it’s muscles & tendons that are weakened & damaged here.
    We understand this side effect is usually temporary, & goes away when zocor is discontinued. Not so, for her. Do you know of anything to ease her suffering, or to correct the underlying cause & help heal these damaged tissues? This was an active, perfectly healthy, socially delightful female in her 60’s, & all of us have stood by in horror.
    She is on no other prescription drug, just this tramadol, which will start today. Would things like MSM be helpful?
    PEOPLE’S PHARMACY RESPONSE: IT IS POSSIBLE THAT MSM MIGHT HELP.

  15. Arline K. B.
    Reply

    At 75 I have severe arthritis in my body and have taken tramadol for about ten years with great results. Some days I’m way stiffer than others, but the dose of 6 pills a
    day sure allows me to keep the connections with folks that mean a lot to me, without
    most of the pain. It’s worth looking into if you want to keep functioning and reduce pain.

  16. CIN
    Reply

    I took tramadol and it really impaired my judgment. I felt dopey and sleepy.

  17. O.G.
    Reply

    My doctor (and the orthopedist to whom I was referred for severe hip pain) prescribed Tramadol for recurring pain. After reading your entry about the drug, I now understand why I was nauseated, dizzy, had hot flashes, and many of the other side effects this supposedly safe drug causes.
    I decided to take all my prescriptions (which included a variety of arthritis drugs — e.g., Naproxen sodium, Arthrotek and Meloxicam– they had been trying out on me in succession, all of which had very little effect on my arthritis and upset my stomach even further) back to the pharmacy drive-through window and ask the pharmacist to incinerate them with the rest of the medical waste.
    I then went through what I can only describe as “withdrawal” for about 48 hours (which made me more sympathetic to celebrities who become dependent on the big-time painkillers) and when it was over it felt like coming out from under a cloud.
    All this, from a patient like me who is conservative and careful in her use of medications. However, the inflammation is still a big issue, so I’m trying a variety of non-drug alternatives like acupuncture, the grape juice/pectin drink, and Chinese herbs. Haven’t tried the gin-soaked raisins yet!
    In the future, I will try my darndest to eschew pharmaceuticals: the “health” care industry is hardly that, but rather an unending flow of drugs thrown at patients, with the effect all too often of only making them sicker. Certainly that has been my experience.
    Yes, if I’m hit by a car, I’ll go to the E.R. and be very grateful for a surgeon… but aside from conditions requiring machines, or illnesses like Bubonic Plague, I’m planning NOT to be sucked into the grinder of conventional medicine again.
    Now, let’s see if those gin-soaked yellow raisins really work! :-)

  18. lds
    Reply

    I take Tegretol, have a serious seizure disorder, and also take Tramadol as needed for pain relief for prolapsed disks that aren’t surgically repairable. At times, I have constant pain for up to ten days, but I’ve always been able to immediately stop taking Tramadol without any noticeable adverse feeling or effect when the pain subsides. We are all different and we react differently to medications, but I wouldn’t rule out Tramadol for pain relief.

  19. cf
    Reply

    I been taking ultram for a while now for lower back pain and i must say this drug is very addictive and i am hopefully looking into the future without it. one of the biggest precautions is that the aggravation and anxiety that comes with it so be very careful…..

  20. Tom
    Reply

    My doctor prescribed ultram for a chronic back pain that I was experiencing about 6-7 years ago. It was the only thing that kept me going for several months. We never determined the origin of the back pain even after nearly every medical test available. It finally went away after about ten months. I was concerned about any addictive properties in the ultram but when the pain finally subsided, I was able to stop taking the drug quickly.

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