Posts Tagged ‘ultram’

Ultram: Prescription Drug Abuse & Testing

November 26th, 2010
Tarun Gupta asked:




Ultram is the trade name for Tramadol which is an atypical opioid. It is a synthetic agent, as a 4-phenyl-piperidine analogue of codeine, and appears to have actions on the GABAergic, noradrenergic and serotonergic systems & is thus used as a centrally acting analgesic for treating moderate to severe pain.

Tramadol is usually marketed as the hydrochloride salt (tramadol hydrochloride) and is available in both injectable (intravenous and/or intramuscular) and oral preparations. It is also available in conjunction with paracetamol.

Ultram Prescription:

Ultram is used to relieve moderate to moderately severe pain. Ultram extended-release tablets are only used by people who are expected to need medication to relieve pain around-the-clock for a long time. Ultram belongs to the class of drugs called opiate agonists. It works by changing the way the body senses pain.

Tramadol comes as a tablet and an extended-release (long-acting) tablet to take by mouth. The regular tablet is usually taken with or without food every 4-6 hours as needed. The extended-release tablet should be taken once a day. Oral doses range from 50–400 mg daily, with up to 600 mg daily when given IV/IM. The formulation containing APAP contains 37.5 mg of Tramadol and 325 mg of paracetamol, intended for oral administration with a common dosing recommendation of one or two tabs every four to six hours although final dosage is decided by physician and is highly case specific.

Ultram Abuse:

MedWatch is a FDA database of adverse events of case reports voluntarily submitted to the FDA. From 1999 through September 2004, the FDA received 766 case reports of Tramadol abuse. It is most commonly abused by narcotic addicts, chronic pain patients, and health professionals.

Tramadol is approximately 10% as potent as morphine, when given by the IV/IM route. It is a potent habit-forming substance. Tramadol is not currently scheduled by the U.S. DEA, unlike other opioid analgesics. Nevertheless, the prescribing information for Ultram warns that Tramadol may induce psychological and physical dependence of the morphine-type. In addition, there are widespread reports by consumers of extremely difficult withdrawal experiences. A controlled study that compared different medications found that the percent of subjects who scored positive for abuse at least once during the 12-month follow-up were 2.5% for NSAIDs, 2.7% for Tramadol, and 4.9% for hydrocodone. Taking more Tramadol / Ultram than what is prescribed by your doctor may cause serious side effects or death.

Effects of Ultram Abuse:

The most commonly reported adverse drug reactions are nausea, vomiting and sweating. Drowsiness is reported, although it is less of an issue than with other opioids. Respiratory depression, a common side effect of opioids, is not clinically significant in normal doses. Serious potential consequences of over dosage are respiratory depression, lethargy, coma, seizure, cardiac arrest and death. Fatalities have been reported in post marketing in association with both intentional and unintentional overdose with Ultram.

Ultram may induce psychic and physical dependence of the morphine-type opioids. Dependence and abuse, including drug-seeking behavior and taking illicit actions to obtain the drug are not limited to those patients with prior history of opioid dependence. The risk in patients with substance abuse has been observed to be higher. Ultram is associated with craving and tolerance development. Withdrawal symptoms may occur if Ultram is discontinued abruptly. These symptoms may be relieved by reinstitution of opioid therapy followed by a gradual, tapered dose reduction of the medication combined with symptomatic support.



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Tramadol Side effects

February 24th, 2010

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using tramadol and call your doctor at once if you have any of these serious side effects:

  • agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;
  • seizure (convulsions);
  • a red, blistering, peeling skin rash; or
  • shallow breathing, weak pulse.

Tramadol side effects includes:

Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, headache, or weakness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you are taking tramadol regularly, it may be useful to start using a laxative right away instead of waiting until you become constipated. Consult your pharmacist for details regarding the correct use of laxatives (e.g., stimulant-type with stool softener).

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: unusual or extreme stiffness in the muscles, shaking (tremor), severe stomach/abdominal pain, change in the amount of urine, vision changes.

This medication may rarely cause a very serious condition called serotonin syndrome. The risk increases when this medication is used with certain other drugs (see Drug Interactions section). Seek immediate medical attention if you develop some of the following symptoms: mental/mood changes (such as agitation, hallucinations), unusual restlessness, loss of coordination, fast heartbeat, severe dizziness, unexplained fever, severe nausea/vomiting/diarrhea, twitchy muscles.

Tell your doctor immediately if any of these rare but very serious side effects occur: slow/shallow breathing, seizures, fever/flu-like symptoms.

A very serious allergic reaction to this drug (which may occur as early as the first dose) is rare. However, seek immediate medical attention if you notice any of the following symptoms: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Less serious tramadol side effects may include:

  • dizziness, drowsiness, weakness;
  • nausea, vomiting, constipation, loss of appetite;
  • blurred vision;
  • flushing (redness, warmth, or tingly feeling); or
  • sleep problems (insomnia).