Tramadol Hydrochloride (Ultram)

What is it?

Tramadol Hydrochloride is a non-narcotic analgesic used to
treat severe post surgical pain and chronic pain.

FDA approved:

March 1995

Brand Names and International Availability:

Contramal (India); Exopen (Korea); Mabron (Thailand); Tadol (Taiwan);
Tradol (Mexico); Tramal (Benin, Burkina-Faso, Ethiopia, Gambia, Ghana,
Guinea, Ivory-Coast, Kenya, Liberia, Malawi, Mali, Mauritania,
Mauritius, Morocco, Niger, Nigeria, Senegal, Seychelles, Sierra-Leone,
Sudan, Tanzania, Tunia, Uganda, Zambia, Zimbabwe; Bahrain, Cyprus,
Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Oman, Qatar,
Republic-of-Yemen, Saudi-Arabia, Syria, United-Arab-Emirates, Taiwan,
Hong-Kong, Malaysia, Philippines, Bulgaria, Germany, Austria,
Switzerland, Netherlands, Colombia, Costa-Rica, Dominican-Republic,
El-Salvador, Guatemala, Honduras, Panama, Ecuador, Peru, Thailand);
Tramed (Taiwan); Tramol (Poland); Tridol (Korea); Ultram (US); Zipan

How does it work?

Its action is not completely understood, however it does appear to have
two actions. It binds with certain opioid receptors, this blocks pain
impulses from reaching the brain, in the same way as with NSAIDs and
opioids. In addition, it inhibits reuptake of norepinephrine and
serotonin, altering the way the brain monitors pain signals.


For the treatment of painful conditions 50 mg to 100 mg can be taken as
needed for relief every four to six hours, not to exceed 400 mg per day.
For moderate pain tramadol 50 mg may be adequate as the initial dose,
and for more severe pain, tramadol 100 mg is usually more effective as
the initial dose.

How should I take it?

Take tramadol as ordered, usually with a full glass of water. If stomach
upset occurs, take after meals. Do not take more than the doctor


If you are over 65, you may need your dose adjusted.

Should not be used in people with a history of narcotic

There are no adequate and well-controlled studies in
pregnant women. Tramadol should be used during pregnancy only if the
potential benefit justifies the potential risk to the fetus.

Should not be used by nursing mothers.

Use with caution in the elderly.

Drug Interactions:

May cause seizures if used with selective serotonin
reuptake inhibitors (SSRI antidepressants or anoretics), tricyclic
antidepressants (TCAs), and other tricyclic compounds (e.g.,
cyclobenzaprine, promethazine, etc.), MAO inhibitors or opioids.

Use with caution with Digoxin and Warfarin.

of the potent nature of this medicine, be sure to tell your doctor about
any other medicines you are taking, including nonprescription medicines
and vitamins.

Possible side effects:

These side effects are not considered serious but are
certainly annoying for those experiencing them. The most frequently
reported side effects include constipation or diarrhea, difficulty
sleeping, dizziness, drowsiness, dry mouth, false sense of well being,
feeling of unreality, mood changes, headache and indigestion

More serious side effects that you should report right away
include changes in vision, difficulty breathing, shortness of breath,
fast or irregular heartbeat, hallucinations, passing urine more
frequently than usual, or not passing urine as often as usual, skin
rash, and seizures.

Precautions & Special Notes:

Do not drive, use machinery, or do anything that needs
mental alertness until you know how tramadol affects you.

alcohol while taking tramadol.

For more information:



Mosby’s GenRx?, 10th ed. Copyright ? 2000 Mosby, Inc.