ULTRAM (tramadol hydrochloride) is indicated for the management of moderate to moderay severe pain in adults. ULTRAM should be administered with greater caution in patients older than 75 years, due to the greater potential for adverse events in this population (see WARNINGS.
If a patient misses a dose, they should take their next dose as soon as they remember. If it is almost time for their next dose, they should not take the missed dose. Instead, they should take the next scheduled dose. They should not make up for the missed dose by taking a double dose.
In general, dose selection for an elderly patient over 65 years old should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function and of concomitant disease or other drug therapy.
Detailed dosage guidelines and administration information for Ultram (tramadol hydrochloride). Includes dose adjustments, warnings and precautions.
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For patients with moderate to moderay severe chronic pain not requiring rapid onset of analgesic effect, the tolerability of ULTRAM can be improved by initiating therapy with the following titration regimen: ULTRAM should be started at 25 mg/day qAM and titrated in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg q.i.d.).
Ultram official prescribing information for healthcare professionals. Includes: indications, dosage, adverse reactions, pharmacology and more.
Steady-state plasma concentrations of both tramadol and M1 are achieved within two days with four times per day dosing. There is no evidence of self-induction (see Figure 1 and Table 1 below).
Serotonin syndrome may include mental-status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination) and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
Opioid activity is due to both low affinity binding of the parent compound and higher affinity binding of the O-demethylated metabolite M1 to µ-opioid receptors.
Acute: 50-100 mg PO q4-6hr PRN; not to exceed 400 mg/day. Conversion from immediate release to extended release: Round total daily dose down to nearest 100 mg. Severe renal impairment (CrCl <30 mL/min): Immediate release, 50-100 mg PO q12hr; extended release not recommended.
ULTRAM (Tramadol) drug information & product resources from MPR including dosage information, educational materials, & patient assistance.
Acute intoxication with alcohol, hypnotics, narcotics, centrally-acting analgesics, other opioids, or psychotropic drugs.
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Concomitant MAOIs, carbamazepine, alcohol, or other forms of tramadol: not recommended. Increased risk of seizures and/or serotonin syndrome with SSRIs, SNRIs, tricyclics, cyclobenzaprine, promethazine, opioids, MAOIs, naloxone, triptans, linezolid, lithium, neuroleptics, others that lower seizure threshold. Potentiation with alcohol, other CNS depressants; reduce dose. May be potentiated by CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, amitriptyline). May potentiate digoxin, warfarin. May be affected by CYP3A4 inhibitors (eg, ketoconazole, erythromycin) or CYP3A4 inducers (eg, rifampin, St. John's Wort). ULTRAM ER Opioid.
Moderate to moderay severe pain.
Dizziness, GI upset, constipation, headache, somnolence, pruritus, CNS stimulation, asthenia, sweating, dry mouth, seizures, anaphylaxis. ER tabs—30; Tabs—100.
Only 4 drugs may be compared at once.
≥17yrs: 50–100mg every 4–6 hours; max 400mg/day. Or, 25mg in AM on 1st day, increase by 25mg every 3 days (ie, to 25mg four times daily), then increase by 50mg every 3 days (ie, to 50mg four times daily), then increase to 50–100mg every 4–6 hours; max 400mg/day. >75 years: max 300mg/day. Renal dysfunction (CrCl <30mL/min): max 100mg every 12 hours. Cirrhosis: max 50mg every 12 hours. <17yrs: not recommended.
Do not give to opioid-dependent patients. Respiratory depression. Increased intracranial pressure. Head injury. Seizure disorders. Acute abdomen. Renal or hepatic impairment. Suicidal ideation. Drug abusers. Avoid abrupt cessation. Elderly (esp. >75 years). Labor & delivery, pregnancy (Cat.C), nursing mothers: not recommended.
Company: Janssen Pharmaceuticals, Inc.
Generic Name and Formulations: Tramadol HCl 50mg; scored tabs.