Tramadol, Ultram, & Ultracet Information

Uses
Tramadol is used for pain relief.

How to Use
Take this medication by mouth as prescribed. It is usually taken every 4 to 6 hours as needed. Use this medication 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 this drug without your doctor's approval. When used for extended periods, this medication may not work as well and may require different dosing. Consult your doctor if the medication stops working well.

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.

Side Effects
This medication 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 this medication: 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 this drug, 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 this drug may make you dizzy/drowsy, use caution performing tasks requiring alertness such as driving. This medication 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
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
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.

Notes
Do not share this medication 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 this medication 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.

Uses
This medicine is an analgesic combination used to treat or prevent pain. Ultracet is an invaluable medicine for many patients. However it is also abused by a few patients.

To control abuse of this medicine, our patients are limited to two bottles every 30 days of any of the following medications: Tramadol, Ultram, or Ultracet. For example, a patient who orders one bottle of Flexeril on the 1st of the month will not be able to order any of the other medicines in the above list until the 15th of the month. A patient who orders one bottle of Flexeril and one bottle of Parafon Forte on the 1st of the moth will not be able to order any of the above medications until the 1st of the next month.

Before Using
It is important that you mention all prescription and over-the-counter medicines in our medical questionnaire and any medical conditions you may have including allergies, pregnancy, or breast-feeding. DO NOT TAKE THIS MEDICINE if you are also taking carbamazepine, cyclobenzaprine, an amphetamine, opiate analgesic, tricyclic antidepressant, serotonin reuptake inhibitor (SSRI), monoamine oxidase inhibitor (MAOI), promethazine, or medicine for appetite suppression, sleep, or a nervous, mood, or behavior condition. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITIONS may be needed if you are taking isoniazid, guanidine, or an oral anticoagulant. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have liver disease or high levels of alcohol, depressants, stimulants, or other analgesics in your blood.

Directions
THIS MEDICINE MAY BE TAKEN on an empty stomach or with food. Side effects you may experience while taking this medicine include drowsiness, dizziness, and constipation. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE IF you develop a skin rash, itching, confusion, changes in mood or behavior, hallucinations, dark urine or pale stools, yellowing of the skin or eyes, or unusual tiredness. CONTACT YOUR DOCTOR IMMEDIATELY IF you experience seizures, difficulty breathing or swallowing, or swelling of face or mouth. Store this medicine at room temperature in a tightly-closed container away from heat and light. IF YOU MISS A DOSE OF THIS MEDICINE and you are taking it regularly, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. DO NOT TAKE TWO DOSES AT ONCE. If your symptoms do not improve or become worse, check with your doctor.

Cautions
DO NOT TAKE THIS MEDICINE IF YOU HAVE HAD A SEVERE ALLERGIC REACTION to codeine, hydrocodone, dihydrocodeine, oxycodone (such as Tylox, Tylenol with Codeine, Vicodin). A severe allergic reaction includes a severe rash, hives, breathing difficulties, or dizziness. IF YOU EXPERIENCE difficulty breathing, tightness of chest, swelling of eyelids, face, or lips, or if you develop a rash or hives, tell your doctor immediately. Do not take any more doses of this medicine unless your doctor tells you to do so. DO NOT EXCEED THE RECOMMENDED DOSE or take this medicine for longer than prescribed. THIS MEDICINE MAY BE HABIT FORMING. Use caution driving or operating machinery. DO NOT DRINK ALCOHOL while taking this medicine. DO NOT TAKE other products containing acetaminophen (check labels closely) while you are taking this medicine. IF DIZZINESS OCCURS, sit or stand up slowly. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, OR SURGERY, tell the doctor that you are taking this medicine. IF YOU EXPERIENCE WITHDRAWAL SYMPTOMS (nervousness, sweating, nausea, diarrhea, tremor, trouble sleeping), check with your doctor . FOR WOMEN: Discuss with your doctor is you are planning on getting pregnant. THIS MEDICINE IS EXCRETED IN BREAST MILK. DO NOT BREAST-FEED while taking this medicine.

Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include nausea, vomiting, sweating, unusual drowsiness, slowed breathing, seizures, stomach pain, dark urine, deep sleep or loss of consciousness, coma and death.

How to take this medication
Follow the directions for using this medicine provided by your doctor. Store this medicine at room temperature, away from heat and light. If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Side Effects
Side effects, which may go away during treatment, include dizziness, nausea, drowsiness, dry mouth, constipation, headache, or sweating. If they continue or are bothersome, check with your doctor. Check with your doctor as soon as possible if you experience skin rash, itching, seizures, or hallucinations. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Precautions
Do not exceed the recommended dose or take this medicine for longer than prescribed. If you experience difficulty breathing or tightness of chest; swelling of eyelids, face, or lips; or develop a rash or hives, tell your doctor immediately. Do not take any more of this medicine unless your doctor tells you to do so. Avoid alcohol while you are using this medicine. This medicine will add to the effects of alcohol and other depressants. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. Before you begin taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. For women: if you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. This medicine is excreted in breast milk. Do not breast-feed while taking this medicine.

Drug Interactions
Inform your doctor about all the medicines you take with and without a prescription.

Missed Dose
If you miss a dose, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the amount used to catch up.

Storage
Store at room temperature away from sunlight. Keep this and all medications out of the reach of children.

Notes
DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.