Ultram is a prescription drug belonging to the opiate (narcotic) pain reliever's class of medications, which is used in relieving moderate to moderately severe pain. Ultram works by changing the manner in which the nervous system and the brain respond to pain. Ultram cannot be used in patients who have a history of seizures because it has weak antidepressant effects.
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Ultram is used to relieve moderate to moderately severe pain. Ultram is similar to narcotic analgesics and works in the brain to change how a patient's body feels in response to pain. Ultram is presumed to bind to brain receptors (narcotic or opioid receptors) that are crucial in transmitting the pain sensation from other parts of the body to the brain. Ultram cannot be used in patients who have a history with seizures because it has weak antidepressant effects. Pain is a discomfort feeling that occurs when one's body send signals to the brain. Ultram changes the way the body and brain perceive pain by inhibiting norepinephrine and serotonin uptake. Ultram activates opiate receptors in the central nervous system to increase the inhibitory effects on transmission of pain in the spinal cord.
Ultram should be taken by mouth (with/without food), normally 4-6 hours as required for pain relief or as instructed by a medical expert. Patients having nausea should take Ultram with food.
- The recommended dose of Ultram is 50-100 mg every 4-6 hours as required for pain. The maximum daily dose should be 400mg (For extended-release tablets)
- To improve patient's tolerance, the dose should be started at 25mg/day. The dose can be increased by 25-50 mg every five days but should not go beyond 300 mg/day. Patients are required to swallow the extended-release tablets as a whole and not chew, open or crush
- For patients exceeding 75 years, the maximum daily dose should be 300 mg/day.
Ultram Side Effects
In rare cases, Ultram can increase serotonin and lead to serotonin toxicity, which is a very serious condition. Patients should watch out for the following symptoms: loss of coordination, severe vomiting/nausea, twitching muscles, unusual restlessness, hallucinations, severe dizziness and fast heartbeat. Common Ultram side effects
- Feeling anxious or nervous
- Stomach pain
- Headache, drowsiness, tired feeling
Serious Ultram side effects
- Severe skin reaction (characterized by swelling in the patient's face or tongue, burning in the eyes, skin pain that is followed by a rash that causes skin peeling)
- Seizure (convulsions)
- High levels of serotonin in the body (characterized by fever, hallucinations, fast heart rate, agitation, nausea, diarrhea, loss of coordination, and overactive reflexes, fainting)
Drug interactions can change how Ultram works and can increase the risk for serious side effects. Patients should ensure they inform their doctors about all the drugs in use, including both prescription and non-prescription drugs. Some products that can interact with Ultram include:
- Some pain medications like pentazocine, nalbuphine and butorphanol (mixed narcotic agonist-antagonists)
- MAO inhibitors, such as selegiline, rasagiline, tranylcypromine, procarbazine, phenelzine, moclobemide, linezolid, methylene blue, isocarboxazid.
- Other drugs that increase serotonin level, such as MDMA, St John's wort
- Some antidepressants (including SSRIs such as paroxetine, SNRIs such as venlafaxine
- HIV drugs such as ritonavir
- Azole antifungals
- Macrolide antibiotics
- Drugs for treating seizures such as carbamazepine
- Antidepressant such as clomipramine, escitalopram, citalopram or desipramine
- Some cancer medications
- ADHD medications
- Some heart rhythm medications