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What is Ultram?

Ultram is a brand-name prescription drug that helps treat pain in adults. Even after being a little weaker than other opioid medicines, it can be addictive and habit-forming. You can find it at a cheaper rate in its generic form, namely, tramadol.

Ultram is available in both structures: immediate-acting tablet and extended-release tablet. Both forms contain Tramadol as an active ingredient and help you deal with pain, but extended-release versions gradually release the medication in your body throughout the day.

You only have to take the extended-release form once a day. In contrast, you can take the immediate-release version whenever you need it for pain relief. Let the medical healthcare provider decide which one is better for your medical condition.

Important Information

Ultram relieves moderate to severe pain like other opioid pain medications, and it also comes with the risk of misuse, abuse, addiction, overdose, and death. Since it is a controlled substance, you need to take it as per the dosage schedule to prevent potential prescription abuse.

In comparison with other opioids, Ultram offers unique pain relief by working on similar receptors as specific antidepressants. But people with seizures (or convulsions) should avoid taking this medication.

It is better than other opioids as it causes less constipation. If you have constipation while taking Ultram, using laxatives and staying hydrated can quickly help treat this side effect.

What to know before taking Ultram?

Before taking it, discuss your medical history with the medical healthcare provider in detail. Tell the doctor treating you about the allergies you have and the medications you were taking earlier, especially:

  • Mental disorders such as brain tumor, head injury, seizure (or convulsions);
  • Difficulty in urination (primarily due to enlarged prostate);
  • Trouble breathing, including interrupted breathing during sleep, asthma, chronic obstructive pulmonary disease (COPD);
  • Mood changes such as confusion, thoughts of suicide, depression;
  • Liver or kidney disease;
  • An individual or family past of substance use disorder such as overuse or addiction to drugs or alcohol;
  • Gallbladder disease;
  • Pancreatitis (disease of the pancreas);
  • Stomach or intestinal diseases that may include diarrhea due to infection, blockage, paralytic ileus, constipation; or
  • Obesity

Like other opioids, try to avoid using them while you are pregnant. It can make the baby drug dependent and cause withdrawal symptoms after birth. Ultram can pass into the breastmilk and become harmful for the nursing baby.

How to take Ultram?

Take Ultram only in the amount that is suitable for your health. Your medical healthcare provider will prepare your dosing schedule depending upon the following factors:

  • Your age and medical condition for which the treatment with Ultram is going on,
  • Your initial response to the therapy with Ultram,
  • The severity of your pain (in deciding the form and strength),
  • Other medical issues you have and other medications you are taking or took in the past

Although you can take Ultram with or without food, you should take it with food to avoid an upset stomach. If you have some liver or kidney disease, your medical healthcare provider may recommend you to take a lower effective dose during the initial phase of treatment.

Do not chew, crush, break, or open an extended-release capsule of Ultram; rather, swallow it whole. Take the extended-release tablets precisely as per your doctor’s prescription. If you forget to have a dose, take it as soon as you remember. Please do not take an extra pill to cover up a missed dose.

Depending upon the severity of your pain, Ultram may take some extra time before you see its full effect. If you are taking opioids for the long term, do not suddenly stop taking them; otherwise, you may face unpleasant withdrawal symptoms.

Ultram dosage

Usual adult dosage of Ultram IR (immediate-release) for pain:

  • For adults (ages 17 years or older), the dosage should be 50 mg to 100 mg orally within every 4 to 6 hours as needed depending upon the severity of pain.
  • For patients who do not require rapid onset of analgesic effect, the initial dose should be 25 mg orally one time a day, titrating 25 mg every three days to reach an amount of 25 mg four times a day. After that, you can increase the quantity by 50 mg every three days, depending upon your tolerance.
  • The maximum amount should not exceed 400 mg per day.

Usual adult dosage of Ultram ER (extended-release) for chronic pain:

  • For adults (18 years or older), the dose should be 100 mg orally one time a day.
  • Your medical healthcare provider may individually titrate in 100 mg increments within every five days to assign an effective dose for you.
  • The maximum amount should not exceed 300 mg per day.

The usual senior (over 75 years) dosage for moderate to severe pain should not exceed 300 mg per day. Ultram is not for use in pediatric patients (less than 17 years of age).


If you feel like you are having an overdose of Ultram, take immediate medical help or call the Poison helpline at 1-800-222-1222. If the condition is severe with symptoms like passing out or trouble breathing, call 911.

An Ultram overdose can be extremely dangerous or fatal, especially in a child or someone taking it without any prescription. Overdose symptoms may include pinpoint pupils, slow or shallow breathing, severe drowsiness, or no breathing.

Your medical healthcare provider may even ask you to purchase naloxone from a pharmacy or local health department and keep it with you. Your attendant or caregiver should know where you keep it and give it to you if you stop breathing or do not wake up.

What to avoid while using Ultram?

Hazardous side effects or death may occur if you consume alcohol while going through the treatment with Ultram.

Ultram can make you dizzy or drowsy. So, avoid activities such as driving any vehicle, using heavy machinery, and performing tasks that require you to be alert.

Ultram side effects

Ultram may cause severe side effects that require you to consult your medical healthcare provider immediately or seek instant medical attention. Such side effects may include:

  • Sighing, noisy or shallow breathing;
  • Interrupted breathing during sleep;
  • External heart rate or weak pulse;
  • Nausea, vomiting, feeling lightheaded;
  • Seizure (or convulsions);
  • Loss of appetite;
  • Severe dizziness and drowsiness; or
  • Worsening weakness or tiredness

Some common side effects of Ultram that may not need you to seek medical help instantly and may vanish within a few days or a couple of weeks include:

  • Nausea, itching, vomiting, constipation;
  • Dizziness, drowsiness, stomach pain;
  • Headache and tiredness

These are not all the possible side effects of Ultram. For further information regarding side effects, you may consult your medical healthcare provider or report it to the FDA at 1-800-FDA-1088.

What drugs can interact with Ultram?

Several drugs may cause a dangerous interaction with Ultram. So, tell the medical healthcare provider if you also use:

  • Other opioid or narcotic medicines;
  • Treatment for allergies, motion sickness, asthma, blood pressure, overactive bladder, or irritable bowel syndrome;
  • Drugs that make you feel tired such as muscle relaxers and sleep medicine;
  • A benzodiazepine sedative like Klonopin, Valium, or Xanax; or
  • Drugs that may affect the level of serotonin in your body, such as stimulants, antidepressants, medicine for migraine headaches, or Parkinson’s disease

It is not a complete list of all possible side effects, and other drugs may also interact with Ultram. It may include prescription and non-prescription drugs, over-the-counter (OTC) medicines, vitamins, herbal products, and supplements.