Tramadol

What is the most important information I should know about Tramadol?

• Seizures have been reported as a rare side effect of treatment with Tramadol. The risk of seizures may be increased in patients who take more than the prescribed dose, have a history of seizures or epilepsy, have head trauma, have a metabolic disorder, have a central nervous system infection, are experiencing alcohol or drug withdrawal, or are taking certain medications. Talk to your doctor about factors that may increase the risk of seizures during treatment.
• Do not drink alcohol while taking Tramadol. Alcohol may cause a dangerous decrease in breathing and/or liver problems when used during treatment with Tramadol.
• Use caution when driving, operating machinery, or performing other hazardous activities. Tramadol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Do not take more of this medication than is prescribed for you. If the pain is not being controlled, talk to your doctor. Taking more than the prescribed amount of this medication could result in seizures or decreased breathing.

What is Tramadol?

• Tramadol is a pain reliever. Tramadol affects chemicals and receptors in the body that are associated with pain.
• Tramadol is used to relieve moderate to moderately severe pain.
• Tramadol may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Tramadol?

• Seizures have been reported as a rare side effect of treatment with Tramadol. The risk of seizures may be increased in patients who have any of the conditions or are taking any of the medications listed below: Do not take Tramadol without first talking to your doctor if you
  · have a history of seizures or epilepsy;
  · have a head injury;
  · have a metabolic disorder;
  · have a central nervous system infection;
  · are experiencing alcohol or drug withdrawal;
  · are taking a tricyclic antidepressant such as amitriptyline (Elavil), nortriptyline (Pamelor), doxepin (Sinequan), imipramine (Tofranil), clomipramine (Anafranil), and others;
  · are taking a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);
  · are taking a psychiatric medication such as chlorpromazine (Thorazine), fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane), mesoridazine (Serentil), perphenazine (Trilafon), thioridazine (Mellaril), thiothixene (Navane), and others;
  · are taking a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or citalopram (Celexa);
  · are taking a narcotic pain reliever such as codeine, fentanyl (Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), hydrocodone (Vicodin, Lorcet, Lortab, others), morphine (MS Contin, MSIR, RMS, Roxanol, others), oxycodone (Roxicodone, Percocet, Percodan, others), propoxyphene (Darvon, Darvocet, others), and others;
  · are taking promethazine (Phenergan) or prochlorperazine (Compazine);
  · are taking sibutramine (Meridia);
  · are taking bupropion (Wellbutrin, Zyban); or
  · are taking cyclobenzaprine (Flexeril).
• Before taking Tramadol, tell your doctor if you have
  · kidney disease;
  · liver disease; or
  · a history of alcohol or drug dependence.
• You may not be able to take Tramadol, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Tramadol is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant.
• It is also not known whether Tramadol passes into breast milk. Do not take Tramadol without first talking to your doctor if you are breast-feeding a baby.
• If you are over 75 years of age, you may be more likely to experience side effects from Tramadol. The maximum daily dose of Tramadol for people over 75 years of age is 300 mg.
• Tramadol is not approved by the FDA for use by children younger than 16 years of age.

How should I take Tramadol?

• Take Tramadol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Tramadol can be taken with or without food.
• Side effects from treatment with Tramadol may be decreased by a slow increase in dose, as directed by your doctor. The tablets can easily be broken in half at the score if needed. The maximum dose of Tramadol for an average healthy adult is 100 mg per dose, every 4 to 6 hours, up to 400 mg per day. People over 75 years of age should not take more than 300 mg per day. People with liver or kidney disease may need lower daily doses. Follow your doctor's directions.
• Do not take more of this medication than is prescribed for you. If the pain is not being controlled, talk to your doctor. Taking more than the prescribed amount of this medication could result in seizures or decreased breathing.
• Store Tramadol at room temperature away from moisture and heat.

What happens if I miss a dose?

• Since Tramadol is taken on an as-needed basis, missing a dose is usually not a problem. Take the dose as soon as you remember, and do not take another dose for the amount of time prescribed by your doctor. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical attention.
• Symptoms of a Tramadol overdose include difficulty breathing; shallow, weak breathing; and seizures.

What should I avoid while taking Tramadol?

• Do not drink alcohol while taking Tramadol. Alcohol may cause a dangerous decrease in breathing and/or liver problems when used during treatment with Tramadol.
• Use caution when driving, operating machinery, or performing other hazardous activities. Tramadol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Avoid sleeping pills, tranquilizers, sedatives, and antihistamines except under the supervision of your doctor. These drugs may increase drowsiness caused by Tramadol.
• Tramadol may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, drowsiness, or decreased breathing may occur if Tramadol is taken with any of these medications. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicines, including herbal products, without first talking to your doctor during treatment with Tramadol.

What are the possible side effects of Tramadol?

• If you experience any of the following serious side effects, stop taking Tramadol and seek emergency medical attention or contact your doctor immediately:
  · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); or
  · seizures.
• Other, less serious side effects may be more likely to occur. Continue to take Tramadol and talk to your doctor if you experience
  · dizziness, drowsiness, or headache;
  · nervousness, tremor, or anxiety;
  · nausea, vomiting, constipation, or diarrhea; or
  · itching, dry mouth, or sweating.
• Tramadol is habit forming. Physical and/or psychological dependence can occur, and withdrawal effects are possible if the medication is stopped suddenly after prolonged or high-dose treatment.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Tramadol?

• Tramadol may increase the risk of seizures especially in patients who have epilepsy or another seizure disorder. Also, Tramadol may increase the risk of seizures if you are taking any of the following drugs:
  · a tricyclic antidepressant such as amitriptyline (Elavil), nortriptyline (Pamelor), doxepin (Sinequan), imipramine (Tofranil), clomipramine (Anafranil), and others;
  · a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);
  · an antipsychotic medication such as chlorpromazine (Thorazine), fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane), mesoridazine (Serentil), perphenazine (Trilafon), thioridazine (Mellaril), thiothixene (Navane), and others;
  · a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or citalopram (Celexa);
  · a narcotic pain reliever such as codeine, fentanyl (Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), hydrocodone (Vicodin, Lorcet, Lortab, others), morphine (MS Contin, MSIR, RMS, Roxanol, others), oxycodone (Roxicodone, Percocet, Percodan, others), propoxyphene (Darvon, Darvocet, others), and others;
  · promethazine (Phenergan) or prochlorperazine (Compazine);
  · bupropion (Wellbutrin, Zyban); or
  · cyclobenzaprine (Flexeril).
• Do not take Tramadol without first talking to your doctor if you are taking any of the medicines listed above.
• Before taking Tramadol, tell your doctor if you are taking any of the following medicines:
  · carbamazepine (Tegretol);
  · quinidine (Quinaglute Dura-Tabs, Cardioquin, Quinora, others);
  · warfarin (Coumadin); or
  · digoxin (Lanoxin, Lanoxicaps).
• You may not be able to take Tramadol, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Tramadol may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicines, including herbal products, without first talking to your doctor during treatment with Tramadol.
• Drugs other than those listed here may also interact with Tramadol. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

• Your pharmacist has more information about Tramadol written for health professionals that you may read.