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Ultram is the trade name for Tramadol which is an atypical opioid. It is a synthetic agent, as a 4-phenyl-piperidine analogue of codeine, and appears to have actions on the GABAergic, noradrenergic and serotonergic systems & is thus used as a centrally acting analgesic for treating moderate to severe pain.

Tramadol is usually marketed as the hydrochloride salt (tramadol hydrochloride) and is available in both injectable (intravenous and/or intramuscular) and oral preparations. It is also available in conjunction with paracetamol.

Ultram Prescription:

Ultram is used to relieve moderate to moderately severe pain. Ultram extended-release tablets are only used by people who are expected to need medication to relieve pain around-the-clock for a long time. Ultram belongs to the class of drugs called opiate agonists. It works by changing the way the body senses pain.

Tramadol comes as a tablet and an extended-release (long-acting) tablet to take by mouth. The regular tablet is usually taken with or without food every 4-6 hours as needed. The extended-release tablet should be taken once a day. Oral doses range from 50–400 mg daily, with up to 600 mg daily when given IV/IM. The formulation containing APAP contains 37.5 mg of Tramadol and 325 mg of paracetamol, intended for oral administration with a common dosing recommendation of one or two tabs every four to six hours although final dosage is decided by physician and is highly case specific.

Ultram Abuse:

MedWatch is a FDA database of adverse events of case reports voluntarily submitted to the FDA. From 1999 through September 2004, the FDA received 766 case reports of Tramadol abuse. It is most commonly abused by narcotic addicts, chronic pain patients, and health professionals.

Tramadol is approximately 10% as potent as morphine, when given by the IV/IM route. It is a potent habit-forming substance. Tramadol is not currently scheduled by the U.S. DEA, unlike other opioid analgesics. Nevertheless, the prescribing information for Ultram warns that Tramadol may induce psychological and physical dependence of the morphine-type. In addition, there are widespread reports by consumers of extremely difficult withdrawal experiences. A controlled study that compared different medications found that the percent of subjects who scored positive for abuse at least once during the 12-month follow-up were 2.5% for NSAIDs, 2.7% for Tramadol, and 4.9% for hydrocodone. Taking more Tramadol / Ultram than what is prescribed by your doctor may cause serious side effects or death.

Effects of Ultram Abuse:

The most commonly reported adverse drug reactions are nausea, vomiting and sweating. Drowsiness is reported, although it is less of an issue than with other opioids. Respiratory depression, a common side effect of opioids, is not clinically significant in normal doses. Serious potential consequences of over dosage are respiratory depression, lethargy, coma, seizure, cardiac arrest and death. Fatalities have been reported in post marketing in association with both intentional and unintentional overdose with Ultram.

Ultram may induce psychic and physical dependence of the morphine-type opioids. Dependence and abuse, including drug-seeking behavior and taking illicit actions to obtain the drug are not limited to those patients with prior history of opioid dependence. The risk in patients with substance abuse has been observed to be higher. Ultram is associated with craving and tolerance development. Withdrawal symptoms may occur if Ultram is discontinued abruptly. These symptoms may be relieved by reinstitution of opioid therapy followed by a gradual, tapered dose reduction of the medication combined with symptomatic support.



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