Posts Tagged ‘ultram’

Ultram: Prescription Drug Abuse & Testing

Tarun Gupta asked:




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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Effective Pain Management

M Roger asked:




Sometimes the name of an academic periodical is just so “right” it needs no further explanation. In this case, we are interested in the August issue of Pain. Told you so! Anyway, Boston University has been researching the number of people in the U.S. who take opioid painkillers including Ultram. Their results show a higher rate of usage than found in earlier studies. This may be explained by differences in research methods or a change in the honesty of those surveyed or the actual usage may have increased. As it is, the random telephone survey of more than 19,000 adults finds that more than 4m Americans regularly take opioids. In any given week, some 10m adults are likely to take a strong painkiller.

This implies that a significant percentage of the adult population believes it suffers from chronic pain of sufficient intensity to justify using one of the stronger painkillers. It is hard to say which is the more worrying. That so many people think they have serious pain, or that so many people routinely rely on opioids to control their pain. The other inference may be that many people are actually abusing their painkillers. It is entirely possible that the true level of opioid abuse is underreported because it is illegal to obtain the drugs without a prescription.

Whatever the level of abuse, the survey finds that the symptoms treated were mainly classified as headache, back pain, arthritis, and so on. Only about 5% admitted to using ultram or one of the other painkillers for anxiety or a condition not directly related to physical pain. It is also significant that people taking painkillers were more likely to be taking other medications. It is not surprising that painkillers should be combined with anti-inflammatories, but it is of some concern that some 30% were also taking antidepressants and more than 25% were taking anticonvulsants. There is also evidence of a link to cardiovascular disease and other chronic conditions. It seems probable that those with such problems find pain more of a problem and so take an opioid.

The researchers conclude that, although there is an obvious place for opioids like ultram, there is a general need to put more effective pain management services in place to reduce the incidence of abuse.



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How is it that Tramadol (Ultram) is not classified as a narcotic?

jeffloveswaffles asked:


All of the effects of Tramadol (Ultram) embody the definition of a narcotic, but it’s always classified as a narcotic-like drug.

What makes it not a narcotic?

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How long will vyvanse and tramadol stay in my system?

Nick asked:


I took Vyvanse (adderall) 10 days ago and i also took some tramadol (ultram)for back pain about 2 weeks ago. The only thing is i have to take a drug test tomorrow. How long will these stay in my system for and are they even going to be tested for in a drug test that the state of kansas will be giving me.

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If I switch from vicodin or tylenol 4 to ultram or tramadol or ultracet, will I feel less loopy?

James Watkin asked:


I need occasional pain relief and hate the vicodin or tylenol 4 the doc gives me because I don’t feel like myself. Yes, it helps the pain but I like being more clear-headed. Does ultram, ultracet or tramadol have the same effects as vicodin or tylenol 4?

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Managing Pain


In the short-term, pain is bearable but, if it persists, it can become the cause of a new range of problems. You may get into trouble at work because you cannot now do the same physical activities or you find it hard to concentrate. It may be more difficult to get a good night’s sleep and this may make you tired and irritable. Life may no longer have the same quality. The first thing to do is to talk to your health provider. There are excellent drugs available like ultram to offer pain relief. There are also an impressive range of alternative therapies for managing the pain. Now it’s a fact that some people do not like the idea of taking drugs. The majority fear addiction. The news is full of stories about people abusing prescription medications. Note the word “abusing”. The reality is that almost everyone can take these drugs safely so long as they follow the instructions given by their physicians. The FDA guidelines to patients are very clear. The drugs are safe so long as you take them as directed. So do not change the dose, or break or crush them. Putting this in context. For better or worse, experiencing pain is a part of life. If you talk to your health provider, you avoid needless suffering. But you cannot expect a miracle cure. The long-term solution to your problem is not in a bottle. Although a drug like ultram will give you excellent relief, you should see medication as only one part of a wider regime of treatment. The first issue to address is that people who are in pain grow afraid and depressed. The greater the levels of anxiety, the lower the tolerance of the pain. That means you have to treat the mind and body together. To help control the stress, counseling and therapy are the ideal but they can be expensive if not covered by your health plan. Check out your local area to see whether there are self-help support groups. Talking to other people in the same situation is an important first step in adjusting your attitude to your condition and the pain it causes. You should also begin regular physical exercise. No matter what your physical problems, the worst thing you can do is to sit as if paralyzed in a chair. You will stiffen and lose muscle tone. Using ultram until you get used to mobility will ease you back into exercise. Try walking or swimming — the water will support you while you exercise. Do some research and try the different meditation and relaxation techniques. Massage or physiotherapy will also help. Eventually, you must come to terms with your body and any new limitations on its movement. You must cope. More importantly, you must accept the condition and maximize a positive outlook on life. Medication can help you as your health provider advises, but self-help is the best long-term solution.



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Tramadol CLINICAL PHARMACOLOGY – Pharmacodynamics

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ULTRAM is a centrally acting synthetic analgesic compound. Although its mode of action is not completely understood, from animal tests, at least two complementary mechanisms appear applicable: binding of parent and M1 metabolite to m-opioid receptors and weak inhibition of reuptake of norepinephrine and serotonin.

Opioid activity is due to both low affinity binding of the parent compound and higher affinity binding of the O-demethylated metabolite M1 to m-opioid receptors. In animal models, M1 is up to 6 times more potent than tramadol in producinganalgesia and 200 times more potent in m-opioid binding.

Tramadol induced analgesia is only partially antagonized by the opiate antagonist naloxone in several animal tests. The relative contribution of both tramadol and M1 to human analgesia is dependent upon the plasma concentrations of each compound (see CLINICAL PHARMACOLOGY, Pharmacokinetics).

Tramadol has been shown to inhibit reuptake of norepinephrine and serotonin in vitro, as have some other opioid analgesics. These mechanisms may contribute independently to the overall analgesic profile of ULTRAM. Analgesia in humans begins approximately within one hour after administration and reaches a peak in approximately two to three hours.

Apart from analgesia, ULTRAM administration may produce a constellation of symptoms (including dizziness, somnolence, nausea, constipation, sweating and pruritus) similar to that of an opioid.

However, tramadol causes less respiratory depression than morphine at recommended doses (see OVERDOSAGE). In contrast to morphine, tramadol has not been shown to cause histamine release. At therapeutic doses, ULTRAM has no effect on heart rate, left-ventricular function or cardiac index. Orthostatic hypotension has been observed.

This page is provided for educational and informational purposes only and is not intended as a substitute for the advice of a medical doctor, nurse, nurse practitioner or other qualified health professional.