Ultram/Tramadol IS USED FOR:

Treating moderate to moderately severe pain.

Tramadol/Ultram is an analgesic. It works in certain areas of the brain and nervous system to decrease pain.

BEFORE USING Ultram/Tramadol :

Some medical conditions may interact with Tramadol/Ultram . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you have had recent abdominal surgery
• if you have a history of stomach or intestinal problems, asthma or other lung or breathing problems, epilepsy, seizures, or chronic inflammation or ulceration of the bowels
• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you have heart problems, liver problems (eg, hepatitis), kidney problems, thyroid problems, enlargement of the prostate gland, or urinary problems
• if you are taking any prescription (especially depression medicines) or nonprescription medicine, herbal preparation, or dietary supplement
• if you have or recently have had any head injury, brain injury or tumor, increased pressure in the brain, or infection of the brain or nervous system
• if you have a history of alcohol abuse, substance abuse, or suicidal thoughts or behaviors
• if you have allergies to medicines, foods, or other substances
• if you are allergic to codeine, a codeine-related medicine (eg, hydrocodone, dihydrocodeine, oxycodone), morphine, or a morphine-related medicine (eg, hydromorphone)

Some MEDICINES MAY INTERACT with Tramadol/Ultram . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Certain medicines for mental or mood disorders (eg, olanzapine/Zyprexa, haloperidol), cyclobenzaprine, isoniazid, other opioid pain medicine (eg, codeine, hydrocodone), phenothiazines (eg, promethazine/Phenergan), sleeping medicines (eg, zolpidem), sodium oxybate (GHB), tricyclic antidepressants (amitriptyline/Endep), or weight loss medicines (eg, phentermine) because side effects, including excessive drowsiness, trouble breathing, liver problems, or seizures, may be increased
• Oral anticoagulants (eg, warfarin/Coumadin) because its side effects, including bleeding, may be increased by Tramadol/Ultram
• Carbamazepine/Carbatrol because it may decrease Tramadol/Ultram 's effectiveness and increase the risk of seizures
• Digoxin/Digitek because the risk of side effects, including nausea, vomiting, or slow heartbeat, may be increased by Tramadol/Ultram
• Furazolidone/Furoxone, monoamine oxidase (MAO) inhibitors (eg, phenelzine), nefazodone, selegiline/Eldepryl, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine/Prozac) because they may cause serious and sometimes fatal reactions, including restlessness, fever, excessive sweating, confusion, twitching, and seizures

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tramadol/Ultram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

HOW TO USE Ultram/Tramadol :

Use Tramadol/Ultram as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• If you miss a dose of Tramadol/Ultram , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
• Take Tramadol/Ultram by mouth with or without food.

Ask your health care provider any questions you may have about how to use Tramadol/Ultram .

DO NOT USE Ultram/Tramadol IF:

• you are allergic to any ingredient in Tramadol/Ultram
• you are taking nefazodone, carbamazepine/Carbatrol, or sodium oxybate (GHB)
• you have severe diarrhea due to taking an antibiotic
• you are intoxicated with alcohol, other opioids or narcotics (eg, morphine, codeine), sedatives or sleeping medicines (eg, temazepam, zolpidem), or other medicines

Contact your doctor or health care provider right away if any of these apply to you.

POSSIBLE SIDE EFFECTS OF Ultram/Tramadol :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; increased sweating; loss of appetite; nausea.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; fainting; fever; incoordination; muscle stiffness or tremor; seizures.

IMPORTANT SAFETY INFORMATION:

• PREGNANCY and BREAST-FEEDING: Tramadol/Ultram has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tramadol/Ultram while you are pregnant. Tramadol/Ultram is found in breast milk. Do not breast-feed while taking Tramadol/Ultram .
• Tramadol/Ultram may cause drowsiness and dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Tramadol/Ultram with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Tell your doctor or dentist that you take Tramadol/Ultram before you receive any medical or dental care, emergency care, or surgery.
• Use Tramadol/Ultram with caution in the ELDERLY; they may be more sensitive to its effects.
• Tramadol/Ultram may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of this effect.
• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Tramadol/Ultram ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Tramadol/Ultram should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed.

When used for long periods of time or at high doses, Tramadol/Ultram may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Tramadol/Ultram stops working well. Do not take more than prescribed.

Some people who use Tramadol/Ultram for a long time without a break may develop a physical need to continue taking it. This is known as physical DEPENDENCE. If you suddenly stop taking Tramadol/Ultram , you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.