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What is Ultram?

Ultram is a prescription pain reliever that is used to treat moderate to severe pain in adults. It relieves pain by acting on the central nervous system (CNS).

Tramadol extended-release formulations (Ultram ER) are typically prescribed for people who require pain relief around the clock for an extended period of time. They are not meant to be used for minor aches and pains.

Important Information

Do not take Ultram if you have severe breathing problems, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others).

Ultram has the potential to slow or stop your breathing, and it may become addictive. Addiction, overdose, or death can result from the misuse of this medicine, even in children or others who do not have a prescription.

Ultram use during pregnancy can result in life-threatening withdrawal symptoms in the baby.

Tramadol can have fatal side effects when combined with alcohol or other drugs that cause drowsiness or slow breathing.

What to know before taking Ultram?

Do not take Ultram if you are allergic to tramadol, or if you have:

  • breathing problems or severe asthma
  • obstruction of the stomach or bowel (including paralytic ileus)
  • if you have recently used sedatives, alcohol, tranquilizers, or narcotic medications
  • if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine)

A child under the age of 12 should not be given Ultram. Anyone under the age of 18 should not be given Ultram ER.

Do not give Ultram to anyone under the age of 18 who has recently had their tonsils or adenoids removed.

Inform your doctor if you had any of the following conditions in the past to ensure that Ultram is safe for you:

  • sleep apnea, breathing issues
  • liver or kidney disease
  • problems with your gallbladder, pancreas, or thyroid
  • urination problems
  • mental illness, or suicide attempt
  • a stomach disorder

Some Ultram users have experienced seizures. You are more likely to have seizures if you have ever had a head injury, epilepsy, or other seizure disorder, drug or alcohol addiction, or a metabolic disorder.

If you use tramadol while pregnant, your baby may be born with potentially fatal withdrawal symptoms and may require medical treatment for several weeks.

If you are breastfeeding, you should consult your doctor before taking tramadol. Inform your doctor if you notice the nursing baby is drowsy or breathing slowly.

How to take Ultram?

Take Ultram exactly as directed by your doctor. Never take Ultram in larger doses or for longer than recommended. Inform your doctor if you have an increased desire to take this medication.

Ultram has the potential to slow or stop your breathing, and it may become addictive. Addiction, overdose, or death can result from the misuse of this medicine, even in children or others who do not have a prescription. You can easily order Ultram online.

When you start taking Ultram, you must stop all other opioid medications.

Take Ultram with or without food the same way each time.

To avoid a potentially fatal overdose, swallow the capsule or tablet whole. Not to be crushed, chewed, broken, opened, or dissolved.

If you stop using abruptly, you may experience withdrawal symptoms. Before discontinuing medication, consult with your doctor.

Keep away from moisture and heat by storing at room temperature. Keep a record of your medications. You should be aware if someone is abusing it or using it without a prescription.

Do not save any leftover Ultram. A single dose can be fatal if used incorrectly or accidentally.

Ultram dosage

Adult Dose for Pain

For pain, take 50mg to 100mg orally every 4 to 6 hours as needed. The maximum daily dose is 400 mg.

Adult Dose for Chronic Pain

Extended-Release (ER):

18 years of age or older (tramadol-naive): 100 mg orally once daily

Maximum Daily Dose: 300 mg


An overdose can be fatal, especially if the patient is a child or someone who is taking the medication without a prescription. The overdose symptoms include pinpoint pupils, severe drowsiness,  slow breathing, or no breathing.


Your doctor may advise you to obtain naloxone (a medication used to reverse an opioid overdose) and keep it on hand at all times. If you stop breathing or do not wake up, someone who is caring for you can administer naloxone. Your caregiver must still seek emergency medical assistance and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help.

What to avoid while using Ultram?

Do not consume any alcohol while using Ultram. Dangerous side effects or death could occur.


Avoid driving or engaging in dangerous activities until you know how this medication will affect you. Dizziness or drowsiness can lead to falls, accidents, or serious injuries.

Ultram side effects

Common side effects of Ultram may include:


  • nausea, constipation, vomiting, stomach pain
  • headache
  • dizziness, drowsiness, tiredness
  • itching

Serious side effects

  • noisy breathing, sighing, shallow breathing, breathing that stops during sleep
  • a slow heart rate or weak pulse
  • a light-headed feeling, like you might pass out
  • seizure (convulsions)
  • low cortisol levels, symptoms may include nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness


Tramadol can slow your breath or stop it, and death may occur. If you have blue lips, slow breathing with long pauses or are difficult to wake up, someone caring for you should administer naloxone and seek emergency medical attention.


If you have serotonin syndrome symptoms, seek medical attention immediately. Symptoms may include agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.


Serious breathing problems may be more common in the elderly, the debilitated, or those suffering from wasting syndrome or chronic breathing disorders.

What drugs can interact with Ultram?

Many other medicines can be dangerous when used with Ultram. Tell your doctor if you also use:


  • medicine for allergies, asthma, blood pressure, motion sickness, irritable bowel, or overactive bladder
  • other opioid medicines
  • a benzodiazepine sedative like Valium, Klonopin, or Xanax
  • sleep medicine, muscle relaxers, or other drugs that make you drowsy; or
  • drugs that affect serotonin, such as antidepressants, stimulants, or medicines for migraines or Parkinson’s disease