Tramadol (TRAM-a-dol)

Treats moderate to severe pain. This medicine is a narcotic pain reliever.

Brand Name(s):

FusePaq Synapryn, Qdolo, Ultram, Ultram ER

When This Medicine Should Not Be Used:

How to Use This Medicine:

Long Acting Capsule, Liquid, Tablet, Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Swallow the extended-release capsule whole. Do not crush, break, or chew it.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Drink plenty of liquids to help avoid constipation.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.
• Some medicines can affect how tramadol works. Tell your doctor if you are using any of the following:
  • Amiodarone, carbamazepine, cyclobenzaprine, digoxin, erythromycin, ketoconazole, lithium, metaxalone, mirtazapine, phenytoin, promethazine, rifampin, ritonavir, quinidine, trazodone
  • Blood thinner (including warfarin)
  • Diuretic (water pill)
  • Medicine to treat depression (including bupropion, fluoxetine, paroxetine, quinidine, SSRIs, TCAs)
  • Phenothiazine medicine
  • Triptan medicine for migraine headaches
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. Tell your doctor if you are using buprenorphine, butorphanol, nalbuphine, pentazocine, or a muscle relaxer (including cyclobenzaprine, metaxalone).
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease (including cirrhosis), adrenal problems, gallstones, lung or breathing problems (including sleep apnea), diabetes, pancreas problems, or a history of head injury, seizures, drug addiction, or depression or similar emotional problems. Tell your doctor if you have phenylketonuria.
• This medicine may cause the following problems:
  • High risk of overdose, which can lead to death
  • Respiratory depression (serious breathing problem that can be life-threatening)
  • Sleep-related breathing problems (including sleep apnea, sleep-related hypoxemia)
  • Worsening of pain
  • Serotonin syndrome (when used with certain medicines)
  • Increased risk of seizures
  • Adrenal gland problem
  • Low blood pressure
  • Unusual change in mood or behavior
  • Hypoglycemia (low blood sugar level)
• This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up carefully.
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
• This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, fast heartbeat, fever, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Blistering, peeling, red skin rash
• Blue lips, fingernails, or skin
• Changes in skin color, dark freckles, cold feeling, tiredness, weight loss
• Extreme dizziness, drowsiness, or weakness, shallow breathing, slow heartbeat, seizures, and cold, clammy skin
• Lightheadedness, dizziness, fainting
• Shaking, trembling, sweating, hunger, confusion
• Unusual mood or behavior, thoughts of killing yourself or others
• Trouble breathing
• Weakness, muscle twitching
• Worsening of pain, increased sensitivity to pain

If you notice these less serious side effects, talk with your doctor:

• Constipation, loss of appetite, stomach upset
• Dry mouth
• Headache

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088