Chemical Information

Tramadol hydrocholoride's molecular weight is 299.8. A crystalline powder that has no odor, and is bitter and white, is Tramadol hydrochloride. It dissolves quite easily in H2O and ethanol, with a pKa level of 9.41. In terms of the logP coefficient for n-octanol/water, the level is 1.35, with pH of 7. The ULTRAM formula includes Tramadol hydrochloride in the amount of 50 mg, and is in white pill form. Corn starch, hypromellose, lactose,magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, titanium dioxide and wax are the inactive ingredients included in the tablet.

Drug Interactions

Studies indicate that the CYP3A4-mediated metabolism of other drugs is not likely to be inhibited by concurrent use of Tramadol (Ultram) in therapeutic doses. It does not appear that Tramadol (Ultram) induces its own metabolism in humans, since observed maximal plasma concentrations after multiple oral doses are higher than expected based on single-dose data. In animal species, Tramadol or ULTRAM causes a slight metabolic reaction for certain drugs.

Storing Tramadol

Storage instructions recommend keeping this drug at 25 degrees C, 77 degrees F, with an outer limit of 15-30 degrees C, 59-86 degrees F.

Carbamazepine Patients

ULTRAM can be contraindicated and interfere with subjects using carbamazepine. Concomitant administration of Ultram with carbamazepine is not recommended because carbamazepine will increase the metabolism of Tramadol, and Tramadol has a risk of seizures associated with it.

Employ with Quinidine

CYP2D6 metabolizes Ultram or Tramadol to M1. Because quinidine is a selective inhibitor of that isoenzyme, taking quinidine and ULTRAM concurrently causes increased concentrations of Tramadol (Ultram) and decreased concentrations of M1. It is not known what the clinical consequences of these findings might be. In vitro drug interaction research performed in microsomes of the human liver show that there is no effect on the metabolism of quinidine from Tramadol (Ultram).

Use With Inhibitors of CYP2D6

Studies have revealed that some inhibition of the metabolism of Tramadol (Ultram) occurs when used concurrently with inhibitors of CYP2D6 such as fluoxetine, paroxetine, and amitriptyline.

Use With Cimetidine

Clinically significant changes in Tramadol (Ultram) pharmacokinetics do not occur when ULTRAM and cimetidine are taken concurrently. Hence, it is not suggested that any modification be made to the ULTRAM dosing instructions.

Use With MAO Inhibitors

Because they interfere with detoxification mechanisms, there have been reports of interactions with MAO Inhibitors for some centrally acting drugs (see WARNINGS, Use With MAO Inhibitors).

Use With Digoxin and Warfarin

Since this drug has been on the market, there have been a few reports of digoxin toxicity and alteration of warfarin effect, including elevation of prothrombin times.

Children

For patients under the age of 16, no specific information exists with regard to the effects of Tramadol (Ultram).

Tramadol Use Warnings

Because Tramadol is in the class of narcotics, you need to realize that it could cause dependency. This medication must always be used according to physician instructions. Be careful not to exceed the prescribed dosage. Inform your medical provider about any other medical issues, like liver or kidney problems. As Tramadol may cause drowsiness, wait until you know how you will be affected by it before driving. Tramadol use in conjunction with alcohol consumption is strictly prohibited. Let your physician know about any other medications or remedies that you are using, and this should include homeopathic remedies like St. John's Wort botanical specimen.

Tramadol has proven successful in treating symptoms of chronic pain in users. Some side effects do seem to occur, such as nervousness, sweating, chills, dry mouth, dizziness, itching, rashes, changes in mood, heartburn, constipation, headache, sleepiness, and more, but usually these are not severe enough to cause people to stop taking this medication.

If your doctor has written you a prescription for Tramadol or if it is something you are considering taking, follow all instructions completely.