Ultram ®

Ultram ® is a narcotic-like painkiller, sometimes referred to as 'synthetic codeine':

• Produces severe withdrawal symptoms with abrupt cessation after prolonged use.
• Ultram ® may provoke life-threatening serotonin syndrome—including hallucinations and coma—when taken with other selective serotonin re-uptake inhibitors (SSRIs, i.e., antidepressants)
• Can impair mental or physical capacities required to perform hazardous tasks such as driving or machine operation.
• Ultram ® is not considered a scheduled controlled substance in the Unites States, although FDA studies in 1997 and 2002 would recommend reevaluation due to its diversion for non-medical use.
• For chronic pain, starting-dose at 25 mg per a day (administered in the morning).
• Daily adjustment dosage up to 200 mg (four doses of 50 mg each, by gradual increase every 3 days until reached).
• After habituation, typical doses of 50 to 100 mg every 4 to 6 hours (dependent on severity of pain).
• The maximum dosage under any circumstances is 400 mg a day (300 mg for those over age 75).
• Consistent with the extended-release formulation of Ultram ®, drug absorption demonstrates a lag time for bioavailability after its administration.
• Physicians should not administer Ultram to patients prone to suicide or addiction.
• Patients must not exceed the prescribed dose and should limit their alcohol intake.
• Abuse of Ultram involves chewing, crushing, injecting, or snorting the dissolved product.
• Abusive intake of Ultram ® results in uncontrolled delivery of the drug, risking the user’s potential overdose and possible death.
• The usual starting dose for patients with kidney problems at 50 to 100 mg every 12 hours (maximum, 200 mg per day); and, patients with cirrhosis at 50 mg every 12 hours.
• The volume of distribution of Tramadol is slightly higher in females than maies (2.6 and 2.9 liters/kg, respectively, in a 100 mg intravenous dose).
• Sometimes mistakenly classified as a non-opioid analgesic, since its liability for abuse is lower than that of other opioids.
• Non-medical recreational use is very dangerous due to the possibility of convulsions at high doses.
• The street names for Ultram ® are unknown, possibly non-existent due to its dangerous recreation use.
• Owned by the German pharmaceutical company Grünenthal, which has cross-licensed the Ultram patent under many trade names around the world (list ):
• Ultram can be habit forming, and must be taken according to instructions under doctor’s orders.
• Potential to cause low physical or psychological dependence, unless used infrequently.
• Use with sedatives, antidepressants, or alcoholic beverages increases risk of adverse side effects, dizziness, or unconsciousness.
• Prolonged dosage other than prescribed can lead to dependency.
• Among 6.4 million Americans using prescriptions for non-medical purposes, more than 73% abused pain relievers like Ultram ® (2006, National Household Survey).

(i) The Diversion of Ultram,® Ultracet,® and Generic Tramadol HCL, University of Delaware Research Center

(ii) http://en.wikipedia.org/wiki/Tramadol

(iii) Grünenthal’s Tramadol marketed as: Acugesic (in Malaysia and Singapore), Adolan, Adolonta, Anadol, Boldol (in Bosnia and Herzegovina), Calmador (in Argentina), Contramal, Crispin, Campex (in Pakistan), Dolol (in Denmark), Dromadol (in UK), Exopen (in South Korea), Ixprim (in France), Lumidol, Mandolgin (in Denmark), Mandolgine, Mosepan, Nobligan, Poltram, Ralivia (In Canada), Sintradon, Siverol (in the Philippines), Tandol (in South Korea), Tiparol, Toplagic, Tradol, Tradolan, Tradolan (in Sweden), Tradonal (in the Philippines), Tralgit, Tralodie (in Italy), Tramacet (in Costa Rica), Tramal Gotas (in Ecuador), Tramacip, Tramadex (in Israel), Tramake Insts (in United Kingdom), Tramadin, Tramadol STADA (in Sweden), Tramadolor, Tramal (in the Netherlands, Finland, Slovenia, Chile, Romania, Australia, New Zealand and Switzerland), Tramalgic (in Hungary), Tramahexal, Tramacet (combined with paracetamol), Tramazac (in India), Trama-Klosidol, Tramedo, Tridol (in South Korea), Trodon (in Serbia), Ultracet (combined with paracetamol), Ultram and Ultram ER (in the US), Ultramed (combined with paracetamol) in India, Veldrol (in Mexico), Zaldiar (combined with paracetamol, in Spain, Russia), Zaledor (in Chile), Zamadol (in UK), Zamudol, Zodol (in Ecuador), Zydol (in the UK and Australia), Zytram , Zytrim (in Spain)