Melody
Moderator
Reged: 03/20/03
Posts: 676
Loc: DrugBuyers.Com
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Tramadol hydrochloride is a centrally acting analgesic. The chemical name for tramadol hydrochloride is (±)cis-2- [(dimethylamino)methyl]-1-(3-methoxyphenyl) cyclohexanol hydrochloride. The molecular weight of tramadol hydrochloride is 299.8.
Tramadol hydrochloride is a white, bitter, crystalline and odorless powder. It is readily soluble in water and ethanol and has a pKa of 9.41. The water/n-octanol partition coefficient is 1.35 at pH 7.
Ultram tablets contain 50 mg of tramadol hydrochloride and are white in color. Inactive ingredients in the tablet are corn starch, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, titanium dioxide and wax.
INDICATIONS
Tramadol is indicated for the management of moderate to moderately severe pain.
DOSAGE AND ADMINISTRATION
For the treatment of painful conditions tramadol 50 mg to 100 mg can be administered as needed for relief every four to six hours, not to exceed 400 mg per day. For moderate pain tramadol 50 mg may be adequate as the initial dose, and for more severe pain, tramadol 100 mg is usually more effective as the initial dose.
Individualization of Dose: Available data do not suggest that a dosage adjustment is necessary in elderly patients 65 to 75 years of age unless they also have renal or hepatic impairment. For elderly patients over 75 years old, not more than 300 mg/day in divided doses as above is recommended. In all patients with creatine clearance less than 30 ml/min, it is recommended that the dosing interval of tramadol HCl be increased to 12 hours with a maximum daily dose of 200 mg. Since only 7% of an administered dose is removed by hemodialysis, dialysis patients can receive their regular dose on the day of dialysis. The recommended dose for patients with cirrhosis is 50 mg every 12 hours. Patients receiving chronic carbamazepine doses up to 800 mg daily may require up to twice the recommended dose of tramadol HCl.
HOW SUPPLIED
Ultram 50 mg (white, film-coated capsule-shaped tablet) is engraved "McNeil" on one side and "659" on the other side.
Dispense in a tight container. Store at controlled room temperature (up to 25°C, 77°F).
PATIENT INFORMATION
Tramadol HCl is used to relieve moderate to severe pain. This drug should be used as directed and only for the period of time determined by the physician. This drug can cause dizziness or tiredness and in some cases nausea, constipation and headache. Avoid the use of alcohol or other depressants such as sleeping pills or tranquilizers. Be especially careful when performing potentially hazardous tasks such as driving or operating machinery while taking this drug. Please tell your pharmacist or physician if you are pregnant or nursing.
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willygoat62
Member
Reged: 06/27/04
Posts: 153
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Has anyone used 50MG Ultram and 10MG Valium at the same time. I was wondering if this was safe because a friend does it occassionally and states he feels really wasted. I just do not want him to get hurt.
thanks!
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VoiceOfReason
Journeyman
Reged: 03/02/02
Posts: 52
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Hi,
My doc prescribed Ultram(for pain) with Valium (muscle spasms) and said to be sure not to drink on the combo. One of Ultrams side effects is seizures and he seems to think that the combo + alcohol will make seizures more probable. As far as Ultram making you wasted, I feel really dizzy (another common side effect) when I take it even without Val. Thats about it. It's hard to say if it's bad for your friend when everyones physiology is different.Is this friend taking 1 50mg Ultram and 1 10mg valium?
Just thought I'd pass along my experience. Oh I was also warned NOT to take SSRI's (Zoloft, Prozac, etc)with Ultram as they too make a seizure more probable.
Hope this helps!
-VOR
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willygoat62
Member
Reged: 06/27/04
Posts: 153
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THANK YOU!!!!
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dsack
Veteran
Reged: 01/20/02
Posts: 543
Loc: midwest
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If your friend is using tramadol to get high, he's really playing with fire. It's only a matter of time before he takes enough to have a seizure. If he's alone or driving at the time, you might not get to talk to your friend again. It's not as tightly controlled as "real" narcotics, but it's more dangerous.
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dsmmcm
Old Hand
Reged: 11/08/03
Posts: 411
Loc: southwest US
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Quote:
If your friend is using tramadol to get high, he's really playing with fire. It's only a matter of time before he takes enough to have a seizure. If he's alone or driving at the time, you might not get to talk to your friend again. It's not as tightly controlled as "real" narcotics, but it's more dangerous.
You're not going to get high on 50 mg of tramadol, even with the valium. And I would really like someone to point me to the literature that says tramadol leads to seizures. Everybody says that, but as I have stated before, my doc was at one time the leading prescriber of tramadol in the U.S., and he says the tramadol/seizure connection is a myth.
D.
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plazo
Journeyman
Reged: 12/24/01
Posts: 75
Loc: USA
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dsmmcm,
regarding seizures as a side effect of tramadol - check out the PDR or any other current drug guide for laymen or docs. Described as "rare" but I know 2 people who have had seizures caused by tram. Any prior history of seizures of course means you're at greater risk.
As for people getting high on 50mg - personally I couldn't get high on any amount. Means nothing. Every person's response and sensitivity to a given med is different, sometimes dramatically so.
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tone
Veteran
Reged: 06/29/03
Posts: 587
Loc: Chicago
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Here is the best page on tramadol metabolism incase anyone needs this for reference:
http://dmd.aspetjournals.org/cgi/content/full/29/8/1146
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tone
Veteran
Reged: 06/29/03
Posts: 587
Loc: Chicago
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how serious of a seizure risk it is varies from person to person. the two factors are how overall prone a person is to one and how well a person metabolizes tramadol. tramadol its self is what can cause seizures, its metabolites are much more benign.
this med should always be started at a low dose and feeling funny or memory blurred calls for lowering the dose and consulting a doctor.
to reduce changes of seizure do not take these meds with tramadol: Antidepressants, MAOIs, CYP2D6 Inhibitors. Consult with doctor if taking other CNS drugs.
List of CYP2D6 Inhibitors ( Source ): amiodarone, buproprion, celecoxib, chlorpheniramine, chlorpromazine, cimetidine, citalopram, clomipramine, cocaine, doxorubicin, escitalopram, fluoxetine, halofantrine, levomepromazine, methadone, moclobemide, paroxetine, quinidine, ranitidine, haloperidol, ritonavir, sertraline, terbinafine
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dsmmcm
Old Hand
Reged: 11/08/03
Posts: 411
Loc: southwest US
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Quote:
dsmmcm,
regarding seizures as a side effect of tramadol - check out the PDR or any other current drug guide for laymen or docs. Described as "rare" but I know 2 people who have had seizures caused by tram.
Thanks for the info. One of the problems with the PDR is that once something gets in, it never gets out. Plus, every single side effect that has every been reported, real or not, is listed in the PDR. I seriously doubt that your two friends suffered seizures from tramadol. My doc has had about 1000 patients on tramadol, with no seizures. When he first gave me a prescription for tramadol, I didn't fill it, because I was worried about the seizure issue. The next time I saw him, he gave me a ten minute lecture on how safe tramadol is. I now take 50 mg four times a day.
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dsmmcm
Old Hand
Reged: 11/08/03
Posts: 411
Loc: southwest US
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Quote:
Here is the best page on tramadol metabolism incase anyone needs this for reference:
http://dmd.aspetjournals.org/cgi/content/full/29/8/1146
When you follow that link, you will find that the reference to tramadol and seizures deals with rats, and is thus applicable to only a small percentage of DB'ers. (certainly not you, tone). If you follow the link on risk/benefit analysis, you will find the following statement:
"The potential for abuse or addiction seems to be minimal, and serious complications have not been reported."
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plazo
Journeyman
Reged: 12/24/01
Posts: 75
Loc: USA
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Quote:
One of the problems with the PDR is that once something gets in, it never gets out. Plus, every single side effect that has every been reported, real or not, is listed in the PDR.
I agree, but the anecdotal and scientific evidence I've heard and read is enough to make me believe that tramadol related seizures are common enough that people should at least be aware of the risks, especially with higher doses and/or pre-existing seizure disorders. Personally, I don't worry when I take it, and probably neither should most people.
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dsack
Veteran
Reged: 01/20/02
Posts: 543
Loc: midwest
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Who said this person was only taking 50mg's? My point was that if he was trying to get high on tramadol, he was taking way more than 50mg's. Most people that are unaware of the risks tend to take 300mg's and higher, since at a normal dose(50-150mg's)there is very little euphoria, and the drug is almost completely safe. People that use it recreationally also tend to dose a second time before the first dose has taken full effect, since it takes a couple-three hours to reach a peak serum level. The combination of these two mistakes is where the risk of seizures would probably become more of an issue.
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dsmmcm
Old Hand
Reged: 11/08/03
Posts: 411
Loc: southwest US
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willygoat62:
Quote:
Has anyone used 50MG Ultram and 10MG Valium at the same time. I was wondering if this was safe because a friend does it occasionally and states he feels really wasted. I just do not want him to get hurt.
thanks!
That's the post that mentioned 50 mg. And... if you're taking 300/400 mg of tramadol AND you are seizure prone, then that's probably a bad idea. It's also probably a bad idea for many other medications.
plazo: forget the anecdotal evidence, but please post your scientific evidence that tramadol causes seizures.
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plazo
Journeyman
Reged: 12/24/01
Posts: 75
Loc: USA
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Honestly, this issue is not one which I have spent a lot of time researching. The info I've seen is mostly available in the PDR and the like. i don't really feel compelled to put much more effort into proving my point. Take it or leave it.
As for anecdotal evedence, I thik it's highly underrated. Today we can go online and find dozens or more patients on a given drug, all experiencing side effects not listed in any of the official lit. Eventually the PDR catches up and includes the wacky side effects which our doctors initially laughed off.
I think I'll leave it at that. Sorry If I didn't adequtely prove the tram/seizure connection. Maybe I'll dig up some less refutable evidence at some point, for now, I've offered my 2 cents.
Peace
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spoonwhipper
Stranger
Reged: 02/24/04
Posts: 11
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if he were just taking it for medicinal purposes, he shouldnt feel anything except normal ( a sought after condition from people who geniunely need ultram). Any euphoric side effect probably means he needs a lower dose.
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spoonwhipper
Stranger
Reged: 02/24/04
Posts: 11
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Incidentally, Im surprised so many people's doc's combine these drugs. My doc is so old school, he'd prescribe a basket of fruit if he could.
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JethroBodine
Enthusiast
Reged: 06/20/03
Posts: 217
Loc: Ozark Mountains
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I had a doc prescribe ultram and he knew I was taking citalopram. He also should have known that was not going to be a strong enough medication for my condition; ie, I would probably take more than the recommended amount. typical doc; would rather risk my health than a run-in with the feds.
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?????????????????????????????????????????
If you can't do it for me; If you won't
even do it for yourself; PLEASE do it for
the sake of the giant three toed sloth!
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sandman
Member
Reged: 10/19/04
Posts: 143
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This drug is cheap( no good) in my thoughts.Gives me an headache and does nothing for pain but they see the headache will go away .Who wantsa headache for week?
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sandman
Member
Reged: 10/19/04
Posts: 143
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P.S. I've taken tramadol 100mg and xanax xr 3mg with with no problems,plus with my does of vicoden
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tone
Veteran
Reged: 06/29/03
Posts: 587
Loc: Chicago
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Dsmmcm, this is just one subjective experience, but whenever i combine tagamet (inhibits tramadol metabolism) with tramadol, i feel like im about to go insane and lose my mind and pace around praying i wont black out before xanax kicks in. I believe poor metabolisers would be much more prone to possible seizures.
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dsmmcm
Old Hand
Reged: 11/08/03
Posts: 411
Loc: southwest US
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Quote:
Dsmmcm, this is just one subjective experience, but whenever i combine tagamet (inhibits tramadol metabolism) with tramadol, i feel like im about to go insane and lose my mind and pace around praying i wont black out before xanax kicks in. I believe poor metabolisers would be much more prone to possible seizures.
Thanks. I don't take tagamet, but I am on a daily dose of prevacid. Fortunately, it is not a H2-receptor antagonist, like tagamet.
D.
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nikkicat
Newbie
Reged: 11/30/04
Posts: 38
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Hi Sandman,
So you take how many mg of hydro with how many mgs of Tramadol? I have a few days before my new supply of hydro arrives and I am trying to make my hydro last. If I take one 10 mg hydro with one 50 mg Tramadol, will I be able to function? Also, how does the benzo react w/ the tram and the hydro? Additionally, how many hours between doses? I just got smaples of tramadol w/out instructions.
Thanks!
NIKKI
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skytalker
Newbie
Reged: 06/11/04
Posts: 37
Loc: a nice place to live
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Hi,
Don't know too much about the hydro, but tramadol should help as it does connect with the same receptors, but it is weaker. I like it as an antidepressant but think it is weak as a painkiller.
With benzos... don't know about valium, but goes fine with klonopin. Of course, klonopin is anti-seizure. Interesting mix.
My experience with seizure is none... but you can tell when it could be coming on. If drinking any liquid is hard to swallow... stop for a while. Also, alcohol and this drug have made me feel like seizure.
Basically, do not take a lot and cut way back on occasion if you wish the antidepressant factors or you may be seeking to take too many pills to work in that manner.
Finally, if you take a lot of them, you cannot pee with any force. Do not take if you have kidney problems. However, if you are ok, just cut back and you will have the normal flow before you know it.
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PJoseph
Member
Reged: 09/12/04
Posts: 161
Loc: South of I-80
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Dsmmcm,
The claim that Ultram can trigger seizures is most definitely NOT a myth. DSMMCM there is a message for you at the end of this.
I have intimate knowledge about Ultram causing seizures.
This is going to sound completely far-fetched and we are all pretty much strangers but the following it is most definitely true.
This person was taking 7-8 50mg Ultram EVERY 4-5 HOURS for about 4-5 years. The daily maximum dose is supposed to be 400mg or 8 tabs. This person was taking the daily max every few hours.
This person had 5 full blown grand mal seizures all within the last 12-18 months.
After each one, this person would cut down the dosage to around 4-5 50mg tabs every 4-5 hours.
Eventually creeping back up.
I often wonder if it's because the dose finally got big enough to trigger the seizures or has there been enough brain/brain cell damage to lower the seizure threshold.
A million tests were run and nothing (epilepsy, tumor, etc) was ever found.
You mentioned a warning.
I believe with Epilepsy, there is a warning or an "aura" just prior to the seizure that apparently give a few moments to pull over, sit down or whatever it takes to be a little safer.
With Ultram,however, there is absolutely no warning.
No lightheadedness, dizziness, "aura".
One minute you are awake and the next moment you aren't.
I suspect I lost all credibility with most of you at the 350-400mg dose every four to five hours.
If you've read my past posts and trust what I am writing is the truth and would like more information about my experience with this person and their adventures with Ultram feel free to PM me.
I can't repeat this line enough:
Ultram is very addicting and the risk of seizures from massive doses of Ultram is very, very real.
Based on my reading, especially here at Drugbuyers, Ultram affects everyone differently.
I should rephrase my earlier statement. Ultram is very addicting to those susceptible to dependence/addiction to other Opiates/Benzos.
Millions of people have no problem with this or any of the other controlled substances.
But for those that do have habit problems, Ultram can be a doozy.
Nice thought, huh.
Take care
PJ
DSMMCM, please don't be offended by my contradicting of your statement. I completely understand if you now reply that my post is a crock of you-know-what! 
I didn't want this to read as an attack of you or anyone else. I value everyone's opinion. Of coure, you and everyone else are completely wrong if they don't agree with my opinion but I can't help it I'm brilliant. JUST KIDDING!
Take care
PJ
Edited by PJoseph (01/21/05 10:10 PM)
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Daeshay76
Old Hand
Reged: 03/22/04
Posts: 459
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just a comment on the tramadol thing my brothers wife's aunt loves Ultram i mean the woman loves it....but then again she takes 10 at a time and i advised her about the seizure thing and she really doesnt care about that because she states she is on seizure meds....i am wondering if that is stilla dangerous thing to do...i know in my mind and heart it is but even my sis-in-law that is a nurse thinks it is ok as long as she is on a anti-seizure drug
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roseross
Stranger
Reged: 01/31/04
Posts: 19
Loc: Washington
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It is ok to take the two together. One is for pain, the other for muscle tension or anxiety that can worsen spasms. It is a big problem to use these with alcohol though. You could end up in a coma like Karen Quinlin. Be safe.
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Carolynn43
Stranger
Reged: 11/17/04
Posts: 12
Loc: Mile High
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Could someone tell me the difference between Ultram, hydrcodone and Darvocet ? Thank you.
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dsmmcm
Old Hand
Reged: 11/08/03
Posts: 411
Loc: southwest US
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Quote:
The claim that Ultram can trigger seizures is most definitely NOT a myth.
PJ,
You've got me a little confused here. I specifically said that "if you're taking 300/400 mg of tramadol AND you are seizure prone, then that's probably a bad idea. It's also probably a bad idea for many other medications".
You are talking about a person taking a HUGE overdose of ultram. All bets are off in that case. I am still waiting for someone to show me a study in human beings that demonstrates a positive correlation between 200 mg ultram/day and seizures. Maybe it's out there, but I haven't seen it.
And as far as evidence goes, yours is antidotal. There probably was a cause and effect relationship between ultram and the seizures, but again, all bets are off on doses that high. My evidence is actually knowing an M.D./Ph.D. with a pain practice who has about 1000 patients on ultram and has never had one get a seizure.
Just about any prescription drug taken in a heavy overdose is going to do bad things to you.
Anyway, no hard feelings at all!
Cheers,
D.
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PJoseph
Member
Reged: 09/12/04
Posts: 161
Loc: South of I-80
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Coincidentally, the PDR just recently put a seizure warning in big bold print.
The warning says that seizures have been know to occur in patients taking the normal therapeutic dose of TRamadol.
If it's in the PDR it must be true right?....not.
After going through this whole ordeal with this person having 5 seizures, all occuring within 30 minutes of taking a huge dose-probably the 4th huge dose of the day- so who knows exactly how much was in his blood at the time, I honestly now believe that the PDR is wrong.
Let's assume 100,000 patients taking Ultram reported having a seizure from a normal dose of Ultram.
I really believe that 99,900 of those seizure were due to an overdose of Ultram-not a prescribed dose.
I would even go so far as to say I believe the only way to induce a seizure from Ultram is to take repeated Megadoses.
I have no way to prove that all Ultram seizure victims only had seizures because the patient took a large dose of the drug but like you, I've spoken to sources and scoured the internet for any type of story,study, or test that confirms the bold print in the PDR.
All I can find is the typical "I heard from a guy who knew a guy..."
So, to recap an already too long story;
Dsmmcm, I agree with you that seizures from a prescribed dose of Ultram is a myth.
Even if there are a few people who seized after ingesting a normal dose, I bet that there is more to there story.
Take care
PJ
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