Acute alcohol intoxication, hypnotics, centrally acting analgesics, opioids or psychotropic drugs. Avoid in patients who are opioid dependent or have a history of dependency. Causes increase in tramadol metabolism. Patients may require up to twice the recommended dose of Ultram. May increase levels of tramadol.
Studies show increase in animal deaths.
Ultram should be used in reduce dosage with caution. Daily maximum dose 400 mg daily. May take Ultram with or without food, absorption is not affected. If nausea or vomiting occurs, take with food. Vertigo, headache, somnolence, CNS stimulation, asthenia, nausea, vomiting, constipation, pruritus, rash, hives, life threatening seizures and respiratory depression.