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Ultram ER Warnings and Precautions

Before starting treatment, warnings and precautions for Ultram ER should be fully reviewed with your healthcare provider. For example, it is important that your healthcare provider is aware of any other medical conditions you may have, as Ultram ER is not suitable for everyone. Also, Ultram ER can cause drug interactions, so it is important that your healthcare provider is aware of any other medicines you are taking (including vitamins and herbal supplements).

What Should I Tell My Healthcare Provider Before Taking Ultram ER?

You should talk with your healthcare provider prior to taking Ultram® ER if you have:
  • Seizures or epilepsy
  • Liver disease, such as cirrhosis, liver failure, or hepatitis
  • Kidney disease, such as kidney failure (renal failure)
  • A head injury or high intracranial pressure
  • Severe abdominal (stomach) pain
  • Lung disease of any sort
  • A history of drug or alcohol dependence
  • Suicidal thoughts or behaviors
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Ultram ER Warnings and Precautions

Some warnings and precautions to be aware of prior to taking Ultram ER include the following:
  • Ultram ER can cause seizures, especially in people with a history of seizures, who are withdrawing from alcohol or narcotics, who have a head injury, or who take certain medications (see Tramadol and Seizures for more information).
  • Ultram ER should not be prescribed to people with suicidal tendencies. This medication can be lethal in the case of an overdose, especially if combined with alcohol.
  • Ultram ER can cause a dangerous group of symptoms known as serotonin syndrome. This is most common when Ultram ER is combined with certain other medications (see Tramadol and Serotonin Syndrome for more information).
  • Ultram ER has a significant potential for abuse. It is not a good choice for people who have a history of alcohol or drug abuse (see Tramadol Abuse). Do not take the drug more frequently, longer, or at a higher dose than prescribed. If you feel you may be developing a problem with Ultram ER, please seek help from your healthcare provider.
  • Ultram ER can cause slow and irregular breathing. In severe situations, this may cause life-threatening complications. This may be especially dangerous in people with lung problems.
  • The medication can cause problems in people with head injuries or high intracranial pressure. Ultram ER should only be used with extreme caution in such circumstances.
  • Ultram ER can interfere with the diagnosis of many conditions that cause severe abdominal (stomach) pain.
  • Ultram ER can cause dizziness and drowsiness, and may increase the risk of falls in elderly people.
  • Do not drive or operate heavy machinery until you know how Ultram ER affects you. Your reflexes and reaction times may be significantly affected, even if you feel fine.
  • Ultram ER can potentially interact with several other medications (see Ultram ER Drug Interactions).
  • Ultram ER is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Tramadol and Pregnancy).
  • Ultram ER passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Tramadol and Breastfeeding).
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