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ULTRAM® (tramadol hydrochloride) tablets 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 n-octanol/water log partition coefficient (logP) 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 pregelatinized corn starch, modified starch (corn),
hypromellose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene
glycol, polysorbate 80, sodium starch glycolate, titanium dioxide and carnauba wax.


ULTRAM ER is indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid
treatment and for which alternative treatment options are inadequate.

How to take

Use in Ambulatory Patients
ULTRAM® may impair the mental and or physical abilities required for the performance
of potentially hazardous tasks such as driving a car or operating machinery. The patient
using this drug should be cautioned accordingly.
Use With MAO Inhibitors and Serotonin Re-uptake Inhibitors
Use ULTRAM® with great caution in patients taking monoamine oxidase inhibitors.
Animal studies have shown increased deaths with combined administration. Concomitant
use of ULTRAM® with MAO inhibitors or SSRI’s increases the risk of adverse events,
including seizure and serotonin syndrome.

Side effects

ULTRAM® was administered to 550 patients during the double-blind or open-label
extension periods in U.S. studies of chronic nonmalignant pain. Of these patients,
375 were 65 years old or older. Table 2 reports the cumulative incidence rate of adverse
reactions by 7, 30 and 90 days for the most frequent reactions (5% or more by 7 days).
The most frequently reported events were in the central nervous system and
gastrointestinal system. Although the reactions listed in the table are felt to be probably
related to ULTRAM® administration, the reported rates also include some events that
may have been due to underlying disease or concomitant medication. The overall
incidence rates of adverse experiences in these trials were similar for ULTRAM® and the
active control groups, TYLENOL® with Codeine #3 (acetaminophen 300 mg with
codeine phosphate 30 mg), and aspirin 325 mg with codeine phosphate 30 mg, however,
the rates of withdrawals due to adverse events appeared to be higher in the ULTRAM®

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ULTRAM® should not be administered to patients who have previously demonstrated
hypersensitivity to tramadol, any other component of this product or opioids. ULTRAM®
is contraindicated in any situation where opioids are contraindicated, including acute
intoxication with any of the following: alcohol, hypnotics, narcotics, centrally acting
analgesics, opioids or psychotropic drugs. ULTR AM® may worsen central nervous
system and res piratory depression in these patients.

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