Tramadol Hydrochloride/Acetaminophen, Oral

What are other names for this medicine?

Type of medicine: analgesic (painkiller)

Generic and brand names: tramadol hydrochloride and acetaminophen, oral; Ultracet

What is this medicine used for?

This medicine is taken by mouth for a short time to relieve pain caused by surgery or other conditions.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a head injury
• depression or thoughts of suicide
• liver or kidney disease
• lung disease or breathing problems
• problems with drug or alcohol abuse
• seizures.

This medicine can cause seizures. The risk of seizures increases if you have epilepsy. Your risk is also higher if you are using certain other medicines and treatments. Talk with your healthcare provider about this.

Females of childbearing age: Do not take this medicine if you are pregnant because it may harm the baby. Tell your healthcare provider if you are pregnant or if you plan to become pregnant while taking this medicine. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Taking too much of this medicine may be habit-forming. Do not take more than 8 tablets in 24 hours. Do not stop taking this medicine without your healthcare provider's approval. You may have to reduce your dosage gradually.

You may take this medicine with or without food.

If you are taking this medicine on a regular schedule and you miss a dose or forget to take your medicine, take it as soon as you can. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

What should I watch out for?

Do not take this medicine with other medicines that contain acetaminophen (Tylenol) or tramadol (Ultram) because of a possible overdose. Your healthcare provider or pharmacist can help you identify any medicines you are taking that may contain these medicines.

Do not stop taking this medicine without your healthcare provider's approval. You may have to gradually reduce your dosage. Talk with your healthcare provider about this.

This medicine may make you drowsy or dizzy. Do not drive or operate machinery until you are fully alert.

Do not drink alcohol while you are taking this medicine. It can cause dangerous side effects.

Do not take the medicine for any other conditions without your healthcare provider's approval.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reactions (hives, itching, rash, tightness in your chest, trouble breathing, swelling of your lips, tongue or throat); seizures.

Serious (report these to your healthcare provider right away): Severe dizziness, yellow skin or eyes.

Other: Constipation, drowsiness, sweating, diarrhea, nausea, dry mouth, loss of appetite, trouble sleeping.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• anesthetic or numbing medicines such as lidocaine
• antiseizure medicines such as carbamazepine (Tegretol), gabapentin (Neurontin), and valproic acid (Depakene, Depakote)
• bupropion (Wellbutrin, Wellbutrin SR, Zyban)
• cimetidine (Tagamet)
• muscle relaxants such as cyclobenzaprine (Flexeril), diazepam (Valium), tizanidine (Zanaflex), methocarbamol (Robaxin), and carisoprodol (Soma)
• digoxin (Lanoxin)
• linezolid (Zyvox)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• narcotic cough medicines such as hydrocodone and chlorpheniramine (Tussionex), hydrocodone and homatropine (Hycodan), guaifenesin and codeine (Tussi-organidin, Robitussin AC), promethazine (Phenergan), and promethazine with codeine (Phenergan with codeine)
• narcotic painkillers such as codeine, morphine, oxycodone (Oxy-Contin), and hydromorphone (Dilaudid)
• pergolide (Permax)
• quinine
• quinidine
• ropinirole (Requip)
• sedatives and tranquilizers such as zolpidem (Ambien), triazolam (Halcion), temazepam (Restoril), and flurazepam (Dalmane)
• sibutramine (Meridia)
• SSRI antidepressants such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), fluvoxamine (Luvox), sertraline (Zoloft), and citalopram (Celexa)
• sulfinpyrazone (Anturane)
• warfarin (Coumadin).

DO NOT drink alcohol while you are taking this medicine.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.