Ultram

Do not take more than the recommended dose of Ultram, since larger doses have been known to cause seizures, especially if you have epilepsy or are taking medications that also increase the risk of seizures. Among such medications are almost all antidepressant drugs, plus narcotics and major tranquilizers such as Loxitane and Stelazine.

If you have liver or kidney disease, be sure your doctor knows about it. Your dosage may have to be reduced.

Before you have any kind of surgery, make sure the doctor knows you are taking Ultram.

If you have any kind of breathing problem, use Ultram with caution or take a different kind of painkiller. Ultram can impair respiration, especially if taken with alcohol.

If you have experienced a head injury, consult your doctor before taking Ultram. The medication's effects may be stronger and could hide warning signs of serious trouble.

Possible food and drug interactions when taking Ultram

Ultram may increase the drowsiness caused by alcohol. Do not drink alcohol while taking this medication.

Avoid Ultram, too, if you are taking the seizure medication Tegretol.

If Ultram is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Ultram with the following:

• Cyclobenzaprine (Flexeril)
• Drugs known as MAO inhibitors, including the antidepressants Nardil and Parnate
• Serotonin-boosting antidepressants such as Paxil, Prozac, and Zoloft
• "Tricyclic" antidepressants such as Elavil, Norpramin, and Tofranil
• Major tranquilizers such as Thorazine and Stelazine
• Narcotic pain relievers (Demerol, morphine, Darvon, Percocet)
• Promethazine (Mepergan, Phenergan)
• Quinidine (Quinidex)
• Sleeping pills (Halcion, Dalmane, Restoril)
• Tranquilizers (Valium, Xanax)

Special information if you are pregnant or breastfeeding

There have been reports of serious harm to developing babies when Ultram was used during pregnancy. If you are pregnant or plan to become pregnant, tell your doctor immediately.