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What is Ultram?

Ultram is a pain medication similar to an opioid. Ultram is a combination of two drugs: Paracetamol and Tramadol. Ultram belongs to the class of analgesics. Ultram is used in the symptomatic treatment of moderate to severe degrees of pain. Tramadol is an opioid analgesic, and Paracetamol is a common pain reliever. Paracetamol also has an antipyretic effect (it reduces fever).

Pain can be long-lasting (chronic) or temporary (acute) in nature. Acute pain is for a short period caused by damage to the tissues of the bone, muscle, or other organs. While, chronic pain persists for a longer duration and is caused due to pathologies like osteoarthritis, nerve damage, etc.

The extended-release form of Ultram is for around-the-clock management of pain. Ultram extended-release is not for use on an as-needed basis for pain.

Tramadol targets pain receptors in the CNS. Tramadol works by blocking the nerve signals that cause pain. Paracetamol works as an analgesic by inhibiting the release of chemical mediators responsible for pain. Paracetamol and Tramadol in combination have a faster onset of action and provide quick relief from the pain.

Ultram is available in both injection and tablet form. It must be only used when prescribed by a doctor. The doctor will start the therapy with a small dose and gradually increase it to lower the risk of side effects. Do not take an overdose. The dose of Ultram depends on the severity of your pain.

Drug precautions and warnings

Share with your doctor if you have allergies to Paracetamol, Tramadol, or any other active ingredients in Ultram. Talk to your doctor before taking Ultram if you are taking other medicines containing Tramadol or Paracetamol, using other analgesics, have kidney problems, have liver disease, have asthma or severe lung problems, have alcohol dependence, have central nervous system disorders such as epilepsy or seizures, or have any drug dependence.

You should not stop Ultram without a doctor’s advice. Abrupt stopping can cause withdrawal symptoms such as hallucinations, nervousness, diarrhea, mood disturbances, suicidal thoughts, muscle aches, and nausea.

Ultram can stop or slow your breathing and may be habit-forming. Misuse of Ultram can cause overdose, addiction, or even death, especially in a child or other person using the medicine without a prescription.

How should I take Ultram?

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Oral tablet: The duration and dose of Ultram tablets are prescribed by the doctor. You can take Ultram with or without food. However, it is recommended to take Ultram after meals to prevent nausea. If irritation or stomach upset occurs, it is advisable to take Ultram with milk or food. Ultram must be swallowed whole with a glass of water. Don’t chew, break, or crush it.

Intravenous injection: The duration of the Ultram administration must not exceed the intended time. The dosing interval of Ultram must be a minimum of six hours between two doses of Ultram injection. Store Ultram in a cool and dry place away from sunlight.

Take Ultram precisely as prescribed by your doctor. Read all the medication guides. Do not use Ultram in larger amounts or for longer than prescribed. Share with your doctor if you feel an increased urge to take more of this drug.

Stop taking all other opioid drugs when you start taking Ultram. Never break or crush an Ultram tablet to inhale the powder or mix it into a liquid to inject the drug directly into your vein. This practice has resulted in death.

Don’t keep leftover Ultram. Just one dose of the drug can cause death in someone using it improperly or accidentally. Ask your pharmacist where to locate a medication take-back disposal program. If there isn’t any take-back program, mix the leftover medicine with coffee grounds or cat litter in a plastic bag and seal and discard it in the trash.

Dosing information of Ultram

Usual Adult Dose for Pain:

Adults (18 years or older): 50 to 100 mg orally every four to six hours as needed for pain

-In case of patients not requiring rapid onset of analgesic effect: Initial dose: 25 milligrams orally once a day; titrate in 25 milligrams increments every three days to reach a dose of 25 milligrams four times a day; after that increase by 50 mg as tolerated every three days

Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain:

Extended-Release (ER):

18 years or older (tramadol-naive): 100 milligrams orally once a day

-Individually titrate in 100 milligrams increments every five days to an effective dose that minimizes adverse reactions

-Maximum Dose: 300 mg/day

What is the mechanism of action of Ultram?

Ultram is used to treat pain. Tramadol targets pain receptors in the CNS or central nervous system. Ultram acts by blocking the nerve signals causing pain. Paracetamol works as an analgesic by inhibiting the release of chemical mediators in our brain that cause pain. Paracetamol and Tramadol in combination have a faster onset of action and provide quick relief from the pain.

What should I do before taking Ultram?

You must not take Ultram if you have a metabolic disorder, a head injury, drug or alcohol addiction, epilepsy or other seizure disorder, urination problems, a stomach disorder, problems with your gallbladder, pancreas, or thyroid, mental illness, or suicide attempt.

You must avoid taking Ultram also if you have severe breathing problems, a blockage in your intestines or stomach, or if you have recently used tranquilizers, alcohol, sedatives, narcotic medication, or an MAO inhibitor (methylene blue injection, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, and others).

Taking Ultram during pregnancy can cause life-threatening withdrawal symptoms in the newborn. Do not take Ultram if you are pregnant.

Before using Ultram, tell your doctor if you have any known allergies to Paracetamol, Tramadol, or other medications, herbal supplements, or foods.

What are the side effects of Ultram?

Common side-effects of Ultram are nausea, diarrhea, vomiting, constipation, confusion, redness, itching, or rash at the injection site, sweating, headache, nervousness, or sleep problems. Some people can also experience irregular heart rate, increase or decrease in blood pressure, difficulty passing urine, ringing or buzzing in the ears, mood disorders, bloody diarrhea, chest pain, or dark stools. Talk to your doctor if the side effects persist or worsen after or during your treatment.

However, all the patients might not develop the same side effects. Tell your doctor in case if you notice any abnormal side effects. Stop taking Ultram and consult the doctor immediately if you experience symptoms like fever, skin rashes, tightness of the chest, breathing difficulties, increased heart rate, and or in case of any signs of hypersensitivity.

A person caring for you must give naloxone and seek emergency medical attention if you have blue-colored lips, slow breathing with long pauses and if you are hard to wake up.

What should I avoid while taking Ultram?

You should avoid taking alcohol while using Ultram. Pregnant women should not use Ultram. Breastfeeding mothers should avoid using Ultram as it can get excreted in breast milk. However, if given, breastfeeding mothers should refrain from breastfeeding while using Ultram. Ultram may cause dizziness. Therefore, it is advised not to operate heavy machinery or drive when taking Ultram. Drowsiness or dizziness can cause falls, accidents, or severe injuries.

Ultram interactions

Drug-drug interactions: Ultram may interact with pain medications such as naltrexone, pentazocine, monoamine oxidase inhibitors (MAO) such as procarbazine, phenelzine, isocarboxazid, and rasagiline, antidepressants such as paroxetine, fluoxetine, drugs used to treat seizures like carbamazepine, antifungals such as itraconazole, and HIV drugs such as ritonavir.

Drug-food interactions: No interactions found.

Drug-disease interactions: People affected with heart diseases, liver diseases, respiratory impairment,  alcoholism, uncontrolled seizures, and drug abuse must avoid intake of Ultram.