Treats moderate-to-severe pain in adults who require around-the-clock treatment for an extended period of time.
There may be other brand names for this medicine.
Ultram ER, Ultram, Tramadol Hydrochloride, Rybix ODT, Ryzolt
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to tramadol or other narcotic pain medicines such as codeine, MS Contin®, OxyContin®, Percocet®, or Vicodin®. In some situations, you should not use this medicine if you are also using alcohol, street drugs, sedatives, medicines for depression or mental illness, or other pain medicines. If you are using any of these, ask your doctor if you can still use tramadol. You should not use Ryzolt? extended-release tablets if you have severe breathing or lung problems such as severe asthma or hypercapnia and you are not being monitored.
How to Use This Medicine
Tablet, Dissolving Tablet, Long Acting Tablet
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- This medicine is not for long-term use.
- Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.
- If you are using the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet in your mouth. It should melt quickly. After the tablet has melted, swallow or take a drink of water.
- Swallow the extended-release tablet whole. Do not crush, break, or chew it.
- You may take this medicine with or without food.
- Drink plenty of fluids to help avoid constipation.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are using cyclobenzaprine (Flexeril®), an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®), medicine for depression (such as amitriptyline, doxepin, fluoxetine, imipramine, nortriptyline, paroxetine, Celexa®, Effexor®, Luvox®, Paxil®, Prozac®, Serzone®, or Zoloft®), medicine for mental illness (such as clozapine, olanzapine, risperidone, Clozaril®, Risperdal®, or Zyprexa®), medicine for migraine headaches (such as sumatriptan, zolmitriptan, Imitrex®, Maxalt®, or Zomig®), or medicine for seizures (such as carbamazepine, Tegretol®).
- Tell your doctor if you are also using St. John's wort, digoxin (Lanoxin®), erythromycin (Ery-tab®), ketoconazole (Nizoral®), linezolid (Zyvox®), lithium (Eskalith®), quinidine (Quinaglute®), rifampin (Rifadin®, Rimactane®), a phenothiazine medicine (such as prochlorperazine, promethazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®), or a blood thinner (such as warfarin, Coumadin®).
- Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
- Do not drink alcohol while you are using this medicine.
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant, planning to become pregnant, or breastfeeding.
- Make sure your doctor knows if you have kidney disease, liver disease (including cirrhosis), breathing problems, any infections (such as a central nervous system infection), depression, mental illness, stomach ulcers, or other stomach problems. Tell your doctor if you have a history of head injury or seizures (epilepsy), or if you have been addicted to drugs or alcohol.
- Tell your doctor if you have phenylketonuria (PKU) or a history of a phenylketone allergy because Rybix? orally disintegrating tablets contain aspartame.
- This medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed or have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or get worse quickly. Make sure your caregiver knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Tell your doctor if you have any sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let your doctor know if you or anyone in your family has bipolar disorder (manic-depressive disorder) or has tried to commit suicide.
- Make sure your doctor knows about all the other medicines you are using. This medicine may increase your risk for seizures (convulsions) and may cause a serious condition called serotonin syndrome when it is taken with certain medicines.
- This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; swelling of your hands, face, or mouth; or chest pain while you are using this medicine.
- This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
- If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Signs of an overdose include convulsions (seizures); difficult or troubled breathing; irregular, fast or slow, or shallow breathing; pale or blue lips, fingernails, or skin; pinpoint pupils of the eyes, or shortness of breath.
- This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
- Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
- Make sure any doctor or dentist who treats you knows that you are using this medicine.
- This medicine may cause constipation. This is more common if you use it for a long time. Ask your doctor if you should also use a laxative to prevent and treat constipation.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Blistering, peeling, or red skin rash.
- Lightheadedness, dizziness, or fainting.
- Severe sleepiness or unusual drowsiness.
- Shortness of breath or troubled breathing.
If you notice these less serious side effects, talk with your doctor:
- Dry mouth.
- Feeling nervous, anxious, shaky, or unusually happy.
- Feeling of constant movement of self or surroundings.
- Increased sweating, mild itching.
- Loss of appetite.
- Muscle stiffness.
- Nausea, vomiting, constipation, diarrhea, or upset stomach.
- Tiredness or weakness.
- Trouble sleeping.
- Warmth or redness in your face, neck, arms, or upper chest.
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Review Date: 2011-02-04