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Acetaminophen is a pain reliever and fever reducer. Butalbital is in a class of drugs called barbiturates that slow down your central nervous system (brain and nerve impulses) causing relaxation. Caffeine is believed to constrict dilated blood vessels that may contribute to tension headaches. Together, acetaminophen, butalbital, and caffeine are used to relieve complex tension (muscle contraction) headaches although precisely how it works is unknown. Tramadol hydrochloride / generic Ultram may also be used for purposes other than those listed in this medication guide.

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If you experience serious side effects, stop taking Tramadol hydrochloride / generic Ultram and seek emergency medical attention: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives) slow, weak breathing liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue) blood problems (easy or unusual bleeding or bruising) low blood sugar (fatigue, increased hunger or thirst, dizziness, or fainting). These side effects.. treatment with acetaminophen and caffeine.... serious side-effects may be more likely to occur.

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Do not take acetaminophen / bultabital / caffeine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. Dangerous side effects could result. Acetaminofen and butalbitla may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. Many other medicines contain acetaminphen, especially over-the-counter pain, fever, cold, and allergy medications. Too much acetaminophen can be very dangerous. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines..

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... take acetaminophene / butalbital / caffeine and talk to your doctor if you experience: drowsiness dizziness, confusion or lightheadedness shortness of breath dry mouth nausea, vomiting, abdominal pain, or decreased appetite tiredness, leg pain, or muscle weakness agitation, irritability, nervousness, anxiety or excitability rash or itching feeling of intoxication headache constipation. Butalbital may be habit forming. Side-affects other than those listed here may also occur. Talk to your doctor about any side affect that seems unusual or that is especially bothersome ..

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The following information is a summary about Tramadol. It is not intended to replace a doctor's instructions. Tramadol is an opiate (narcotic) analgesics used for pain relief. Tramadol hydrochloride/ Ultram ® is a prescription medication indicated for the management of moderate to moderately severe pain. It may be used to treat acute pain and chronic pain, and pain caused by surgery or other conditions such as cancer or joint pain.Tramadol / generic Ultram may also be used for purposes other than those listed in this medication guide. Tramadol 50 mg, 90 Tablets.

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Take Tramadol / generic Ultram by mouth as prescribed. It is usually taken every 4 to 6 hours as needed. Use this medication exactly as prescribed. Do not increase your dose, use it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for an extended period of time, do not suddenly stop using this drug without your doctor's approval. When used for extended periods, this medication may not work as well and may require different dosing. Consult your doctor if the medication stops working well.

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If you miss a dose, take it as soon as rememberher corticosteroids (e.g., prednisone). Do not start or stop any medicine without doctor or pharmacist approval. If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double-up the dose to catch up.

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If overdose is suspected, contact your local poison control center or emergency room immediately. Tramadol overdose may include the following symptoms: confusion, vomiting, smaller pupil, difficulty breathing, drowsiness, unconciousness, coma, seizure, heart attack.

Tramadol Side Effects
This medication may cause dizziness, weakness, incoordination, nausea or vomiting, stomach upset, constipation, headache, drowsiness, anxiety, irritability, dry mouth, or increased sweating. If any of these effects persist or worsen, inform your doctor. Notify your doctor if you develop any of these serious effects while taking this medication chest pain, rapid heart rate, skin rash or itching, mental confusion, disorientation, seizures, tingling of the hands or feet, trouble breathing. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, breathing trouble. If you notice other effects not listed above, contact your doctor or pharmacist.

Tramadol Precautions
Tell your doctor your medical history, especially of kidney disease, liver disease, seizure disorder, lung disease, history of drug or alcohol dependency, any allergies you may have. Limit alcohol as it may add to the dizziness or drowsiness effects caused by the medication. Because this drug may make you dizzydrowsy, use caution performing tasks requiring alertness such as driving. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Tramadol is excreted into breast milk. Because the effects on a nursing infant are not known, consult your doctor before breast- feeding.

Tramadol Drug interaction
Tell your doctor of all prescription and nonprescription medications you may use, especially of carbamazepine, narcotic pain relievers (e.g., codeine), drugs used to aid sleep, antidepressants (e.g., SSRI-types such as fluoxetine or fluvoxamine), MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine), psychiatric medicine (e.g., nefazodone), triptan-type drugs, anti-anxiety drugs (e.g., diazepam), sibutramine. Also, report use of certain antihistamines (e.g., diphenhydramine) which are also present in many cough-and-cold products. Do not start or stop any medicine without doctor or pharmacist approval.

Tramadol Notes
Do not share this medication with others. Medical examinations including the nose are generally performed during prolonged use of this product to check for side effects. Inform all your doctors you use (or have used) this medication..

Tramadol Manufacturer
Ultram ® and Ultracet ® are trademarks of Ortho-McNeil Pharmaceutical, Inc.

Other Brand Names
Ultram ® (tramadol hydrochloride tablets) Ultracet® (a combination of tramadol hydrochloride with acetaminophen tablets)
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