Ultracet

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Generic Name: acetaminophen and tramadol (a SEET a MIN o fen and TRAM a dol)
Brand Names: Ultracet
What is Ultracet?
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Tramadol is a narcotic-like pain reliever.

Acetaminophen is a less potent pain reliever that increases the effects of tramadol.

The combination of Ultracet is used to treat moderate to severe pain.

Ultracet may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Ultracet?
You should not take this medication if you are allergic to Ultracet, if you are intoxicated (drunk), or if you have recently used narcotic pain medicine, a sedative or tranquilizer, medicine for depression or mental illness, or any type of street drug. Do not take more of this medication than is recommended. An Ultracet overdose can be fatal. The maximum amount of Ultracet is 2 tablets per dose, or 8 tablets per day.

Tell your doctor if you drink more than three alcoholic beverages per day or if you have ever had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen.

Seizures (convulsions) have occurred in some people taking Ultracet. You may be more likely to have a seizure while taking Ultracet if you have a history of seizures or head injury, a metabolic disorder, a brain or spinal cord infection, or if you are taking certain medicines. Talk with your doctor about your individual risk of having a seizure.
Ultracet can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking Ultracet?
You should not take this medication if you are allergic to Ultracet, if you are intoxicated (drunk), or if you have recently used any of the following drugs:

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alcohol;
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narcotic pain medicine;
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sedatives or tranquilizers (such as Valium);
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medicine for depression or anxiety;
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medicine for mental illness (such as bipolar disorder, schizophrenia); or
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street drugs.

Tell your doctor if you drink more than three alcoholic beverages per day or if you have ever had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen.

Seizures have occurred in some people taking Ultracet. Your risk of a seizure may be higher if you have any of these conditions:

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a history of drug or alcohol addiction;
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a history of epilepsy or other seizure disorder;
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a history of head injury;
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a metabolic disorder;
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an infection of your brain or spinal cord, such as meningitis or encephalitis;
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if you are also taking an antidepressant, mood stabilizer, or another narcotic pain medicine; or
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if you have taken an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

Talk with your doctor about your individual risk of having a seizure.

Before taking Ultracet, tell your doctor if you are allergic to any drugs, or if you have:

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kidney disease;
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liver disease;
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asthma or other breathing disorder;
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a stomach disorder; or
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a history of depression, mental illness, or suicide attempt.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Ultracet may also cause serious or fatal side effects in a newborn if the mother uses the medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Ultracet can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Ultracet?

Take Ultracet exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label.
Do not take more of this medication than is recommended. An Ultracet overdose can be fatal. The maximum amount of Ultracet is 2 tablets per dose, or 8 tablets per day. Take this medicine with a full glass of water.

Ultracet can be taken with or without food, but take it the same way each time.
Do not stop using this medication suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when you stop taking Ultracet. Store Ultracet at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. A Ultracet overdose can be fatal.

Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes, feeling light-headed, fainting, or coma.

What should I avoid while taking Ultracet?
Do not drink alcohol while you are taking Ultracet. Alcohol may cause a dangerous decrease in your breathing when used together with Ultracet. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tramadol. Tell your doctor if you regularly use any of these medicines. Ultracet can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Do not use any other over-the-counter cough, cold, allergy, or pain medication without first asking your doctor or pharmacist. Acetaminophen is contained in many cold and pain medicines available over the counter. If you take certain products together you may accidentally take too much acetaminophen. Read the label of any other medicine you are using to see if it contains acetaminophen.

Ultracet side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Ultracet and call your doctor at once if you have any of these serious side effects:

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seizure (convulsions);
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a red, blistering, peeling skin rash; or
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shallow breathing, weak pulse.

Less serious side effects may include:

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dizziness, drowsiness, weakness;
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nausea, vomiting, constipation, loss of appetite;
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blurred vision;
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flushing (redness, warmth, or tingly feeling); or
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sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Ultracet?

Before taking Ultracet, tell your doctor if you also use:

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carbamazepine (Tegretol);
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warfarin (Coumadin);
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digoxin (Lanoxin, Lanoxicaps);
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ketoconazole (Nizoral);
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erythromycin (E-Mycin, E.E.S., Ery-Tab);
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rifampin (Rifadin, Rimactane, Rifater);
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St. John's wort;
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quinidine (Quinaglute, Quinidex, Cardioquin, Quinora); or
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an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).

This list is not complete and there may be other drugs that can interact with Ultracet. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.