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UltramPain Medicine / Ultram
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Tramadol is used for:

Treating moderate to moderately severe pain.

Tramadol is an analgesic. It works in certain areas of the brain and nervous system to decrease pain.

Do NOT use Tramadol if:

  • you are allergic to any ingredient in Tramadol
  • you have severe diarrhea due to taking an antibiotic
  • you are intoxicated with alcohol, other opioids or narcotics (eg, morphine, codeine), sedatives or sleeping medicines (eg, temazepam, zolpidem), or other medicines
  • you are taking nefazodone, carbamazepine, or sodium oxybate (GHB)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Tramadol :

Some medical conditions may interact with Tramadol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription (especially depression medicines) or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you are allergic to codeine, a codeine-related medicine (eg, hydrocodone, dihydrocodeine, oxycodone), morphine, or a morphine-related medicine (eg, hydromorphone)
  • if you have a history of alcohol abuse, substance abuse, or suicidal thoughts or behaviors
  • if you have or recently have had any head injury, brain injury or tumor, increased pressure in the brain, or infection of the brain or nervous system
  • if you have a history of stomach or intestinal problems, asthma or other lung or breathing problems, epilepsy, seizures, or chronic inflammation or ulceration of the bowels
  • if you have had recent abdominal surgery
  • if you have heart problems, liver problems (eg, hepatitis), kidney problems, thyroid problems, enlargement of the prostate gland, or urinary problems

Some MEDICINES MAY INTERACT with Tramadol. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Carbamazepine because it may decrease Tramadol 's effectiveness and increase the risk of seizures
  • Certain medicines for mental or mood disorders (eg, olanzapine, haloperidol), cyclobenzaprine, isoniazid, other opioid pain medicine (eg, codeine, hydrocodone), phenothiazines (eg, promethazine), sleeping medicines (eg, zolpidem), sodium oxybate (GHB), tricyclic antidepressants (amitriptyline), or weight loss medicines (eg, phentermine) because side effects, including excessive drowsiness, trouble breathing, liver problems, or seizures, may be increased
  • Furazolidone, monoamine oxidase (MAO) inhibitors (eg, phenelzine), nefazodone, selegiline, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because they may cause serious and sometimes fatal reactions, including restlessness, fever, excessive sweating, confusion, twitching, and seizures
  • Oral anticoagulants (eg, warfarin) because its side effects, including bleeding, may be increased by Tramadol
  • Digoxin because the risk of side effects, including nausea, vomiting, or slow heartbeat, may be increased by Tramadol

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tramadol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Tramadol :

Use Tramadol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Tramadol by mouth with or without food.
  • If you miss a dose of Tramadol , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Tramadol.

Important safety information:

  • Tramadol may cause drowsiness and dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Tramadol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Tramadol ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Tramadol may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of this effect.
  • Tell your doctor or dentist that you take Tramadol before you receive any medical or dental care, emergency care, or surgery.
  • Use Tramadol with caution in the ELDERLY; they may be more sensitive to its effects.
  • Tramadol should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Tramadol has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tramadol while you are pregnant. Tramadol is found in breast milk. Do not breast-feed while taking Tramadol.

When used for long periods of time or at high doses, Tramadol may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Tramadol stops working well. Do not take more than prescribed.

Some people who use Tramadol for a long time without a break may develop a physical need to continue taking it. This is known as physical DEPENDENCE. If you suddenly stop taking Tramadol , you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of Tramadol :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; increased sweating; loss of appetite; nausea.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; fainting; fever; incoordination; muscle stiffness or tremor; seizures.

The drug information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects.  This information is generalized and is not intended as specific medical advice.  If you have questions about the medicines you are taking or would like more information, check with your doctor, pharmacist or other healthcare professional.

A HUNGRY AND HURTING: EMOTIONAL AND PHYSICAL ABUSE (MARTHA’S STORY)

MARTHA: "I didn't have a clue about how to connect with people."

Martha, a thirty-seven-year-old Jewish lesbian mother, links the onset of her compulsive eating to emotional abuse she suffered as a child, abuse that made her feel "disconnected from the world." She never learned the basic lesson of "connecting with other people" that she believes comes from allowing children to be themselves and trust others and nurturing them emotionally and physically. Martha describes herself in terms characteristic of abused children, portraying herself as a lost soul who lacked direction, roots, and a sense of belonging to anyone, including herself.4 She was almost always alone when she was a child. She has almost no memories of the time before she was eleven.

Martha grew up in a home in which she was deprived of basic physical and emotional care. There was no touching; she sometimes pretended to be asleep so her father would pick her up and carry her to bed, providing at least a moment of physical contact. Her father was rarely home because he worked nights. One of Martha's sisters treated her as if she were the family's maid. Another was emotionally cruel to her, keeping Martha from her friends and simultaneously telling Martha that any friends she had were a result of her sister's popularity.

Nor did Martha know how to reach out for attention or friends at school. When she made her first friend, in eighth grade, and told her mother about it, her mother said, "Don't get too excited because as high as you will be is as far as you will fall. These people will hurt you." It was a slap in the face, a punch in the chest. Martha cried as she told me the story: "I opened my heart a little and she pulled it down. A lot of emotional abuse and neglect.

The family labeled Martha overly sensitive and teased her incessantly. She cannot remember ever eating a meal with her family when she did not break down and cry because of the teasing. She watched between ten and twelve hours of television each day, even on school days. She knows she was a bright child because she was able to do well in school even though she never studied. There were no books in the house, and she didn't know how to seek them out. She was mildly dyslexic but no one realized it when she was growing up. She was repeatedly told by the members of her family that she was fat and ugly and had no personality. She had no sense of her body size or whether or not she was attractive.

Her mother controlled what Martha and her sisters ate. Even though her sisters were fat and her mother was obese and a compulsive eater, Martha was the one considered to have the biggest problem with food. She was always served last and castigated for eating. Her mother took her to a diet doctor when Martha was eleven and continued to limit her food. Yet her mother also participated in Martha's bingeing. Martha remembers being told by her mother that she could have three cookies each day when she got home from school. Martha would eat three cookies, want more, think about it, and then have more. Then she would struggle to decide whether' to get more and usually did, typically stopping after finishing a dozen cookies. Her mother would come home and ask her how many she ate. Martha would lie and say three. Her mother never questioned this openly, although she was the one who filled the cookie jar every day. Although Martha was obviously compulsively eating and lying, no one said anything.

Eating compulsively was how Martha comforted herself from the pain of not feeling connected to any person or to the rest of the world. Bingeing calmed her, leaving her feeling drugged and dazed. When I asked her if she thinks she ate compulsively out of fear of her feelings, she said it wasn't as if she had feelings and then ate to get rid of them. That would assume she had feelings to begin with. That would assume some connection. She ate from disconnection. No specific feelings triggered eating. Simply being triggered her desire to eat. She ate, felt numb, and watched television. And no one seemed to care.

 

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