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Ecting the greater frequency of decreased hepatic, renal, or cardiac function; of concomitant disease and multiple drug therapy. Acute Abdominal Conditions The administration of ULTRACET may complicate the clinical assessment of patients with acute abdominal conditions. Use in Renal Disease ULTRACET has not been studied in patients with impaired renal function. Experience with tramadol suggest that impaired renal function results in a decreased rate and extent of excretion of tramadol and its active metabo-lite, M1. In patients with creatinine clearances of less than 30 mL min, it is recommended that the dosing interval of ULTRACET be increased not to exceed 2 tablets every 12 hours. Use in Hepatic Disease ULTRACET has not been studied in patients with impaired hepatic function. The use of ULTRACET in patients with hepatic impairment is not recommended (see WARNINGS, Use With Alcohol). Carcinogenesis, Mutagenesis, Impairment of Fertility There are no animal or laboratory studies on the
tramadol pregnancy (CNS) Depressants ULTRACET should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol tramadol pregnancy, opioids tramadol pregnancy, anesthetic agents tramadol pregnancy, narcotics tramadol pregnancy, phenothiazines tramadol pregnancy, tranquilizers or sedative hypnotics. Tramadol increases the risk of CNS and respiratory depression in these patients. Increased Intracranial Pressure or Head Trauma ULTRACET should be used with caution in patients with increased intracranial pressure or head injury. The respiratory depressant effects of opioids include carbon dioxide retention and secondary elevation of cerebrospinal fluid pressure and may be markedly exaggerated in these patients. Additio tramadol pregnancy.
tramadol pregnancy Nally tramadol pregnancy, pupillary changes (miosis) from tramadol may obscure the existence tramadol pregnancy, extent tramadol pregnancy, or course of intracranial pathology. Clinicians should also maintain a high index of suspicion for adverse drug reaction when evaluating altered mental status in these patients if they are receiving ULTRACET (see Respiratory Depression). Use in Ambulatory Patients Tramadol may impair the mental and or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. The patient using this drug should be cautioned accordingly. Use With MAO Inhibitors and Serotonin Re-uptake Inhibitors Use ULTRACET with great caution in patients taking monoamine oxidase inhibitors. Animal studies have shown increased deaths with combined administration of MAO inhibitors and tramadol. Concomitant use of tramadol with MAO inhibitors or SSRI’s increases the risk of adverse events tramadol pregnancy, including seizure and serotonin syndrome. Use With Alcohol ULTRACET should not be used concomitantly with alcohol consumption. The use of ULTRACET in patients with liver disease is not recommended. Use With Other Acetaminophen-containing Products Due to the potential for acetaminophen hepatotoxicity at doses higher than the recommended dose tramadol pregnancy, ULTRACET should not be used concomitantly with other acetaminophen-containing.
tramadol pregnancy Atients taking monoamine oxidase inhibitors. Animal studies have shown increased deaths with combined administration of MAO inhibitors and tramadol. Concomitant use of tramadol with MAO inhibitors or SSRI’s increases the risk of adverse events tramadol pregnancy, including seizure and serotonin syndrome. Use With Alcohol ULTRACET should not be used concomitantly with alcohol consumption. The use of ULTRACET in patients with liver disease is not recommended. Use With Other Acetaminophen-containing Products Due to the potential for acetaminophen hepatotoxicity at doses higher than the recommended dose tramadol pregnancy, ULTRACET should not be used concomitantly with other acetaminophen-containing .
tramadol pregnancy 
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Ted dose in foreign fatalities have been in the range of 3 to 5 g. A 3 g intentional overdose in a patient in the clinical studies produced emesis and no sequelae. The lowest dose reported to be associated with a fatality was possibly between 500 and 1000 mg in a 40 kg woman, but details of the case are not completely known. Serious potential consequences of overdosage are respiratory depression and seizure. Naloxone will reverse some, but not all symptoms caused by overdosage with Ultram so that general supportive treatment is recommended. Primary attention should be given to the assurance of adequate respiratory exchange. Hemodialysis is not expected to be helpful because it removes only a small percentage of the administered dose. Convulsions occurring in mice following the administration of toxic doses of tramadol could be suppressed with barbiturates or benzodiazepines, but were increased with naloxone. Naloxone did not change the lethality of an overdose in mice. DOSAGE AND ADMIN
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