Medications and Drugs
GENERIC NAME: tramadol and acetaminophen
BRAND NAME: Ultracet
DRUG CLASS AND MECHANISM: Ultracet is a combination of two drugs, tramadol (Ultram) and acetaminophen (Tylenol), that is used to relieve moderate, acute pain such as pain following dental or surgical procedures. Tramadol and acetaminophen each relieve pain, but they do so by different mechanisms. Tramadol achieves pain relief in two ways. It binds to the µ-opioid receptor on nerves (the same mechanism that is responsible for the effectives of narcotics, such as morphine), and it also inhibits the reuptake of serotonin and norepinephrine by nerves. This inhibition may lead to reduced transmission of pain signals through the spinal cord to the brain. Acetaminophen achieves pain relief in the spinal cord and brain by increasing the threshold to pain, that is, by increasing the strength of the painful stimulus that is necessary in order to give rise to the sensation of pain. It does this by inhibiting an enzyme that makes prostaglandins. Ultracet was approved by the FDA in 2001.
GENERIC: No
PRESCRIPTION: Yes
PREPARATIONS: Tablets: tramadol, 37.5 mg and acetaminophen, 325 mg.
STORAGE: Ultracet should be stored at room temperature, between 15 and 30 C (59-86 F). It should be kept out of the reach of children.
PRESCRIBED FOR: Ultracet is used to for the short-term (up to five days) relief of moderately-severe, acute pain.
DOSING: The usual dose of Ultracet is two tablets every four to six hours as needed for the relief of pain. Patients should not take more than two tablets at a time nor more than 8 tablets per day.
DRUG INTERACTIONS: Carbamazepine (Tegretol) can increase the rate of metabolic breakdown of tramadol, thus making tramadol less effective.
PREGNANCY: Toxic doses of Ultracet in pregnant rats have resulted in toxic effects in the fetuses. Safe use during
pregnancy has not been established.
NURSING MOTHERS: Tramadol is excreted in
breast milk. Safe use in nursing mothers has not been established.
SIDE EFFECTS: Ultracet usually is well-tolerated. The most common side effects are constipation (1 in 17 patients), tiredness (1 in 17), and increased sweating (1 in 25). Because tramadol is chemically related to the narcotic class of drugs such as morphine and hydrocodone (Vicodin ES, Anexsia, Lorcet, Lorcet Plus, Norco), it can cause psychological or physical dependence, although it is less likely than narcotics to do so. An overdose of acetaminophen can result in severe liver damage.
Reference: FDA Prescribing Information
Last Editorial Review: 10/18/2004 10:23:23 PM
Report Problems to the Food and Drug Administration
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