Product Name Price Order link
Butalbital/APAP/Caffeine – 30 Tabs $50
Butalbital/APAP/Caffeine – 90 Tabs $65
Fioricet – 30 Tabs $85
Fioricet – 90 Tabs $183
Carisoprodol (Soma Generic) 350mg – 30 Tabs $55
Carisoprodol (Soma Generic) 350mg – 90 Tabs $85
Soma 350mg – 30 Tabs ( Watson Brand ) $60
Soma 350mg – 90 Tabs ( Watson Brand ) $95
Tramadol 50mg – 30 Tabs $65
Tramadol 50mg – 90 Tabs $75
Tramadol 50mg – 180 Tabs $99

Tramadol, which is in a class of medication called Opiate Narcotic Analgesics, is used to alleviate moderate to severe pain. Tramadol works by lessening your body`s sense of pain. It is also used in treating pain caused by joint pains, surgery and other chronic conditions such as cancer.Tramadol works like a narcotic pain reliever. While Tramadol treats moderate to severe pain, Tramadol extended-release works by treating moderate to chronic pain (designed particularly for around-the-clock treatments).

ULTRAM® (tramadol hydrochloride) tablets is a centrally acting analgesic. The chemical name for tramadol hydrochloride is (±)cis-2-[(dimethylamino)methyl]-1-(3methoxyphenyl) cyclohexanol hydrochloride. 

For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, the tolerability of ULTRAM® can be improved by initiating therapy with the following titration regimen: ULTRAM® should be started at 25 mg/day qAM and titrated in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg q.i.d.). Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg q.i.d.). After titration, ULTRAM® 50 to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.

For the subset of patients for whom rapid onset of analgesic effect is required and for whom the benefits outweigh the risk of discontinuation due to adverse events associated with higher initial doses, ULTRAM® 50 mg to 100 mg can be administered as needed for pain relief every four to six hours, not to exceed 400 mg per day.

Individualization of Dose

Good pain management practice dictates that the dose be individualized according to patient need using the lowest beneficial dose. Studies with tramadol in adults have shown that starting at the lowest possible dose and titrating upward will result in fewer discontinuations and increased tolerability.

  • In all patients with creatinine clearance less than 30 mL/min, it is recommended that the dosing interval of ULTRAM® be increased to 12 hours, with a maximum daily dose of 200 mg. Since only 7% of an administered dose is removed by hemodialysis, dialysis patients can receive their regular dose on the day of dialysis.
  • The recommended dose for adult patients with cirrhosis is 50 mg every 12 hours.
  • In general, dose selection for an elderly patient over 65 years old should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function and of concomitant disease or other drug therapy. For elderly patients over 75 years old, total dose should not exceed 300 mg/day.

Tramadol, which is in a class of medication called Opiate Narcotic Analgesics, is used to alleviate moderate to severe pain. Tramadol works by lessening your body`s sense of pain. It is also used in treating pain caused by joint pains, surgery and other chronic conditions such as cancer.

Tramadol works like a narcotic pain reliever. While Tramadol treats moderate to severe pain, Tramadol extended-release works by treating moderate to chronic pain (designed particularly for around-the-clock treatments).

Tramadol can also be used for other purposes when your doctor recommends its use and prescribes it to you.

Like other pain relievers, Tramadol can cause side effects such as difficulty of breathing, hives, skin rashes, weak pulse, convulsions and swelling of throat, tongue, lips or face. It is important that you stop taking Tramadol and seek immediate medical attention when any of these side effects occur.

Less serious side effects from using Tramadol may occur. Although you can continue Tramadol use, you should consult your doctor if you experience blurred vision, weakness, nausea, constipation, vomiting, appetite loss, flushing and sleeping problems. If you experience other unusual effects, talk to your doctor about them.

ULTRAM® was administered to 550 patients during the double-blind or open-label extension periods in U.S. studies of chronic nonmalignant pain. Of these patients, 375 were 65 years old or older. Table 2 reports the cumulative incidence rate of adverse reactions by 7, 30 and 90 days for the most frequent reactions (5% or more by 7 days). The most frequently reported events were in the central nervous system and gastrointestinal system. Although the reactions listed in the table are felt to be probably related to ULTRAM® administration, the reported rates also include some events that may have been due to underlying disease or concomitant medication. The overall incidence rates of adverse experiences in these trials were similar for ULTRAM® and the active control groups, TYLENOL® with Codeine #3 (acetaminophen 300 mg with codeine phosphate 30 mg), and aspirin 325 mg with codeine phosphate 30 mg, however, the rates of withdrawals due to adverse events appeared to be higher in the ULTRAM® groups.

Table 2: Cumulative Incidence of Adverse Reactions for ULTRAM® in Chronic Trials of Nonmalignant Pain (N=427)

  Up to 7 Days Up to 30 Days Up to 90 Days
Dizziness/Vertigo 26% 31% 33%
Nausea 24% 34% 40%
Constipation 24% 38% 46%
Headache 18% 26% 32%
Somnolence 16% 23% 25%
Vomiting 9% 13% 17%
Pruritus 8% 10% 11%
CNS Stimulation1 7% 11% 14%
Asthenia 6% 11% 12%
Sweating 6% 7% 9%
Dyspepsia 5% 9% 13%
Dry Mouth 5% 9% 10%
Diarrhea 5% 6% 10%
1 “CNS Stimulation ” is a composite of nervousness, anxiety, agitation, tremor, spasticity, euphoria, emotional lability and hallucinations

 

Incidence 1% to less than 5% possibly causally related: the following lists adverse reactions that occurred with an incidence of 1% to less than 5% in clinical trials, and for which the possibility of a causal relationship with ULTRAM® exists.

Body as a Whole: Malaise.

Cardiovascular: Vasodilation.

Central Nervous System: Anxiety, Confusion, Coordination disturbance, Euphoria, Miosis, Nervousness, Sleep disorder.

Gastrointestinal: Abdominal pain, Anorexia, Flatulence.

Musculoskeletal: Hypertonia.

Skin: Rash.

Special Senses: Visual disturbance.

Urogenital: Menopausal symptoms, Urinary frequency, Urinary retention.

Incidence less than 1%, possibly causally related: the following lists adverse reactions that occurred with an incidence of less than 1% in clinical trials and/or reported in post-marketing experience.

Body as a Whole: Accidental injury, Allergic reaction, Anaphylaxis, Death, Suicidal tendency, Weight loss, Serotonin syndrome (mental status change, hyperreflexia, fever, shivering, tremor, agitation, diaphoresis, seizures and coma).

Cardiovascular: Orthostatic hypotension, Syncope, Tachycardia.

Central Nervous System: Abnormal gait, Amnesia, Cognitive dysfunction, Depression, Difficulty in concentration, Hallucinations, Paresthesia, Seizure (see WARNINGS). Tremor.

Respiratory: Dyspnea.

Skin: Stevens-Johnson syndrome/Toxic epidermal necrolysis, Urticaria, Vesicles.

Special Senses: Dysgeusia.

Urogenital: Dysuria, Menstrual disorder.

Other adverse experiences, causal relationship unknown: A variety of other adverse events were reported infrequently in patients taking ULTRAM® during clinical trials and/or reported in post-marketing experience. A causal relationship between ULTRAM® and these events has not been determined. However, the most significant events are listed below as alerting information to the physician.

Cardiovascular: Abnormal ECG, Hypertension, Hypotension, Myocardial ischemia, Palpitations, Pulmonary edema, Pulmonary embolism.

Central Nervous System: Migraine, Speech disorders.

Gastrointestinal: Gastrointestinal bleeding, Hepatitis, Stomatitis, Liver failure.

Laboratory Abnormalities: Creatinine increase, Elevated liver enzymes, Hemoglobin decrease, Proteinuria.

Sensory: Cataracts, Deafness, Tinnitus.

Drug Abuse And Dependence

Abuse

Tramadol has mu-opioid agonist activity. ULTRAM can be abused and may be subject to criminal diversion.

Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. Drug addiction is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, use for non-medical purposes, and continued use despite harm or risk of harm, and craving. Drug addiction is a treatable disease, utilizing a multidisciplinary approach, but relapse is common.

“Drug-seeking” behavior is very common in addicts and drug abusers. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated “loss” of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating physician(s). “Doctor shopping” to obtain additional prescriptions is common among drug abusers and people suffering from untreated addiction.

Abuse and addiction are separate and distinct from physical dependence and tolerance. Physicians should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of ULTRAM® can occur in the absence of true addiction and is characterized by misuse for non-medical purposes, often in combination with other psychoactive substances.

Concerns about abuse and addiction should not prevent the proper management of pain. However all patients treated with opioids require careful monitoring for signs of abuse and addiction, because use of opioid analgesic products carries the risk of addiction even under appropriate medical use.

Proper assessment of the patient and periodic re-evaluation of therapy are appropriate measures that help to limit the potential abuse of this product.

ULTRAM® is intended for oral use only.

Dependence

Tolerance is the need for increasing doses of drugs to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Physical dependence is manifested by withdrawal symptoms after abrupt discontinuation of a drug or upon administration of an antagonist (see also WARNINGS, Withdrawal).

The opioid abstinence or withdrawal syndrome is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.

Generally, tolerance and/or withdrawal are more likely to occur the longer a patient is on continuous therapy with ULTRAM.

Tramadol can be purchased as tablets and taken by mouth every 4 to 6 hours as needed. It can be consumed with or without food. Usually, doctors will give you low doses of Tramadol, which will be gradually increased every three days.

Be aware that if you take excessive Tramadol, you could experience severe side effects. Consult your doctor about the number of tablets you could take for 1-day period or for each dose. Make sure to take Tramadol pain relievers exactly as the prescription label describes.

When you stop Tramadol medication suddenly, you could experience various side effects such as sweating, panic, nervousness, changes in sleeping patterns, sneezing, cough, runny nose, pain, burning or tingling sensations of hands or feet, numbness and hallucinations. For this reason, doctors usually lower your doses gradually to prevent any unwanted side effects or danger to your health.

Just like other medications, taking Tramadol can be habit-forming that`s why doctors do not prescribe Tramadol to people who have histories of drugs or alcohol. Make sure you do not take larger doses (over 300 mg per day) of Tramadol or longer periods of medication without your doctor`s prescription.

Medications react differently from Tramadol use. Make sure you discuss all medications you have used or have been using before taking Tramadol tablets. Tramadol can be a great help in alleviating moderate to severe pain. If used properly, Tramadol can help in temporarily relieving various kinds of body pain.