A maximum of 400mg daily is recommended for adults for immediate release given orally every 4 to 6 hours as needed. For chronic patients suffering from moderate to severe pain not on immediate release Ultram(Tramadol Hydrochloride) can be started at 100mg upto a maximum of 300mg incremented every 5 days with 100mg daily looking up to the needs. To switch the use of Tramadol Hydrochloride (Ultram) for a chronic patient from immediate to extended release, calculate the total daily doses of Tramadol Hydrochloride (Ultram)and start extended release tramadol at a dose rounded down at the nearest 100mg increment, not to exceed 300mg daily. The safety and efficacy of immediate release tramadol in patients under 16 years of age and extended release tramadol in patients under 18 years of age are not established.

The most commonly reported side effects in patients taking tramadol are dizziness and vertigo (26%), nausea and/or constipation (24%), headache (18%), somnolence (drowsiness 16%), vomiting (9%), pruritus (itching 8%), and CNS stimulation consisting of restlessness, tremors, euphoria, hallucinations, and emotional lability (7%).

The most common side effects of this medicine are disturbance, hallucinations, fever, irregular heartbeats, overactive reflexes, nausea, vomiting, diarrhea, fainting, seizure (convulsions), blistering, peeling and skin rash, trouble in breathing. If you feel any kind of these side effects, just talk to your doctor instantly.

Pregnant and breastfeeding women must avoid using this medicine. You should not use it if you have allergy problems with the elements of this medicine. This medicine may have interactions while using it in the blend of other medicines so it is better to share your medical record with your doctor. You should also tell him the medicine that you have used earlier.