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Soma is a muscle relaxer that blocks pain sensations between the nerves and the brain.

Soma is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Soma should only be used for short periods (up to two or three weeks) because there is no evidence of its effectiveness in long term use and most skeletal muscle injuries are generally of short duration.

Warnings
You should not take Soma if you have porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system) or are allergic to carisoprodol or meprobamate.

Carisoprodol may be habit-forming. Never share this medicine with another person. Misuse of habit-forming medicine can cause addiction, overdose, or death.

Carisoprodol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase drowsiness and dizziness caused by this medicine.

You may have withdrawal symptoms when you stop using Soma after using it over a long period of time. Do not stop using this medication suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.


Before taking this medicine
You should not use Soma if you are allergic to carisoprodol or meprobamate, or if you have:

porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system).

Tell your doctor if you have ever had:

liver disease;

kidney disease; or

a seizure.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant.

Carisoprodol can pass into breast milk and may cause drowsiness in a nursing baby. Tell your doctor if you are breast-feeding.

Soma is not approved for use by anyone younger than 16 years old.

Older adults may be more sensitive to the effects of this medicine.

Soma pregnancy and breastfeeding warnings (more detail)
How should I take Soma?
Take Soma exactly as it was prescribed for you. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Carisoprodol may be habit-forming. Misuse can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.

Soma is usually taken 3 times per day and at bedtime. Follow your doctor's dosing instructions very carefully.

Soma should be taken only 2 or 3 weeks. Call your doctor if your s

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After the death of actor Matthew Perry, ketamine—for decades used as a popular party drug—came into the public eye once more. According to the medical examiner, Perry, who had been undergoing “ketamine infusion therapy” for depression, had levels of the drug in his body in the range used for general anesthesia during surgery. 

While the actor’s death wasn’t shown to be directly connected to his therapy, it did call into question how ketamine—which is not FDA-approved for the treatment of mental health disorders, much less Lyme disease, alcoholism, or other ailments for which it’s been advertised as a cure—is being used today.

In this Q&A, adapted from the January 26 episode of Public Health On Call, Lindsay Smith Rogers speaks with Caleb Alexander, MD, MS, professor of Epidemiology and co-director of the Center for Drug Safety and Effectiveness, about the drug’s dangerous side effects and addictive potential, and how antiquated marketing laws allow its promotion for unproven uses.

Ketamine is an NMDA receptor antagonist, meaning it blocks the N-methyl-D-aspartate neurotransmitter in the brain. It was developed in the 1960s and used as a battlefield anesthetic in the Vietnam War, as well as clinically in health care settings. But the settings in which ketamine was developed and historically used were highly regulated and supervised inpatient health care facilities. That’s not how ketamine is being used in 2024.

Is ketamine approved for mental health treatment?

There's one other actor in this play that’s important to mention, which is esketamine. Ketamine and esketamine are chemically very similar, but they're two different drugs. Ketamine is only FDA-approved as an anesthetic, and is still widely used for anesthesia and acute pain in surgical, operative, and emergency trauma settings. Esketamine was brought to market around 2019 for the management of treatment-refractory depression [depression not responsive to standard treatment]. Most of what we're hearing about in the news is ketamine. 

How is ketamine being used “off label”?

Thanks to an interesting loophole in the laws governing drug advertising, ketamine is now marketed for the management of any number of different psychiatric illnesses. Depression, anxiety, post-traumatic stress disorder, and chronic pain are the big ones, but it's also being marketed for other uses, ranging from Lyme disease to alcoholism to opioid addiction. As is often the case, enthusiasm and marketing have gotten ahead of the evidence. 

Just because a product is marketed for a use does not mean it’s approved for that use—is that correct? 

Typically, drug companies are restricted to marketing and promoting their products only for FDA-approved indications. But in the case of ketamine, the product is being marketed and promoted by clinics and telehealth companies that aren't manufacturing the drug. 

The laws and regulations that govern drug marketing and promotion are enforced by the overlapping authorities of the FDA and the Federal Trade Commission and a patchwork of state consumer protection statutes. But they were written in an era before the rise of telemedicine and pop-up clinics. If you look at the claims being made by these entities regarding the safety and effectiveness of ketamine, they range from potentially misconstruing the evidence to being bald-faced lies. 

Is ketamine safe and effective for treating mental health issues? 

One of the pearls of the field of pharmacoepidemiology is that it's not just about safety or effectiveness, it's about safety and effectiveness and the balance of these. 

With ketamine, we have a drug that has unclear effectiveness with some very well described dose-response and cumulative adverse effects that run all the way up to death. There is a remarkable dearth of evidence of well controlled, randomized, blinded trials, which really represent the gold standard for how we assess effectiveness. Many trials only look at short-term, not at moderate or long-term, outcomes of effectiveness. And the measures of effectiveness are often quite limited. 

Safety is really where things open up, because this is a drug that affects perception and can cause hallucinations and visions. It can cause mood changes, ranging from euphoria to suicidality. It affects behavior, ranging from sedation to violence. And it typically reduces cognition. The biggest concern is that the effects aren't always short-lived and the onset of these effects isn't always immediate. 

In these instances, how is ketamine being administered?

This is a drug that should be administered in highly controlled, highly supervised, structured clinical settings. But it's being used in a lot of different settings, the most concerning of which is non-health care settings. In some places, you can get this drug compounded by a pharmacy for in-home use, which is really asking for trouble. The drug is also being used and delivered in cash-only clinics. These clinics can purchase a vial for less than $100 and charge $500 to $1,500 for an infusion. Insurance may not cover it. The non-anesthesia uses aren't FDA-approved; these are off-label uses. It's a cash business. 

Drug compounding adds extra uncertainty into the mix. These compounds are loosely regulated, and the notion that you would use





this as a nasal spray or something is just bonkers. Having any standardization of the exposure is very difficult when you're compounding. You can’t really control the dose that you receive.

Is ketamine addictive?

I don't think we have the same level of evidence that we do with opioids

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In the U.S., Farmapram is called alprazolam (brand name: Xanax). Alprazolam is a benzodiazepine drug used to treat anxiety and panic disorder. Farmapram appears to be a common name for alprazolam in Mexico and may be manufactured in that country.

In the U.S. alprazolam is classified as a Schedule 4 Controlled Substance by the Drug Enforcement Agency (DEA) due to a the possibility of misuse, addiction, and diversion. Alprazolam and other members of the benzodiazepine class can lead to risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions.

Can I bring Farmapram into the U.S?
It can be dangerous to purchase alprazolam on the Internet or outside the United States. Pharmaceutical laws outside the U.S. may not comply with safe-use regulations of the Food and Drug Administration (FDA). Medications purchased in some other countries may contain dangerous ingredients, may be counterfeit, or may not be distributed by a legal pharmacy. It may be against the law to bring these products into the US from a foreign country.

According to the FDA, when you come to the U.S. with medications, you fall under the authority of the FDA, the U.S. Customs and Border Protection (CBP) and the Transportation Security Administration (TSA) agents operating the nation’s airports. There are varying restrictions, and different agencies may have other requirements or jurisdiction over a product. Check with each agency before you bring foreign-bought medications into the country.

What is alprazolam used for?
In the US, alprazolam is classified as a benzodiazepine and is approved by the FDA to treat:

anxiety disorder
panic disorder
Alprazolam may also be prescribed by your doctor to treat “off-label” conditions such as:

insomnia
depression
chemotherapy-induced nausea and vomiting
social phobia
Unapproved, or "off-label" uses of alprazolam are uses that have not been approved by the FDA and are not found in the package labeling. However, some doctors may have had good experience using alprazolam in an "off-label" fashion, and it may be an accepted use even though not specifically listed in the product label.

Benzodiazepines can be dangerous and addictive should only be used if specifically prescribed for you by your doctor.
Using any benzodiazepine with an opiate may result in profound sedation, slowed or stopped breathing, coma, and death. Opiates include prescription medicines like hydrocodone or oxycodone, and illegal drugs like heroin.
Fatal side effects can occur if you take alprazolam with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing.

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Clonazepam is commonly used to treat the following conditions.

Certain types of seizure disorders, also called epilepsy
Panic disorder with or without the fear of open spaces, also called agoraphobia
Clonazepam may also be used for other conditions as determined by your healthcare provider.

How does clonazepam work (mechanism of action)?
Clonazepam produces a calming effect on the brain and nerves, which helps to reduce anxiety, prevent seizures, and promote relaxation.

How is clonazepam supplied (dosage forms)?
Clonazepam is available as Klonopin, Klonopin ODT, and generic clonazepam in the following dosage forms that are taken by mouth. 

0.125 mg orally disintegrating tablets
0.25 mg orally disintegrating tablets
0.5 mg orally disintegrating tablets 
1 mg orally disintegrating tablets
2 mg orally disintegrating tablets
0.5 mg oral tablets 
1 mg oral tablets
2 mg oral tablets
How should I store clonazepam?
Clonazepam should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C  to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place, in a tightly closed container.

Side Effects
What are the most common side effects of clonazepam?
The most common side effects of clonazepam are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

Drowsiness
Problems with walking and coordination
Dizziness
Depression
Fatigue
Problems with memory
There may be other side effects of clonazepam that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of clonazepam?
While less common, the most serious side effects of clonazepam are described below, along with what to do if they happen.

Severe Allergic Reactions. Clonazepam can cause allergic reactions, which can be serious. Stop using clonazepam and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain
Suicidal Thoughts and Actions. Clonazepam may cause suicidal thoughts or actions in a small number of people. If you’re about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.

New or increased thoughts of suicide or death
Suicide attempt
New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior
Risk of Misuse and Addiction. Misusing clonazepam can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take clonazepam exactly as prescribed. Tell your healthcare provider if you feel that clonazepam is not working. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

Sudden confusion or feeling disoriented
Feeling paranoid
Suicidal thoughts or actions
Seizures
Trouble breathing
Dependence and Withdrawal Reactions. Clonazepam can cause physical dependence, which means your body relies on the medicine to function properly. If you stop clonazepam suddenly, it could lead to withdrawal symptoms, which may be life-threatening. Do not stop taking clonazepam without talking with your healthcare provider. Your healthcare provider will tell you how to stop clonazepam to reduce the risk of withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

Unusual movements, responses, or expressions
Seizures
Sudden and severe mental or nervous system changes
Seeing or hearing things that others do not see or hear, also called hallucinations
An extreme increase in activity or talking
Losing touch with reality
Some people may experience the following symptoms of a withdrawal reaction that can last for several weeks to more than 12 months.

Anxiety
Trouble remembering, learning, or concentrating
Depression
Problems sleeping
Feeling like insects are crawling under the skin
Weakness
Shaking
Muscle twitching
Burning or prickling feeling in the hands, arms, legs, or feet
Ringing in the ears
Risk With Opioid Medicines. Taking clonazepam with an opioid medicine, such as codeine, morphine, and oxycodone, may lead to severe drowsiness, breathing problems, coma, and death. Get emergency help right away if you experience the following symptoms.

Slow or shallow breathing
Breathing stops (which may lead to the heart stopping)
Excessive sleepiness or trouble staying awake 
Decreased Alertness or Coordination. Clonazepam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how clonazepam affects you.

Warnings & Precautions
Who should not use clonazepam?
Allergies to Ingredients. People who are allergic to any of the following should not use clonazepam. 

Clonazepam
Klonopin
Any other medicine known as a benzodiazepine, such as alprazolam or lorazepam
Any of the ingredients in the specific product dispensed.
Your pharmacist can tell you all of the ingredients in the specific clonazepam products they stock.

Liver Problems. Clonazepam should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.

Glaucoma. Do not use clonazepam if you have acute narrow-angle glaucoma. There are different types of glaucoma. If you do not know what type you have, talk with your healthcare provider before taking clonazepam.

What should I know about clonazepam before using it?
Do not take clonazepam unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share clonazepam with other people, even if they have the same condition as you. It may harm them.

Clonazepam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how clonazepam affects you.

Keep clonazepam out of the reach of children. Clonazepam is a controlled substance because it can be misused or lead to dependence. Store clonazepam in a safe place to protect it from theft. It is illegal to sell or give away this medicine.
 
 

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Clonazepam is commonly used to treat the following conditions.

Certain types of seizure disorders, also called epilepsy
Panic disorder with or without the fear of open spaces, also called agoraphobia
Clonazepam may also be used for other conditions as determined by your healthcare provider.

How does clonazepam work (mechanism of action)?
Clonazepam produces a calming effect on the brain and nerves, which helps to reduce anxiety, prevent seizures, and promote relaxation.

How is clonazepam supplied (dosage forms)?
Clonazepam is available as Klonopin, Klonopin ODT, and generic clonazepam in the following dosage forms that are taken by mouth. 

0.125 mg orally disintegrating tablets
0.25 mg orally disintegrating tablets
0.5 mg orally disintegrating tablets 
1 mg orally disintegrating tablets
2 mg orally disintegrating tablets
0.5 mg oral tablets 
1 mg oral tablets
2 mg oral tablets
How should I store clonazepam?
Clonazepam should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C  to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place, in a tightly closed container.

Side Effects
What are the most common side effects of clonazepam?
The most common side effects of clonazepam are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

Drowsiness
Problems with walking and coordination
Dizziness
Depression
Fatigue
Problems with memory
There may be other side effects of clonazepam that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of clonazepam?
While less common, the most serious side effects of clonazepam are described below, along with what to do if they happen.

Severe Allergic Reactions. Clonazepam can cause allergic reactions, which can be serious. Stop using clonazepam and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain
Suicidal Thoughts and Actions. Clonazepam may cause suicidal thoughts or actions in a small number of people. If you’re about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.

New or increased thoughts of suicide or death
Suicide attempt
New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior
Risk of Misuse and Addiction. Misusing clonazepam can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take clonazepam exactly as prescribed. Tell your healthcare provider if you feel that clonazepam is not working. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

Sudden confusion or feeling disoriented
Feeling paranoid
Suicidal thoughts or actions
Seizures
Trouble breathing
Dependence and Withdrawal Reactions. Clonazepam can cause physical dependence, which means your body relies on the medicine to function properly. If you stop clonazepam suddenly, it could lead to withdrawal symptoms, which may be life-threatening. Do not stop taking clonazepam without talking with your healthcare provider. Your healthcare provider will tell you how to stop clonazepam to reduce the risk of withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

Unusual movements, responses, or expressions
Seizures
Sudden and severe mental or nervous system changes
Seeing or hearing things that others do not see or hear, also called hallucinations
An extreme increase in activity or talking
Losing touch with reality
Some people may experience the following symptoms of a withdrawal reaction that can last for several weeks to more than 12 months.

Anxiety
Trouble remembering, learning, or concentrating
Depression
Problems sleeping
Feeling like insects are crawling under the skin
Weakness
Shaking
Muscle twitching
Burning or prickling feeling in the hands, arms, legs, or feet
Ringing in the ears
Risk With Opioid Medicines. Taking clonazepam with an opioid medicine, such as codeine, morphine, and oxycodone, may lead to severe drowsiness, breathing problems, coma, and death. Get emergency help right away if you experience the following symptoms.

Slow or shallow breathing
Breathing stops (which may lead to the heart stopping)
Excessive sleepiness or trouble staying awake 
Decreased Alertness or Coordination. Clonazepam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how clonazepam affects you.

Warnings & Precautions
Who should not use clonazepam?
Allergies to Ingredients. People who are allergic to any of the following should not use clonazepam. 

Clonazepam
Klonopin
Any other medicine known as a benzodiazepine, such as alprazolam or lorazepam
Any of the ingredients in the specific product dispensed.
Your pharmacist can tell you all of the ingredients in the specific clonazepam products they stock.

Liver Problems. Clonazepam should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.

Glaucoma. Do not use clonazepam if you have acute narrow-angle glaucoma. There are different types of glaucoma. If you do not know what type you have, talk with your healthcare provider before taking clonazepam.

What should I know about clonazepam before using it?
Do not take clonazepam unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share clonazepam with other people, even if they have the same condition as you. It may harm them.

Clonazepam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how clonazepam affects you.

Keep clonazepam out of the reach of children. Clonazepam is a controlled substance because it can be misused or lead to dependence. Store clonazepam in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

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Tramadol is an opioid agonist that may be used to treat moderate to moderately severe chronic pain in adults.

Extended-release forms of tramadol may be used in adults who require around-the-clock treatment of their pain for an extended period.
Brands of tramadol include ConZip, Qdolo, Ultram, and Ultram ER. Generic tramadol is available.

Taking tramadol in combination with other pain-relieving medicines such as acetaminophen, ibuprofen, or aspirin can provide better pain relief than just taking one pain-relieving medicine by itself (see Can you take tramadol in combination with acetaminophen, ibuprofen, or aspirin?)

Tramadol first gained FDA approval on March 3, 1995. Originally it was classified as a non-controlled substance but it was reclassified in 2014 to Schedule IV of the Controlled Substances Act with restrictions on its prescribing. Tramadol is an opioid (see Is tramadol an opioid?). 

A person's genetics can affect the pain-relieving properties of tramadol (see How do genetics affect tramadol?).

Tramadol uses
Tramadol is used for the management of moderate to moderately severe pain in adults, including postoperative pain (pain after surgery).

Tramadol treats pain severe enough to require opioids and may be used as an alternative to other forms of pain relief that did not relieve pain well enough or were not tolerated. 

Tramadol extended-release capsules may be used by adults who require around-the-clock treatment of their moderate to moderately severe chronic pain for an extended time.

Tramadol should not be used in children younger than 12 years old, or anyone younger than 18 years old with other risk factors (such as breathing problems), or who have recently had surgery to remove their tonsils or adenoids.

Extended-release tramadol (Ultram ER) should not be given to anyone younger than 18 years.
Is Tramadol an opioid?
Yes, tramadol is an opioid. The opioid activity of tramadol is due to its binding to mu-opioid receptors.

Tramadol side effects
Common side effects
The most common side effects of tramadol are:

nausea
constipation
dry mouth
drowsiness
dizziness
vomiting.
A person's genetics can affect their response to tramadol, including their risk of side effects (see How do genetics affect tramadol?).

Serious tramadol side effects and warnings
Tramadol may cause serious side effects, some of which may be fatal.

Tramadol can slow or stop your breathing and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep this medicine where others cannot get to it. Do not take more tramadol than prescribed as an overdosage can be fatal. Selling or giving away this medicine is against the law.

A person caring for you should give naloxone and seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you find it hard to wake up. Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.
Call your doctor at once if you have:
noisy breathing, sighing, shallow breathing, breathing that stops during sleep
a slow heart rate or weak pulse
a light-headed feeling, like you might pass out
seizure (convulsions) or
low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Seizures have been reported in patients taking tramadol. Your risk of seizures is higher if you are taking higher doses than recommended. Seizure risk is also higher in those with a seizure disorder or those taking certain antidepressants or opioid medications.

You should not take tramadol if you have severe breathing problems, a head injury or increased pressure inside your skull, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others). Tramadol should not be used if you are suicidal or prone to addiction.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing. People taking extended-release forms of tramadol should not consume alcohol-containing beverages at the same time. Alcohol is also not advised with immediate-release forms of tramadol.

Serious allergic reactions, including anaphylaxis, have occurred with tramadol, some of which caused death. People who are allergic to other opioids are at higher risk. Other hypersensitivity reactions include itching, hives, narrowing of the airways, swelling of the face and airways (angioedema), and serious skin reactions such as Stevens-Johnson Syndrome. Get emergency medical help if you have signs of an allergic reaction to tramadol (symptoms include hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, a red or purple skin rash that spreads and causes blistering and peeling).

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Tramadol is an opioid agonist that may be used to treat moderate to moderately severe chronic pain in adults.

Extended-release forms of tramadol may be used in adults who require around-the-clock treatment of their pain for an extended period.
Brands of tramadol include ConZip, Qdolo, Ultram, and Ultram ER. Generic tramadol is available.

Taking tramadol in combination with other pain-relieving medicines such as acetaminophen, ibuprofen, or aspirin can provide better pain relief than just taking one pain-relieving medicine by itself (see Can you take tramadol in combination with acetaminophen, ibuprofen, or aspirin?)

Tramadol first gained FDA approval on March 3, 1995. Originally it was classified as a non-controlled substance but it was reclassified in 2014 to Schedule IV of the Controlled Substances Act with restrictions on its prescribing. Tramadol is an opioid (see Is tramadol an opioid?). 

A person's genetics can affect the pain-relieving properties of tramadol (see How do genetics affect tramadol?).

Tramadol uses
Tramadol is used for the management of moderate to moderately severe pain in adults, including postoperative pain (pain after surgery).

Tramadol treats pain severe enough to require opioids and may be used as an alternative to other forms of pain relief that did not relieve pain well enough or were not tolerated. 

Tramadol extended-release capsules may be used by adults who require around-the-clock treatment of their moderate to moderately severe chronic pain for an extended time.

Tramadol should not be used in children younger than 12 years old, or anyone younger than 18 years old with other risk factors (such as breathing problems), or who have recently had surgery to remove their tonsils or adenoids.

Extended-release tramadol (Ultram ER) should not be given to anyone younger than 18 years.
Is Tramadol an opioid?
Yes, tramadol is an opioid. The opioid activity of tramadol is due to its binding to mu-opioid receptors.

Tramadol side effects
Common side effects
The most common side effects of tramadol are:

nausea
constipation
dry mouth
drowsiness
dizziness
vomiting.
A person's genetics can affect their response to tramadol, including their risk of side effects (see How do genetics affect tramadol?).

Serious tramadol side effects and warnings
Tramadol may cause serious side effects, some of which may be fatal.

Tramadol can slow or stop your breathing and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep this medicine where others cannot get to it. Do not take more tramadol than prescribed as an overdosage can be fatal. Selling or giving away this medicine is against the law.

A person caring for you should give naloxone and seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you find it hard to wake up. Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.
Call your doctor at once if you have:
noisy breathing, sighing, shallow breathing, breathing that stops during sleep
a slow heart rate or weak pulse
a light-headed feeling, like you might pass out
seizure (convulsions) or
low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Seizures have been reported in patients taking tramadol. Your risk of seizures is higher if you are taking higher doses than recommended. Seizure risk is also higher in those with a seizure disorder or those taking certain antidepressants or opioid medications.

You should not take tramadol if you have severe breathing problems, a head injury or increased pressure inside your skull, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others). Tramadol should not be used if you are suicidal or prone to addiction.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing. People taking extended-release forms of tramadol should not consume alcohol-containing beverages at the same time. Alcohol is also not advised with immediate-release forms of tramadol.

Serious allergic reactions, including anaphylaxis, have occurred with tramadol, some of which caused death. People who are allergic to other opioids are at higher risk. Other hypersensitivity reactions include itching, hives, narrowing of the airways, swelling of the face and airways (angioedema), and serious skin reactions such as Stevens-Johnson Syndrome. Get emergency medical help if you have signs of an allergic reaction to tramadol (symptoms include hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, a red or purple skin rash that spreads and causes blistering and peeling).

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Tramadol is an opioid agonist that may be used to treat moderate to moderately severe chronic pain in adults.

Extended-release forms of tramadol may be used in adults who require around-the-clock treatment of their pain for an extended period.
Brands of tramadol include ConZip, Qdolo, Ultram, and Ultram ER. Generic tramadol is available.

Taking tramadol in combination with other pain-relieving medicines such as acetaminophen, ibuprofen, or aspirin can provide better pain relief than just taking one pain-relieving medicine by itself (see Can you take tramadol in combination with acetaminophen, ibuprofen, or aspirin?)

Tramadol first gained FDA approval on March 3, 1995. Originally it was classified as a non-controlled substance but it was reclassified in 2014 to Schedule IV of the Controlled Substances Act with restrictions on its prescribing. Tramadol is an opioid (see Is tramadol an opioid?). 

A person's genetics can affect the pain-relieving properties of tramadol (see How do genetics affect tramadol?).

Tramadol uses
Tramadol is used for the management of moderate to moderately severe pain in adults, including postoperative pain (pain after surgery).

Tramadol treats pain severe enough to require opioids and may be used as an alternative to other forms of pain relief that did not relieve pain well enough or were not tolerated. 

Tramadol extended-release capsules may be used by adults who require around-the-clock treatment of their moderate to moderately severe chronic pain for an extended time.

Tramadol should not be used in children younger than 12 years old, or anyone younger than 18 years old with other risk factors (such as breathing problems), or who have recently had surgery to remove their tonsils or adenoids.

Extended-release tramadol (Ultram ER) should not be given to anyone younger than 18 years.
Is Tramadol an opioid?
Yes, tramadol is an opioid. The opioid activity of tramadol is due to its binding to mu-opioid receptors.

Tramadol side effects
Common side effects
The most common side effects of tramadol are:

nausea
constipation
dry mouth
drowsiness
dizziness
vomiting.
A person's genetics can affect their response to tramadol, including their risk of side effects (see How do genetics affect tramadol?).

Serious tramadol side effects and warnings
Tramadol may cause serious side effects, some of which may be fatal.

Tramadol can slow or stop your breathing and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep this medicine where others cannot get to it. Do not take more tramadol than prescribed as an overdosage can be fatal. Selling or giving away this medicine is against the law.

A person caring for you should give naloxone and seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you find it hard to wake up. Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.
Call your doctor at once if you have:
noisy breathing, sighing, shallow breathing, breathing that stops during sleep
a slow heart rate or weak pulse
a light-headed feeling, like you might pass out
seizure (convulsions) or
low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Seizures have been reported in patients taking tramadol. Your risk of seizures is higher if you are taking higher doses than recommended. Seizure risk is also higher in those with a seizure disorder or those taking certain antidepressants or opioid medications.

You should not take tramadol if you have severe breathing problems, a head injury or increased pressure inside your skull, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others). Tramadol should not be used if you are suicidal or prone to addiction.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing. People taking extended-release forms of tramadol should not consume alcohol-containing beverages at the same time. Alcohol is also not advised with immediate-release forms of tramadol.

Serious allergic reactions, including anaphylaxis, have occurred with tramadol, some of which caused death. People who are allergic to other opioids are at higher risk. Other hypersensitivity reactions include itching, hives, narrowing of the airways, swelling of the face and airways (angioedema), and serious skin reactions such as Stevens-Johnson Syndrome. Get emergency medical help if you have signs of an allergic reaction to tramadol (symptoms include hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, a red or purple skin rash that spreads and causes blistering and peeling).

Buy tramadol online Overnight Delivery and Get Instant 10% Off On all Medicine Connect our Support team Now If Extra discount or any query 





Tramadol is an opioid agonist that may be used to treat moderate to moderately severe chronic pain in adults.

Extended-release forms of tramadol may be used in adults who require around-the-clock treatment of their pain for an extended period.
Brands of tramadol include ConZip, Qdolo, Ultram, and Ultram ER. Generic tramadol is available.

Taking tramadol in combination with other pain-relieving medicines such as acetaminophen, ibuprofen, or aspirin can provide better pain relief than just taking one pain-relieving medicine by itself (see Can you take tramadol in combination with acetaminophen, ibuprofen, or aspirin?)

Tramadol first gained FDA approval on March 3, 1995. Originally it was classified as a non-controlled substance but it was reclassified in 2014 to Schedule IV of the Controlled Substances Act with restrictions on its prescribing. Tramadol is an opioid (see Is tramadol an opioid?). 

A person's genetics can affect the pain-relieving properties of tramadol (see How do genetics affect tramadol?).

Tramadol uses
Tramadol is used for the management of moderate to moderately severe pain in adults, including postoperative pain (pain after surgery).

Tramadol treats pain severe enough to require opioids and may be used as an alternative to other forms of pain relief that did not relieve pain well enough or were not tolerated. 

Tramadol extended-release capsules may be used by adults who require around-the-clock treatment of their moderate to moderately severe chronic pain for an extended time.

Tramadol should not be used in children younger than 12 years old, or anyone younger than 18 years old with other risk factors (such as breathing problems), or who have recently had surgery to remove their tonsils or adenoids.

Extended-release tramadol (Ultram ER) should not be given to anyone younger than 18 years.
Is Tramadol an opioid?
Yes, tramadol is an opioid. The opioid activity of tramadol is due to its binding to mu-opioid receptors.

Tramadol side effects
Common side effects
The most common side effects of tramadol are:

nausea
constipation
dry mouth
drowsiness
dizziness
vomiting.
A person's genetics can affect their response to tramadol, including their risk of side effects (see How do genetics affect tramadol?).

Serious tramadol side effects and warnings
Tramadol may cause serious side effects, some of which may be fatal.

Tramadol can slow or stop your breathing and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep this medicine where others cannot get to it. Do not take more tramadol than prescribed as an overdosage can be fatal. Selling or giving away this medicine is against the law.

A person caring for you should give naloxone and seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you find it hard to wake up. Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.
Call your doctor at once if you have:
noisy breathing, sighing, shallow breathing, breathing that stops during sleep
a slow heart rate or weak pulse
a light-headed feeling, like you might pass out
seizure (convulsions) or
low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Seizures have been reported in patients taking tramadol. Your risk of seizures is higher if you are taking higher doses than recommended. Seizure risk is also higher in those with a seizure disorder or those taking certain antidepressants or opioid medications.

You should not take tramadol if you have severe breathing problems, a head injury or increased pressure inside your skull, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others). Tramadol should not be used if you are suicidal or prone to addiction.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing. People taking extended-release forms of tramadol should not consume alcohol-containing beverages at the same time. Alcohol is also not advised with immediate-release forms of tramadol.

Serious allergic reactions, including anaphylaxis, have occurred with tramadol, some of which caused death. People who are allergic to other opioids are at higher risk. Other hypersensitivity reactions include itching, hives, narrowing of the airways, swelling of the face and airways (angioedema), and serious skin reactions such as Stevens-Johnson Syndrome. Get emergency medical help if you have signs of an allergic reaction to tramadol (symptoms include hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, a red or purple skin rash that spreads and causes blistering and peeling).

Buy tramadol online Overnight Delivery and Get Instant 10% Off On all Medicine Connect our Support team Now If Extra discount or any query 





Tramadol is an opioid agonist that may be used to treat moderate to moderately severe chronic pain in adults.

Extended-release forms of tramadol may be used in adults who require around-the-clock treatment of their pain for an extended period.
Brands of tramadol include ConZip, Qdolo, Ultram, and Ultram ER. Generic tramadol is available.

Taking tramadol in combination with other pain-relieving medicines such as acetaminophen, ibuprofen, or aspirin can provide better pain relief than just taking one pain-relieving medicine by itself (see Can you take tramadol in combination with acetaminophen, ibuprofen, or aspirin?)

Tramadol first gained FDA approval on March 3, 1995. Originally it was classified as a non-controlled substance but it was reclassified in 2014 to Schedule IV of the Controlled Substances Act with restrictions on its prescribing. Tramadol is an opioid (see Is tramadol an opioid?). 

A person's genetics can affect the pain-relieving properties of tramadol (see How do genetics affect tramadol?).

Tramadol uses
Tramadol is used for the management of moderate to moderately severe pain in adults, including postoperative pain (pain after surgery).

Tramadol treats pain severe enough to require opioids and may be used as an alternative to other forms of pain relief that did not relieve pain well enough or were not tolerated. 

Tramadol extended-release capsules may be used by adults who require around-the-clock treatment of their moderate to moderately severe chronic pain for an extended time.

Tramadol should not be used in children younger than 12 years old, or anyone younger than 18 years old with other risk factors (such as breathing problems), or who have recently had surgery to remove their tonsils or adenoids.

Extended-release tramadol (Ultram ER) should not be given to anyone younger than 18 years.
Is Tramadol an opioid?
Yes, tramadol is an opioid. The opioid activity of tramadol is due to its binding to mu-opioid receptors.

Tramadol side effects
Common side effects
The most common side effects of tramadol are:

nausea
constipation
dry mouth
drowsiness
dizziness
vomiting.
A person's genetics can affect their response to tramadol, including their risk of side effects (see How do genetics affect tramadol?).

Serious tramadol side effects and warnings
Tramadol may cause serious side effects, some of which may be fatal.

Tramadol can slow or stop your breathing and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep this medicine where others cannot get to it. Do not take more tramadol than prescribed as an overdosage can be fatal. Selling or giving away this medicine is against the law.

A person caring for you should give naloxone and seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you find it hard to wake up. Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.
Call your doctor at once if you have:
noisy breathing, sighing, shallow breathing, breathing that stops during sleep
a slow heart rate or weak pulse
a light-headed feeling, like you might pass out
seizure (convulsions) or
low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Seizures have been reported in patients taking tramadol. Your risk of seizures is higher if you are taking higher doses than recommended. Seizure risk is also higher in those with a seizure disorder or those taking certain antidepressants or opioid medications.

You should not take tramadol if you have severe breathing problems, a head injury or increased pressure inside your skull, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others). Tramadol should not be used if you are suicidal or prone to addiction.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing. People taking extended-release forms of tramadol should not consume alcohol-containing beverages at the same time. Alcohol is also not advised with immediate-release forms of tramadol.

Serious allergic reactions, including anaphylaxis, have occurred with tramadol, some of which caused death. People who are allergic to other opioids are at higher risk. Other hypersensitivity reactions include itching, hives, narrowing of the airways, swelling of the face and airways (angioedema), and serious skin reactions such as Stevens-Johnson Syndrome. Get emergency medical help if you have signs of an allergic reaction to tramadol (symptoms include hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, a red or purple skin rash that spreads and causes blistering and peeling).