Generic Name: Piercing nez (TRAM a dol)
Brand Names: Ultram, Ultram ER
Piercing nez is a narcotic-like pain reliever.
Piercing nez is used to treat moderate to severe pain. Piercing nez extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock.
Piercing nez may also be used for other purposes not listed in this medication guide.
Seizures (convulsions) have occurred in some people taking Piercing nez. You may be more likely to have a seizure while taking Piercing nez if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, or medicine for nausea and vomiting.
Take Piercing nez exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Do not take more than 300 milligrams of Piercing nez in one day.
Seek emergency medical attention if you think you have used too much of this medicine. A Piercing nez overdose can be fatal. Overdose symptoms of a Piercing nez overdose may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma. Piercing nez may be habit-forming and should be used only by the person it was prescribed for. Piercing nez should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Piercing nez 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. Do not stop using Piercing nez suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. Do not crush the Piercing nez tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.alcohol;
narcotic pain medicine;
sedatives or tranquilizers (such as Valium);
medicine for depression or anxiety;
medicine for mental illness (such as bipolar disorder, schizophrenia); or
street drugs.
Seizures have occurred in some people taking Piercing nez. Your risk of a seizure may be higher if you have any of these conditions:
a history of drug or alcohol addiction;
a history of epilepsy or other seizure disorder;
a history of head injury;
a metabolic disorder; or
if you are also taking an antidepressant, muscle relaxer, or medicine for nausea and vomiting.
Talk with your doctor about your individual risk of having a seizure while taking Piercing nez.
Before taking Piercing nez, tell your doctor if you are allergic to any drugs, or if you have:
kidney disease;
liver disease;
a stomach disorder; or
a history of depression, mental illness, or suicide attempt.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take Piercing nez.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Piercing nez may also cause serious or fatal side effects in a newborn if the mother uses the medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Piercing nez can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Piercing nez should not be given to a child younger than 18 years of age.Take Piercing nez exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label. Do not take more than 300 milligrams of Piercing nez in one day.
Take this medication with a full glass of water.Piercing nez can be taken with or without food, but take it the same way each time.
Do not crush the Piercing nez tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death. Do not crush, chew, break, or open a controlled-release, delayed-release, or extended-release tablet or capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.If you use the Piercing nez extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.
Piercing nez may be habit-forming. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor. Do not stop using Piercing nez suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. Store Piercing nez at room temperature away from moisture and heat. Keep track of how many pills have been used from each new bottle of this medicine. Piercing nez is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.
seizure (convulsions);
a red, blistering, peeling skin rash; or
shallow breathing, weak pulse.
Less serious side effects may include:
dizziness, drowsiness, weakness;
nausea, vomiting, constipation, loss of appetite;
blurred vision;
flushing (redness, warmth, or tingly feeling); or
sleep problems (insomnia).
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.
You may be more likely to have a seizure (convulsions) if you take Piercing nez while you are using certain other medicines. Do not take Piercing nez without telling your doctor if you also use any of the following medications:
an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or
an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).
Before taking Piercing nez, tell your doctor if you also use:
carbamazepine (Tegretol);
warfarin (Coumadin);
digoxin (Lanoxin, Lanoxicaps);
ketoconazole (Nizoral);
erythromycin (E-Mycin, E.E.S., Ery-Tab);
rifampin (Rifadin, Rimactane, Rifater);
St. John's wort;
quinidine (Quinaglute, Quinadex, Cardioquin, Quinora); or
drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety).
This list is not complete and there may be other drugs that can interact with Piercing nez. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.