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    Tramadol ER, Tramadol Hydrochlorideer, Tramadol Hcl ER

    Generic Ultram, Conzip, Qdolo

    Tramadol (TRA ma dole) is a generic medication prescribed for moderate to severe pain in adults. Tramadol belongs to a group of drugs called opioid pain relievers.

    Medically reviewed by Amber Watson, PharmD on May 30, 2023
    Written by Sarah Lewis, PharmD

    This article describes tramadol’s uses, side effects, and more. Below you’ll also find some coupon options to help save on the cost of tramadol.

    This article doesn’t provide coupons for all forms of tramadol. To find coupons for tramadol oral tablet, see this article.

    Boxed warnings

    Tramadol oral tablet and extended-release (ER)* oral tablet have boxed warnings, which are the most serious warnings from the Food and Drug Administration (FDA). These include:

    * With extended-release tablets, the drug is released over time in your body after you take it.

    For details, see the “Interactions and warnings for tramadol” section below.

    Side effects of tramadol

    Tramadol may cause mild or serious side effects. More common mild side effects of tramadol and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

    To learn more about tramadol’s side effects, see this article or ask your doctor or pharmacist. You can also read the prescribing information* for tramadol.

    * To view tramadol’s prescribing information, see the “Article resources” section below.

    Mild side effects

    More common mild side effects reported with some forms of tramadol are listed below.

    This article doesn’t include all possible mild side effects of the drug. To learn more about tramadol’s side effects based on the form, see the prescribing information* for tramadol.

    With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

    Tramadol oral tablet and extended-release† oral tablet’s mild side effects include:

    * To view tramadol’s prescribing information, see the “Article resources” section below.
    † With extended-release tablets, the drug is released over time in your body after you take it.
    ‡ For details about this side effect, see the “Interactions and warnings for tramadol” section below.

    Serious side effects

    Serious side effects of tramadol are listed below.

    This article doesn’t include all possible serious side effects of the drug. To learn more about tramadol’s side effects based on the form, see the prescribing information* for tramadol.

    With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

    In general, tramadol’s serious side effects include:

    * To view tramadol’s prescribing information, see the “Article resources” section below.
    † For details about this side effect, see the “Interactions and warnings for tramadol” section below.

    Common questions about tramadol

    Below you’ll find answers to a few commonly asked questions about tramadol.

    Is tramadol a ‘narcotic’? Can it cause withdrawal?

    Yes, tramadol is a narcotic drug (also known as an opioid drug). Opioids are controlled substances that treat moderate to severe pain.

    Tramadol can cause withdrawal in people who are dependent on it. Withdrawal can happen when people who are dependent on a drug stop taking it suddenly. Being dependent means your body needs the drug to function as usual.

    If you have questions or concerns about taking tramadol, talk with your doctor or pharmacist. 

    Can tramadol be used for dogs?

    Yes, veterinarians can use tramadol for dogs and other animals. They sometimes use human medications to treat conditions in animals.

    However, it’s important that you do not give a dog tramadol that’s been prescribed for human use. You’ll only give tramadol to a dog if it’s been prescribed by a veterinarian.

    To learn more about the use of tramadol in animals, talk with your dog’s veterinarian.

    How does tramadol compare with oxycodone or Toradol?

    Similar to tramadol, oxycodone and Toradol are pain relievers.

    Oxycodone (Oxycontin, Roxicodone, Roxybond, and Xtampza ER) is an opioid pain reliever. It has many of the same side effects and warnings as tramadol. But it’s more potent than tramadol, so it has a higher risk of misuse and addiction.* (With misuse, you take a drug in a way other than how a doctor prescribes it. With addiction, a drug is taken even if doing so causes harm.)

    Toradol was the brand-name version of ketorolac, but brand-name Toradol is no longer available in the United States. Ketorolac is prescribed for moderate to severe pain, similar to tramadol. But it’s a nonsteroidal anti-inflammatory (NSAID) drug. So it has different side effects and warnings than tramadol. Since it isn’t an opioid drug, Toradol doesn’t have a risk of misuse or addiction.

    Talk with your doctor if you think tramadol isn’t relieving your pain. They can prescribe a different pain reliever that might work better.

    * Tramadol has a boxed warning for misuse and addiction. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Interactions and warnings of tramadol” section below.

    Is it safe to take tramadol with ibuprofen or Tylenol?

    Yes, it’s safe to take tramadol with ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol). In fact, doctors often recommend this combination.

    Taking tramadol with either of these two drugs can relieve pain more effectively. This usually means people don’t need to take as much tramadol, which lowers the risk of misuse and addiction.* (With misuse, you take a drug in a way other than how a doctor prescribes it. With addiction, a drug is taken even if doing so causes harm.)

    Talk with your doctor about taking ibuprofen or Tylenol with tramadol. They’ll advise whether it’s safe for you to take these medications.

    * Tramadol has a boxed warning for misuse and addiction. A boxed warning is the most serious warning from the FDA. For details, see the “Interactions and warnings of tramadol” section below.

    How does tramadol work? And how long does it take to start working?

    Tramadol is an opioid medication. So it attaches to opioid receptors in the brain and spinal cord. (Receptors are binding sites on cells.) This causes tramadol’s pain-relieving effects.

    Tramadol oral tablet will start to work within an hour. It’ll reach its peak pain relief in about 3 hours. Due to its half-life, you’ll take your dose every 4 to 6 hours. (A drug’s half-life is about how long it takes your body to get rid of half of a dose.)

    Tramadol extended-release oral tablet will last longer. (With extended-release tablets, the drug is released over time in your body after you take it.) You’ll take a dose once every 24 hours.

    To find out more about what you can expect with tramadol, ask your doctor or pharmacist.

    Does tramadol increase the risk of side effects in older adults?

    Yes, certain older adults (ages 75 and older) may have a higher risk of side effects from tramadol compared with younger adults (under 65 years of age).

    In studies* of the drug, adults 75 years and older were more likely to have treatment-limiting side effects. This means the side effects were serious enough to limit the dose or length of their treatment. In some cases, they had to stop treatment.

    The most common treatment-limiting side effects were digestive problems, including constipation. Slowed breathing is also a serious risk for older adults. (Tramadol has a boxed warning for serious breathing problems. A boxed warning is the most serious warning from the FDA. For details, see the “Interactions and warnings of tramadol” section below.)

    If you’re an older adult and concerned about taking tramadol, talk with your doctor or pharmacist.

    * For details about tramadol’s studies, see its prescribing information in the “Article resources” section below.

    Dosage of tramadol

    The dosage of tramadol your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

    Taking tramadol

    Tramadol oral tablet is swallowed, with or without food.

    Tramadol extended-release (ER)* oral tablet is swallowed, with or without food. Your doctor will likely recommend taking the drug in the same way each day, either always with food or always without food. This is because food can affect how quickly the drug works. And taking it the same way each day helps the drug provide steady pain relief over time.

    Be sure to swallow the ER oral tablet whole. Do not crush, chew, break, or dissolve it. Doing so could result in a fatal overdose.

    Your doctor will talk with you about how to take tramadol. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

    * With extended-release tablets, the drug is released over time in your body after you take it.

    Overdose of tramadol

    You should not take more tramadol than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

    If you think you’ve taken too much tramadol, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

    Uses of tramadol

    The Food and Drug Administration (FDA) approves prescription drugs such as tramadol for certain conditions. Approved uses for tramadol are described below.

    Use for pain

    Doctors may prescribe tramadol oral tablet and extended-release (ER)* oral tablet for treating moderate to severe pain. It’s used for this purpose in adults. Tramadol oral tablet can be prescribed as a long-term or short-term treatment. Tramadol extended-release oral tablet is a long-term treatment for chronic pain.

    With moderate to severe pain, you may have pain that’s hard to ignore. And it may affect your daily activities. Doctors prescribe tramadol for pain caused by various conditions, such as injury or surgery. In these cases, an opioid pain reliever is needed.

    Doctors may not prescribe tramadol oral tablet and ER oral tablet in certain situations, such as if:

    * With extended-release tablets, the drug is released over time in your body after you take it.
    † Tramadol has a boxed warning for misuse and addiction. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Interactions and warnings of tramadol” section below.

    Interactions and warnings for tramadol

    Below, you’ll find information about tramadol’s possible interactions and warnings.

    Interactions of tramadol

    Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.*

    Before you take tramadol, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

    • prescription medications
    • over-the-counter medications
    • vitamins, herbs, or supplements

    To learn about drug-condition interactions, see the “Warnings for tramadol” section below.

    * Tramadol has a boxed warning for the risk of interactions with certain medications. It also has a boxed warning about the risk of interactions with benzodiazepines and other central nervous system depressants. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see “Warnings for tramadol” below.

    Warnings for tramadol

    Some people should not take tramadol, and others should take it cautiously.

    Boxed warnings

    Tramadol has boxed warnings about the following risks. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

    To learn more about these warnings, read below. You can also talk with your doctor or pharmacist.

    Risk of misuse and addiction. With misuse, you take tramadol in a way other than how a doctor prescribes it. An example is taking it when you aren’t in pain or taking it more often than you should.

    Misuse can lead to addiction, which is continuing to take a drug even though it may be causing harm.

    Symptoms of addiction may include craving the drug and taking the drug to cope with problems.

    If you experience misuse or addiction, tell your doctor. They’ll likely recommend ways to get help.

    Risk of serious breathing problems. With serious breathing problems, such as respiratory depression, you have slowed or stopped breathing. It can be fatal.

    The risk is highest when you first start tramadol treatment and after a dosage increase. The risk is also higher in older adults (ages 65 and older).

    If you experience serious breathing problems, seek immediate medical care or call 911 or a local emergency number.

    Risk of accidental ingestion. With accidental ingestion, you accidentally take tramadol. This can lead to an overdose, which can be fatal. Accidentally taking tramadol can be especially dangerous in children. (For details about overdose with tramadol, see the “Dosage of tramadol” section above.)

    Symptoms may include slowed breathing, small pupils, cold and clammy skin, extreme sleepiness, and coma.

    If you experience an accidental ingestion, seek immediate medical care or call 911 or a local emergency number.

    Note: Tramadol is not approved for use in children.

    Risk of life threatening side effects in children. If your child takes tramadol, they may have a high risk of life threatening side effects, including slowed or stopped breathing. The risk is even higher with certain factors, including if your child:

    • metabolizes (breaks down) the drug faster than usual, leading to high levels of a more active form of the drug in the body
    • has lung disease, obesity, sleep apnea (a serious sleep disorder), or a nervous system disease that affects breathing
    • has surgery to remove the tonsils or adenoids (glands in the roof of your mouth)
    • taking other medications that can slow breathing

    If your child is experiencing life threatening side effects, seek emergency help by calling 911 or a local emergency number.

    Due to the above risks, doctors will likely not prescribe tramadol in children younger than 12 years. And they may not prescribe tramadol for children ages 12–17 years who have the risk factors listed above.

    Note: Tramadol is not approved for use in children. But doctors may prescribe the drug off-label for children. This means they can prescribe the drug for children even though it’s not approved for this use.

    Risk of neonatal withdrawal syndrome. With neonatal opioid withdrawal syndrome, a newborn experiences withdrawal symptoms after birth. This is because they were exposed to the drug in the womb before birth. And they were dependent on it. With dependence, your body needs a drug to function as usual.

    Symptoms in newborns may include tremor (shaking), a high-pitched cry, diarrhea, or vomiting. These and other symptoms of withdrawal can be fatal.

    If you become pregnant while taking tramadol, tell your doctor. They’ll help you decide if you should continue taking tramadol.

    Risk of interactions with certain medications. If you take tramadol with certain medications, dangerous drug interactions can occur. This includes drugs that affect how your body processes and gets rid of tramadol.

    Symptoms may include serious side effects, such as slowed breathing or seizures. Withdrawal symptoms, such as anxiety, nausea, vomiting, or diarrhea, may also occur.

    If you have concerns about interactions with certain medications, tell your doctor. They’ll likely adjust your treatment.

    Risk of interactions with benzodiazepines and other central nervous system depressants. If you take tramadol with benzodiazepines and other central nervous system (CNS) depressants, coma and death may occur. CNS depressants slow brain activity. Benzodiazepines, alcohol, and many other substances are CNS depressants. Taking them with tramadol can slow brain activity too much, which can be fatal.

    Symptoms may include slowed or stopped breathing, loss of consciousness, and coma. Death can also occur.

    If you have concerns about interactions with benzodiazepines and other CNS depressants, tell your doctor. They’ll likely recommend that you stop taking your other CNS depressants while taking tramadol.

    Other warnings

    Tramadol could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether tramadol is a safe option for you. These warnings may differ based on the form of tramadol you take.

    Ask your doctor about specific warnings for tramadol, and be sure to tell your doctor about your:

    • current health, including any allergies to medications
    • past health conditions or surgeries

    Allergic reaction

    Tramadol can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

    If you’ve had an allergic reaction to tramadol or any of its ingredients, your doctor will likely not prescribe tramadol. They can tell you about medications that are safer options for you.

    A mild allergic reaction may cause the following symptoms:

    A severe allergic reaction may cause the following symptoms:

    • severe skin rashes that may blister and peel
    • swelling under your skin, usually in your hands, feet, eyelids, or lips
    • swelling of your mouth, throat, or tongue, which can cause breathing problems

    If you have an allergic reaction to tramadol, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

    Pregnancy or breastfeeding and tramadol

    Information about tramadol and pregnancy and breastfeeding is described below.

    Tramadol and pregnancy

    There are risks to taking tramadol during pregnancy. There’s a boxed warning for risk of neonatal withdrawal syndrome. A boxed warning is the most serious warning from the FDA. (For more details, see the “Warnings for tramadol” section just above.) There are also risks with having untreated moderate to severe pain while pregnant. (Keep in mind that tramadol is prescribed for treating moderate to severe pain.)

    If you’re planning a pregnancy or can become pregnant, talk with your doctor about moderate to severe pain treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether you should take tramadol during pregnancy.

    Tramadol and breastfeeding

    Tramadol should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with tramadol.

    Tramadol coupon

    You may be able to save money on your prescription for tramadol by using our Perks discount coupons. They can be found at the end of this article.

    If you have questions about how to pay for tramadol, talk with your doctor or pharmacist. You can also learn more about the cost of tramadol in this article.

    Note: Optum Perks coupons cannot be used with insurance copays or benefits.

    What to ask your doctor

    This article describes tramadol’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about tramadol or would like more details about it.

    Here’s a list of some possible questions you may want to ask your doctor:

    • Is tramadol available as a brand name?
    • Does tramadol make you sleepy?
    • Is there a best time of day to take tramadol extended-release oral tablet?

     Article resources

    Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

    • Brand
    • Tablet Extended Release 24 HR
    • 100mg
    • 7 Tablets

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    Name

    Tramadol Extended-Release Capsules and Tablets

    Pronunciation

    (TRA ma dole)

    Brand Names: US

    ConZip

    Warning

    For all patients taking this drug: This drug is a strong pain drug that can put you at risk for addiction, abuse, and misuse. Misuse or abuse of this drug can lead to overdose and death. Talk with your doctor. You will be watched closely to make sure you do not misuse, abuse, or become addicted to this drug. This drug may cause very bad and sometimes deadly breathing problems. Call your doctor right away if you have slow, shallow, or trouble breathing. The chance of very bad and sometimes deadly breathing problems may be greater when you first start this drug or anytime your dose is raised. Even one dose of this drug may be deadly if it is taken by someone else or by accident, especially in children. If this drug is taken by someone else or by accident, get medical help right away. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor. This drug has an opioid drug in it. Severe side effects have happened when opioid drugs were used with benzodiazepines or other drugs that may make you drowsy or slow your actions. This includes slow or troubled breathing and death. Benzodiazepines include drugs like alprazolam, diazepam, and lorazepam. Benzodiazepines may be used to treat many health problems like anxiety, trouble sleeping, or seizures. If you have questions, talk with your doctor. Many drugs interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs. Do not take with alcohol or products that have alcohol. Unsafe and sometimes deadly effects may happen. Get medical help right away if you feel very sleepy, very dizzy, or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up. Children: This drug is not approved for use in children. Do not give to a child younger than 12 years of age. Children between 12 and 18 years of age who are very overweight or have certain other health problems like sleep apnea or other lung or breathing problems must not use this drug. If your child has been given this drug, ask the doctor for information about the benefits and risks. Some children have had very bad and sometimes deadly breathing problems when using tramadol after surgery to remove tonsils or adenoids. Do not give to a child younger than 18 years of age who has had surgery to remove tonsils or adenoids. Talk with your child's doctor.

    What is this drug used for?

    It is used to ease pain.

    What do I need to tell my doctor BEFORE I take this drug?

    If you have an allergy to tramadol or any other part of this drug. If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had. If you have any of these health problems: Lung or breathing problems like asthma, trouble breathing, or sleep apnea; high levels of carbon dioxide in the blood; or stomach or bowel block or narrowing. If you have any of these health problems: Kidney disease or liver disease. If you have thoughts of suicide or if you have ever had alcohol or other drug abuse or dependence. If you have been told by your doctor that you are a rapid metabolizer of some drugs. If you have recently drunk a lot of alcohol or taken a big amount of drugs that may slow your actions like phenobarbital or some pain drugs like oxycodone. If you are taking carbamazepine. If you are taking another drug that has the same drug in it. If you are taking any of these drugs: Buprenorphine, butorphanol, nalbuphine, or pentazocine. If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen. If you are taking any of these drugs: Linezolid or methylene blue. If you are breast-feeding. Do not breast-feed while you take this drug. This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

    What are some things I need to know or do while I take this drug?

    Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists. Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs. Very bad and sometimes deadly allergic side effects have rarely happened. Talk with your doctor. Do not take more than what your doctor told you to take. Taking more than you are told may raise your chance of very bad side effects. Do not take this drug with other strong pain drugs or if you are using a pain patch without talking to your doctor first. This drug may raise the chance of seizures. The chance may be higher in people who have certain health problems, use certain other drugs, or drink a lot of alcohol. Talk to your doctor to see if you have a greater chance of seizures while taking this drug. If you have been taking this drug for a long time or at high doses, it may not work as well and you may need higher doses to get the same effect. This is known as tolerance. Call your doctor if this drug stops working well. Do not take more than ordered. Long-term or regular use of opioid drugs like this drug may lead to dependence. Lowering the dose or stopping this drug all of a sudden may cause a greater risk of withdrawal or other severe problems. Talk to your doctor before you lower the dose or stop this drug. You will need to follow your doctor’s instructions. Tell your doctor if you have more pain, mood changes, thoughts of suicide, or any other bad effects. Long-term use of an opioid drug may lead to lower sex hormone levels. Call your doctor if you have a lowered interest in sex, fertility problems, no menstrual period (women), or change in sex ability (men). Taking an opioid drug like this drug may lead to a rare but very bad adrenal gland problem. Call your doctor right away if you have very bad dizziness or passing out, very bad upset stomach or throwing up, or if you feel less hungry, very tired, or very weak. If you are 65 or older, use this drug with care. You could have more side effects. This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away.

    What are some side effects that I need to call my doctor about right away?

    WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. Signs of depression, suicidal thoughts, emotional ups and downs, abnormal thinking, anxiety, or lack of interest in life. Very bad dizziness or passing out. Feeling confused. Seizures. Chest pain or pressure or a fast heartbeat. Trouble passing urine. Passing urine more often. Noisy breathing. Breathing problems during sleep (sleep apnea). Change in eyesight. Severe constipation or stomach pain. These may be signs of a severe bowel problem. A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache. A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

    What are some other side effects of this drug?

    All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: Feeling dizzy, sleepy, tired, or weak. Diarrhea or constipation. Dry mouth. Headache. Itching. Upset stomach or throwing up. Trouble sleeping. Flushing. Sweating a lot. These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely. Take by mouth only. Do not inject or snort this drug. Doing any of these things can cause very bad side effects like trouble breathing and death from overdose. Swallow whole. Do not chew, break, crush, or dissolve before swallowing. Doing these things can cause very bad side effects and death. Take this drug with or without food. Some products need to be taken the same way each time, either always with food or always without food. Be sure you know how to take your product with regard to food. If you are not sure how to take your product with regard to food, talk with your doctor or pharmacist. Take this drug at the same time of day. Do not use for fast pain relief or on an as needed basis. Do not use for pain relief after surgery if you have not been taking drugs like this drug. If you have trouble swallowing, talk with your doctor.

    What do I do if I miss a dose?

    Take a missed dose as soon as you think about it. If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    Store at room temperature in a dry place. Do not store in a bathroom. Store this drug in a safe place where children cannot see or reach it, and where other people cannot get to it. A locked box or area may help keep this drug safe. Keep all drugs away from pets. Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    If your symptoms or health problems do not get better or if they become worse, call your doctor. Do not share your drugs with others and do not take anyone else's drugs. This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

    Consumer Information Use and Disclaimer

    This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

    This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.