The rules for use Ultram Don't use ultram if: * you are allergic to any ingredient in Ultram * you have severe diarrhea due to taking an antibiotic * you are intoxicated with alcohol, narcotics or other opioids (eg, morphine, codeine), sedatives or sleeping medicines (eg, temazepam, zolpidem), or other medicines * you are taking nefazodone, carbamazepine Before using Ultram : Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you : * if you are pregnant, planning to become pregnant, or are breast- * if you are taking any prescription (especially depression medicines) or nonprescription medicine, herbal preparation * dietary supplement or if you have allergies to medicines, foods, or other substances * if you are allergic to codeine, a codeine-related medicine (eg, hydrocodone, dihydrocodeine, oxycodone), morphine, or a morphine-related medicine (eg, hydromorphone) * if you have a history of alcohol abuse, substance abuse, or suicidal thoughts or behaviors * if you have or have recently had any head injury, brain injury or tumor, increased pressure in the brain, or infection of the brain or nervous system * if you have a history of stomach or intestinal problems, asthma or other lung or breathing problems, epilepsy, seizures, or chronic inflammation or ulceration of the bowels * if you have had recent abdominal surgery * if you have heart problems, liver problems (eg, hepatitis), kidney problems, thyroid problems, enlargement of the prostate gland, or urinary problems How to use Ultram : Ultram Use as directed by your doctor. Check the label on the medicine for exact dosing instructions. * Take Ultram by mouth with or without food. If you miss a dose of Ultram, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Important safety information: * Ultram may cause drowsiness and dizziness. These effects may be worse if you take it with alcohol or certain medicines. Ultram Use with caution. Do not drive or perform other tasks possibly unsafe until you know how you react to it. * Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Ultram. it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness. * Ultram may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit or stand up slowly, especially in the morning. Sit or lie down at the first sign of this effect. * Tell your doctor or dentist that you take Ultram before you receive any medical or dental care, emergency care, or surgery. * Use with caution in the ELDERLY; they may be more sensitive to its effects. * Ultram should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed. * PREGNANCY and BREAST-FEEDING : Ultram has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Ultram while you are pregnant. Ultram is found in breast milk. Do not breast-feed while taking Ultram.