Hi Donna,

Glad we can share our knowlage with you. I have had no stomach problems at all, the ultra long acting I take has no aceteminophen in it. Only the tramadol.....tramadol has no tylenol in it. tramacet has tylenol in it and it shuld not effect your BP but the tramadol may. But if you have not noticed any difference between before and after taking it then you should be able to take it. How often are you taking your bp at home???? are you monitering it or just at doc's. pain will make bp go up!!! only a little stress will do the same ! worrying about the meds will also bring up your bp!

I hope this is a good med for you it is a very good drug in my opinion.


I have info from the ultram er site...hope this is useful.

Indication
ULTRAM ER is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time.
Important Safety Information
ULTRAM ER is contraindicated in any situation where opioids are contraindicated, including a history of anaphylactoid reactions to opioids, and in patients who have previously demonstrated hypersensitivity to tramadol.
ULTRAM ER must be swallowed whole and must not be chewed, crushed, or split. Chewing, crushing, or splitting the tablet will result in the uncontrolled delivery of the opioid and could result in overdose and death. This risk is increased with concurrent abuse of alcohol and other substances.
Tramadol, like other opioids used in analgesia, can be abused.
Seizures have been reported in patients receiving tramadol. The risk of seizure is increased with doses of tramadol above the recommended range.
Concomitant use of tramadol increases the seizure risk in patients taking tricyclic antidepressants, selective serotonin reuptake inhibitors, or other opioids.
Tramadol may enhance the seizure risk in patients taking MAO inhibitors, neuroleptics, or other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections).
Do not prescribe ULTRAM ER for patients who are suicidal or addiction-prone.
ULTRAM ER should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers, antidepressants or sedative hypnotics. ULTRAM ER increases the risk of CNS and respiratory depression in these patients.
Administer ULTRAM ER cautiously in patients at risk for respiratory depression. In these patients nonopioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
Use ULTRAM ER cautiously in patients over 65 years of age due to the greater frequency of adverse events observed in this population.
ULTRAM ER should not be used in patients with severe renal (CrCl <30 mL/min) or hepatic (Child-Pugh Class C) impairment.
In clinical trials, the most frequently reported side effects in patients receiving ULTRAM ER and placebo, respectively, were dizziness (not vertigo, 15.9%-22.5% vs 6.9%), nausea (15.1%-25.5% vs 7.9%), constipation (12.2%-21.3% vs 4.2%), somnolence (7.3%-11.3% vs 1.7%), and flushing (7.7%-10.0% vs 4.4%).
ULTRAM ER should not be administered at a dose exceeding 300 mg per day.
Please see full Prescribing Information




Efficacy and safety of extended-release, once-daily tramadol in chronic pain: A randomized 12-week clinical trial in osteoarthritis of the knee.

Babul N, Noveck R, Chipman H, Roth SH, Gana T, Albert K. J Pain Symptom Manage. 2004;28:59-71.


Background

• Recent guidelines from the American Pain Society recommend "tramadol alone or in combination with acetaminophen or NSAIDs at any time during the treatment of OA when NSAIDs alone produce inadequate pain relief."[1]
• The clinical efficacy of immediate-release tramadol has been established in numerous studies in chronic pain states, including cancer pain, neuropathic pain, low back pain, and osteoarthritis,[1-10] and tramadol also provides additive analgesic effects when combined with NSAIDs.[8]
• The short duration of action of immediate-release tramadol requires dosing every 4-6 hours in order to maintain relief in chronic pain.[3]

Study Overview

• Twelve-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study, involving 246 patients ≥ 18 years of age with Functional Class I-III primary OA of the knee.
• Following a washout period of 2-7 days, subjects experiencing a pain intensity VAS score of ≥40 mm in the index joint were randomized to receive either extended-release tramadol (n=124) administered once a day in the morning or placebo (n=122).
• Extended-release tramadol treatment was initiated at 100 mg daily and increased to 200 mg daily as early as Day 4 and no later than Day 8, based on tolerability of treatment.
• After the first week, further increases to 300 mg or 400 mg extended-release tramadol daily were allowed, based on the adequacy of pain relief and the tolerability of side effects.
• NSAIDs and other analgesics were not permitted during either the washout or double-blind periods, except for acetaminophen up to 2000 mg per day for reasons other than for chronic pain, if absolutely necessary, and for no more than 3 consecutive days.
• Patients returned to the clinic for efficacy and safety evaluations at Week 1, Week 2, Week 4, Week 8, and Week 12, or at early termination.
• The primary endpoint of the study was the mean change from baseline in arthritis pain intensity VAS scores averaged over the 12-week study.
• Secondary endpoints included the affects of pain on sleep parameters measured by the following Chronic Pain Sleep Inventory assessments[11]:
  • "trouble falling asleep because of pain"
  • "need for sleeping medication to help you fall asleep"
  • "been awakened by pain during the night"
  • "been awakened by pain in the morning"
  • "overall quality of your sleep"
• Patients were also asked to record their pain intensity every day in a daily diary.

Findings

• Patients taking ULTRAM ER experienced a significantly greater mean change from baseline in Arthritis Pain Intensity VAS scores averaged over 12 weeks (30.4 mm vs 17.7 mm, least squares mean difference = 12.7 mm, P<0.001).
• Treatment differences in favor of ULTRAM ER were seen as early as the first return visit at week 1, when patients were receiving either a 100 mg or 200 mg dose.
• Analysis of data from patient daily diaries showed significant separation from placebo as early as day 1.
• Differences increased over time and persisted until week 12.
• When Chronic Pain Sleep Inventory scores were averaged over Weeks 1 to 12, patients taking ULTRAM ER experienced significantly greater improvements in: trouble falling asleep due to pain (P=0.016) compared to patients taking placebo (P=0.016), awakening by pain during the night (P=0.005) and in the morning (P=0.004), and overall quality of sleep (P=0.031).

Summary

• ULTRAM ER not only reduced chronic osteoarthritis pain intensity, but also improved a variety of outcome measures on the Chronic Pain Sleep Inventory.