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Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie. |
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01-19-2007, 07:07 PM | #11 | ||
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This is just coming off the top of my head- I need to look it up to make sure- but I think that tramadol is the generic form of Ultram (in the US), which doesn't contain acetaminophen. The tramadol that does have aceta. is called Ultracet (name brand) here and the generic name for the form with Aceta. is called tramadol/APAP. That's what I use for pain. I'm looking at my bottle right now and it says, "this medication contains acetaminophen. Taking more acetaminophen than recommended may cause serious liver problems". |
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01-19-2007, 07:20 PM | #12 | |||
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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
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How poor are they who have not patience! What wound did ever heal but by degrees. . |
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01-19-2007, 07:21 PM | #13 | ||
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Do you have a problem with stomach pain/nausea with your med? Have you found any way to minimize that? Take care, Donna |
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01-19-2007, 07:27 PM | #14 | ||
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Victoria, we posted at the same time! Thanks so much for the info..maybe it wouldn't be a good choice with the bp issues. I had just discovered, also, that the tramadol affects blood pressure. Never had hypertension until the last 6-8 months, so I'm not used to thinking about it!
I'll talk to the doc about it...maybe my system's oversensitive to it with the stomach issues. Wonder if the ER would make a difference there. Thanks again, though, for all the info and discussion! Take care, Donna Last edited by Donna7; 01-19-2007 at 10:58 PM. Reason: grammar |
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01-19-2007, 07:29 PM | #15 | |||
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more info on the drug.............................................. ............................ Most Common Adverse Events (%) Reported in Clinical TrialsAdverse Events100 mg QD(N=403)200 mg QD (N=400)300 mg QD (N=400)Placebo (N=406)Dizziness (excl. vertigo)1620237Nausea1523268Constipation1217214Som nolence81172Flushing81094
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 Most Common Adverse Events (%) Reported in Clinical TrialsAdverse Events100 mg QD (N=403)200 mg QD (N=400)300 mg QD (N=400)Placebo (N=406)Dizziness (excl. vertigo)1620237Nausea1523268Constipation1217214Som nolence81172Flushing81094
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 Analgesic drugs are associated with limitations that may hamper their use. NSAIDs, COX-2 inhibitors, and opioids all play an important role in chronic pain management, but can potentially inhibit successful treatment in certain patient types. NSAIDS NSAIDs, which are among the most widely prescribed drugs for a variety of conditions, are associated with gastrointestinal, renal, and cardiovascular-related safety concerns:
Although COX-2 inhibitors were developed as gastrointestinally safer alternatives to NSAIDs, their use has raised concerns with other safety issues, as evidenced by the withdrawal of rofecoxib[3]
Opioids are associated with safety risks and prescribing concerns such as:
In a survey conducted among 2,000 general practitioners in the United Kingdom to determine their prescribing patterns for analgesics in patients with osteoarthritis,[6] the majority of physicians (69%) reported that their main therapeutic objective was to control pain without GI side effects. The findings of this study, however, suggest that a conservative approach to use of NSAIDs may have resulted in suboptimal pain management in patients with OA:
The chronic pain treatment ladder below incorporates recommendations by the American Pain Society, the American College of Rheumatology, and the World Health Organization. Patients presenting with moderate chronic pain may already have tried non-prescription analgesics for mild pain (acetaminophen or NSAIDs, such as aspirin or ibuprofen). These patients can be initiated on ULTRAM ER. Early initiation of ULTRAM ER for the treatment of moderate to moderately severe pain can reduce the number of NSAID rotations that patients experience and provide earlier pain control.
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 References
Patients may be eligible to receive UP TO $25 off their out-of-pocket expenses for each of 3 ULTRAM ER prescriptions.
* Eligibility Criteria (1) The ULTRAM ER Extended-Savings Card is not valid for patients participating in Medicaid, Medicare, or any other federal or state programs (including any state prescription drug program). (2) Card is limited to one (1) per patient for up to 3 uses and is not transferable. (3) Offer good only in the US at retail pharmacies and cannot be redeemed at government-subsidized clinics. This offer is valid in Massachusetts for cash-paying customers only (ie, those who do not have any prescription coverage). (4) Ortho-McNeil, Inc. reserves the right to rescind, revoke, or amend this offer without notice. (5) The selling, purchasing, trading, or counterfeiting of this card is prohibited by federal law, and such activities may result in imprisonment for not more than 10 years or fines not more than $250,000 or both. (6) Patients must understand and agree to comply with the terms and conditions of this offer as set forth above. 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 http://www.medscape.com/infosite/ultramer/#question you have to join, but it is no pay so just join and get the info!!! hope this helps if you have more questions please feel free to email or pm me I will be happy to help you and answer what questions if I can!! take care, love and hugs, Victoria
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How poor are they who have not patience! What wound did ever heal but by degrees. . |
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01-19-2007, 08:00 PM | #16 | ||
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01-19-2007, 08:07 PM | #17 | |||
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red,
I too hate the aspects of elavil and lyrica and baclofen.....I find it effects the most important parts of my life....as does the pain, but it effects my relations with my boyfriend and myself....as well as the pain causing mood swings and snapping at him angry for no reason.....silly stuff but seems huge at the time, I guess I focus on the little things to try to get away from the pain and suffering....trying to refocus attention need to try to do it in a more positive way!!! I hate the sleepyness and the fact that if I want to get pregnant I will have to come off all the meds as they effect the baby all of them!!!!!!!!!!!!!!!!!!! Damn is ever going to hurt but I suppose it will be worth it!!!! The effects are life altering but having a child when you have chronic pain may not be a good idea....have to think long and hard about this one...definatly want a child...would adopt for sure.....but the life changes..picking up child....etc....couldn't pick up a baby carrier or pull a stroller out of the trunk of my car......need I go on?????? anyhow point is I can relate and concur with your assessment of the hate we feel for the aspects of med side effects!! take care, Victoria
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How poor are they who have not patience! What wound did ever heal but by degrees. . |
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01-19-2007, 09:40 PM | #18 | ||
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01-19-2007, 10:10 PM | #19 | |||
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Hi Red,
thanks that was nice! I agree things do have a way of working out and Marc loves me enough I know that we were only together for 3 mths when all this happened so I guess he knew what he was in for being a doctor....or not....nobody really expects an injury at work to last for five years....hmmmmm oh well...can't wait to have children I am 32 now so.....thinking and seeing babies and clothes as well as those little shoes....oohhhhhhhhh I willl find a way you are right, I always seem to find a way and if women in wheel chairs with greater disability than I can do it.....then I damn well will FIND a way!! just have to come off the drugs! Thanks again take care all love and hugs red! Victoria
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How poor are they who have not patience! What wound did ever heal but by degrees. . |
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01-19-2007, 11:04 PM | #20 | ||
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