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Tramadol HCL / Ultram

- Discussion:
    - centrally acting agent used to manage moderately severe pain;
    - low potential for abuse;
    - comparable efficacy to Tylenol #3;
    - no anti-inflammatory activity and no interference with prostaglandin synthesis (which makes it safe
           for patients who are at risk for ulcer formation or who are at risk for renal failure);

- Dose:
    - 50-100 mg PO q4-6 hr prn;
    - maximum dose should not exceed 400 mg/day;

- Cautions:
    - constipation, nausea, dizziness, HA, and/or vomiting may occur in 10-30% of patients, but these symptoms
           often resolve after the first week

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