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Mergency medical attention if you think you have used too much of this medicine. A Ultram overdose can be fatal. Symptoms of a Ultram overdose may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma. While you are taking Ultram, do not drink alcohol or use drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety). These drugs may slow your breathing or increase drowsiness when used together with Ultram. Ultram can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. What is Ultram? Ultram is a narcotic-like pain reliever. Ultram is used to treat moderate to severe pain. Ultram extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock. Ultram may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking Ultram? You should not take Ultram if you have ever been addicted to drugs or alcohol. Do not take Ultram if you are intoxicated (drunk), or if you have recently used any of the following drugs: alcohol; narcotic pain medicine; sedatives or tranquilizers (such as Valium); medicine for depression or anxiety; medicine for mental illness (such as bipolar disorder, schizophrenia); or street drugs. Seizures have occurred in some people taking Ultram. Your risk of a seizure may be higher if you have

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