Excessive intake of alcohol may increase the risk of induced hepatotoxicity; avoid or limit alcohol intake.
Caution is recommended when giving Ultradol to:
Patients with preexisting anemia;
Patients with hepatic or renal impairment, susceptible individuals, alcohol dependence;
Patients at risk for respiratory depression, patients with increased intracranial pressure or head injury;
Patients with epilepsy, those with a history of seizures, or patients with a recognized risk for seizure (e.g., head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections);
Patients dependent on opiate agonists or in patients who are chronically using opiate agonists;
Patients taking other CNS depressants (e.g., alcohol, anesthetic agents, phenothiazines, sedatives and hypnotics, other centrally acting analgesics, opiate agonists); selective serotonin-reuptake inhibitors (SSRIs), tricyclic antidepressants, other tricyclic compounds, or other opiate agonists, monoamine oxidase (MAO) inhibitors, antipsychotic agents, or other drugs that decrease the seizure threshold.
Naloxone administration in patients with tramadol overdose also may increase the risk of seizure.
Withdrawal symptoms may occur if Ultradol is discontinued abruptly.
The physicians need to warn the patients of the signs of serious skin reactions known as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) or Lyell’s syndrome, acute generalized exanthematous pustulosis (AGEP).
Ultradol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. This drug is not recommended for nursing mothers.
Ultradol reduces alertness, therefore, Ultradol should not been taken when driving, operating machinery and working on high.