Tramahexal SR



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Generic Name: tramadol
(TRAM a dol)

What is Tramahexal SR?

Tramahexal SR is a narcotic-like pain reliever.

Tramahexal SR is used to treat moderate to severe pain. Tramadol extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock.

Tramahexal SR may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Tramahexal SR?

You should not take Tramahexal SR if you have ever been addicted to drugs or alcohol.

Seizures (convulsions) have occurred in some people taking Tramahexal SR. You may be more likely to have a seizure while taking tramadol if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, or medicine for nausea and vomiting.

Take Tramahexal SR exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Do not take more than 300 milligrams of tramadol in one day.

Seek emergency medical attention if you think you have used too much of this medicine. A Tramahexal SR overdose can be fatal. Overdose symptoms of a tramadol overdose may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.

Tramahexal SR may be habit-forming and should be used only by the person it was prescribed for. Tramadol should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Tramahexal SR 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.

Do not stop using Tramahexal SR suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Do not crush the Tramahexal SR tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

What should I discuss with my healthcare provider before taking Tramahexal SR?

You should not take Tramahexal SR if you have ever been addicted to drugs or alcohol, if you are currently 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 Tramahexal SR. Your risk of a seizure may be higher if you have any of these conditions:

  • a history of drug or alcohol addiction
  • a history of epilepsy or other seizure disorder
  • a history of head injury
  • a metabolic disorder; or
  • if you are also taking an antidepressant, muscle relaxer, or medicine for nausea and vomiting.

Talk with your doctor about your individual risk of having a seizure while taking Tramahexal SR.

Before taking Tramahexal SR, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease
  • liver disease
  • a stomach disorder; or
  • a history of depression, mental illness, or suicide attempt.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Tramahexal SR.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tramahexal SR may also cause serious or fatal side effects in a newborn if the mother uses the medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Tramahexal SR can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Tramahexal SR should not be given to a child younger than 18 years of age.

How should I take Tramahexal SR?

Take Tramahexal SR exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label. Do not take more than 300 milligrams of tramadol in one day.

Take this medication with a full glass of water.

Tramahexal SR can be taken with or without food, but take it the same way each time.

Do not crush the Tramahexal SR tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body.Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

Do not crush, chew, break, or open a controlled-release, delayed-release, or extended-release tablet or capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

If you use the Tramahexal SR extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Tramahexal SR may be habit-forming. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor.

Do not stop using Tramahexal SR suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Store Tramahexal SR at room temperature away from moisture and heat.

Keep track of how many pills have been used from each new bottle of this medicine. Tramahexal SR is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. A Tramahexal SR overdose can be fatal.

Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma.

What should I avoid while taking Tramahexal SR?

Do not drink alcohol while you are taking Tramahexal SR. Alcohol may cause a dangerous decrease in your breathing when used together with tramadol.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Tramahexal SR. Tell your doctor if you regularly use any of these other medicines.

Tramahexal SR 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 are the possible side effects of Tramahexal SR?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Tramahexal SR and call your doctor at once if you have any of these serious side effects:

  • seizure (convulsions)
  • a red, blistering, peeling skin rash; or
  • shallow breathing, weak pulse.

Less serious side effects may include:

  • dizziness, drowsiness, weakness
  • nausea, vomiting, constipation, loss of appetite
  • blurred vision
  • flushing (redness, warmth, or tingly feeling); or
  • sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Tramahexal SR?

You may be more likely to have a seizure (convulsions) if you take Tramahexal SR while you are using certain other medicines. Do not take tramadol without telling your doctor if you also use any of the following medications:

  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or
  • an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).
  • Before taking Tramahexal SR, tell your doctor if you also use:

    • carbamazepine (Tegretol)
    • warfarin (Coumadin)
    • digoxin (Lanoxin, Lanoxicaps)
    • ketoconazole (Nizoral)
    • erythromycin (E-Mycin, E.E.S., Ery-Tab)
    • rifampin (Rifadin, Rimactane, Rifater)
    • St. John's wort
    • quinidine (Quinaglute, Quinadex, Cardioquin, Quinora); or
    • drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety).

    This list is not complete and there may be other drugs that can interact with Tramahexal SR. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

    Where can I get more information?

    Your pharmacist can provide more information about Tramahexal SR.


    Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

    Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.