Acetaminophen and Tramadol Brand Name – Ultracet
What is Acetaminophen and Tramadol
Acetaminophen and Tramadol is used orally for short-term (<= 5 days) management of acute pain.
Acetaminophen is a non-narcotic analgesic and tramadol is a centrally acting analgesic with a unique, dual mechanism of action.
Some studies have evaluated acetaminophen; tramadol for the treatment of chronic pain, such as osteoarthritis and low-back pain. In a 4-week study, pain relief scrores between acetaminophen; tramadol and acetaminophen; codeine were similar.
The primary advantage of Ultracet(R) appears to be a quicker onset of action than Ultram(R) and greater pain relief than either acetaminophen or tramadol given alone.
However, in oral surgical patients the analgesia produced by acetaminophen; tramadol was comparable to ibuprofen.
Ultracet was approved by the FDA August 15, 2001.
Indications
- diabetic neuropathy
- moderate pain
Side Effects
- abdominal pain
- acute generalized exanthematous pustulosis (AGEP)
- adrenocortical insufficiency
- agranulocytosis
- amenorrhea
- amnesia
- anaphylactic shock
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anxiety
- asthenia
- ataxia
- bronchospasm
- chest pain (unspecified)
- chills
- confusion
- constipation
- contact dermatitis
- depression
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dysphagia
- dyspnea
- edema
- elevated hepatic enzymes
- emotional lability
- encephalopathy
- erythema
- euphoria
- exfoliative dermatitis
- fatigue
- fetal death
- fever
- flatulence
- GI bleeding
- gonadal suppression
- hallucinations
- headache
- hemolysis
- hemolytic anemia
- hepatic failure
- hepatic necrosis
- hepatitis
- hepatotoxicity
- hot flashes
- hyperhidrosis
- hypertension
- hypertonia
- hyponatremia
- hypoprothrombinemia
- hypotension
- impotence (erectile dysfunction)
- infertility
- insomnia
- interstitial nephritis
- jaundice
- libido decrease
- maculopapular rash
- melena
- methemoglobinemia
- migraine
- miosis
- muscle cramps
- mydriasis
- nausea
- neonatal opioid withdrawal syndrome
- neutropenia
- nightmares
- oliguria
- orthostatic hypotension
- palpitations
- pancytopenia
- paranoia
- paresthesias
- physiological dependence
- pruritus
- psychological dependence
- pulmonary edema
- purpura
- QT prolongation
- rash
- renal failure (unspecified)
- renal papillary necrosis
- renal tubular necrosis
- respiratory arrest
- respiratory depression
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- Stevens-Johnson syndrome
- syncope
- thrombocytopenia
- thrombocytosis
- tinnitus
- tolerance
- torsade de pointes
- toxic epidermal necrolysis
- tremor
- urinary retention
- urticaria
- vertigo
- vomiting
- weight loss
- withdrawal
- xerostomia
Monitoring Parameters
- LFTs
- serum creatinine/BUN: in chronic use or acute toxicity
Contraindications
- abrupt discontinuation
- accidental exposure
- acetaminophen hypersensitivity
- acute abdomen
- acute intoxication of CNS depressants
- adenoidectomy
- adrenal insufficiency
- alcoholism
- anemia
- asthma
- biliary tract disease
- bone marrow suppression
- breast-feeding
- children
- coadministration with other CNS depressants
- constipation
- depression
- diarrhea
- driving or operating machinery
- ethanol ingestion
- ethanol intoxication
- G6PD deficiency
- geriatric
- GI disease
- GI obstruction
- head trauma
- hepatic disease
- hepatitis
- hepatotoxicity
- hypothyroidism
- ileus
- immunosuppression
- increased intracranial pressure
- infants
- infection
- labor
- MAOI therapy
- myxedema
- neonatal opioid withdrawal syndrome
- neonates
- neuromuscular disease
- neutropenia
- obesity
- obstetric delivery
- opiate agonist hypersensitivity
- pancreatitis
- potential for overdose or poisoning
- pregnancy
- pulmonary disease
- renal failure
- renal impairment
- respiratory depression
- respiratory infection
- seizure disorder
- seizures
- sleep apnea
- substance abuse
- suicidal ideation
- tonsillectomy
- ulcerative colitis
Interactions
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Abiraterone
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Alfentanil
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Almotriptan
- Alprazolam
- Amifampridine
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amiodarone
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxapine
- Amphetamine; Dextroamphetamine Salts
- Antacids
- Anticholinergics
- Apalutamide
- Apomorphine
- Aprepitant, Fosaprepitant
- Aripiprazole
- Artemether; Lumefantrine
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir; Cobicistat
- Atenolol; Chlorthalidone
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine
- Azelastine; Fluticasone
- Azilsartan; Chlorthalidone
- Baclofen
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Benztropine
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
- Brexpiprazole
- Brigatinib
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bumetanide
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Busulfan
- Butabarbital
- Butorphanol
- Candesartan; Hydrochlorothiazide, HCTZ
- Cannabidiol
- Capsaicin; Metaxalone
- Captopril; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Celecoxib
- Cenobamate
- Ceritinib
- Cetirizine
- Cetirizine; Pseudoephedrine
- Charcoal
- Chloral Hydrate
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroprocaine
- Chlorothiazide
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone
- Chlorthalidone; Clonidine
- Chlorzoxazone
- Cholestyramine
- Choline Salicylate; Magnesium Salicylate
- Cinacalcet
- Citalopram
- Clemastine
- Clobazam
- Clonazepam
- Clopidogrel
- Clorazepate
- Clozapine
- Cobicistat
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Crizotinib
- Cyclobenzaprine
- Cyproheptadine
- Dacomitinib
- Dantrolene
- Dapsone
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desvenlafaxine
- Deutetrabenazine
- Dexmedetomidine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Dicyclomine
- Diflunisal
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dolasetron
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Dronedarone
- Droperidol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Duloxetine
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Eletriptan
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Eltrombopag
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enalapril; Hydrochlorothiazide, HCTZ
- Enzalutamide
- Eprosartan; Hydrochlorothiazide, HCTZ
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esketamine
- Estazolam
- Eszopiclone
- Ethacrynic Acid
- Ethanol
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Ethotoin
- Everolimus
- Exenatide
- Ezogabine
- Fedratinib
- Fentanyl
- Flavoxate
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Fluvoxamine
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fosphenytoin
- Fostamatinib
- Frovatriptan
- Furosemide
- Gabapentin
- General anesthetics
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydantoins
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxyprogesterone
- Hydroxyzine
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Idelalisib
- Iloperidone
- Imatinib
- Indacaterol; Glycopyrrolate
- Indapamide
- Insulin Glargine; Lixisenatide
- Iobenguane I 131
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Isavuconazonium
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isosulfan Blue
- Istradefylline
- Ivacaftor
- Ketoconazole
- Lamivudine, 3TC; Zidovudine, ZDV
- Lamotrigine
- Lanthanum Carbonate
- Lapatinib
- Larotrectinib
- Lasmiditan
- Lefamulin
- Lemborexant
- Letermovir
- Levocetirizine
- Levomilnacipran
- Levorphanol
- Lidocaine
- Lidocaine; Prilocaine
- Linezolid
- Lisdexamfetamine
- Lithium
- Lixisenatide
- Lofexidine
- Lomitapide
- Loop diuretics
- Lopinavir; Ritonavir
- Lorazepam
- Lorcaserin
- Lorlatinib
- Loxapine
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Magnesium Salicylate
- Maprotiline
- Melatonin
- Mepenzolate
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Mepivacaine
- Mepivacaine; Levonordefrin
- Meprobamate
- Mesoridazine
- Metaxalone
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methocarbamol
- Methohexital
- Methscopolamine
- Methyclothiazide
- Methylene Blue
- Metoclopramide
- Metolazone
- Metyrapone
- Midazolam
- Milnacipran
- Mipomersen
- Mirabegron
- Mirtazapine
- Mitotane
- Molindone
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Nalmefene
- Naloxone
- Naltrexone
- Naproxen; Sumatriptan
- Naratriptan
- Nefazodone
- Netupitant, Fosnetupitant; Palonosetron
- Nilotinib
- Non-Ionic Contrast Media
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Ondansetron
- Opiate Antagonists
- Oritavancin
- Orphenadrine
- Osilodrostat
- Oxazepam
- Oxybutynin
- Oxycodone
- Oxymorphone
- Ozanimod
- Palbociclib
- Paliperidone
- Palonosetron
- Panobinostat
- Paroxetine
- Pazopanib
- Peginterferon Alfa-2b
- Penicillin G Benzathine; Penicillin G Procaine
- Penicillin G Procaine
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Perampanel
- Perindopril; Amlodipine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Phenytoin
- Pimozide
- Pneumococcal Vaccine, Polyvalent
- Posaconazole
- Potassium-sparing diuretics
- Pramipexole
- Pramlintide
- Prasugrel
- Pregabalin
- Prilocaine
- Prilocaine; Epinephrine
- Primidone
- Procarbazine
- Prochlorperazine
- Promethazine
- Propafenone
- Propantheline
- Propoxyphene
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Ramelteon
- Ranolazine
- Rasagiline
- Remifentanil
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Risperidone
- Ritonavir
- Rizatriptan
- Rolapitant
- Ropinirole
- Ropivacaine
- Rotigotine
- Rucaparib
- Safinamide
- Salsalate
- Scopolamine
- Secobarbital
- Segesterone Acetate; Ethinyl Estradiol
- Selpercatinib
- Serotonin-Receptor Agonists
- Sertraline
- Sibutramine
- Simeprevir
- Sodium Bicarbonate
- Sodium Oxybate
- Solifenacin
- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sulfinpyrazone
- Sumatriptan
- Suvorexant
- Tapentadol
- Tasimelteon
- Tazemetostat
- Tedizolid
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Temazepam
- Terbinafine
- Tetrabenazine
- Tetracaine
- Tezacaftor; Ivacaftor
- Thalidomide
- Thiazide diuretics
- Thiethylperazine
- Thiopental
- Thioridazine
- Thiothixene
- Ticagrelor
- Tizanidine
- tobacco
- Tolterodine
- Topiramate
- Torsemide
- Trazodone
- Triamterene
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimethobenzamide
- Trimetrexate
- Trospium
- Tucatinib
- Valproic Acid, Divalproex Sodium
- Vemurafenib
- Venlafaxine
- Vigabatrin
- Vilazodone
- Voriconazole
- Vortioxetine
- Voxelotor
- Warfarin
- Zaleplon
- Ziconotide
- Zidovudine, ZDV
- Ziprasidone
- Zolmitriptan
- Zolpidem
