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Ultram in detail
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About Ultram
How does Ultram work?
Talking to your doctor about Ultram
Before you take Ultram
Possible side-effects of Ultram
Dosage and administration
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How does Ultram work?

Ultram is either described as a synthetic opioid or as an atypical nonopioid. Thus, it does not occur naturally in nature or inside the body, but works in the same general way as the naturally produced opiates (for example, it is approximately 10% as potent as an equivalent dose of morphine). Ultram belongs to the aminocyclohexanol group of drugs which includes codeine. You can either take Ultram orally, or it can be injected into muscle or a vein. Like morphine, it is a centrally acting analgesic that works both by:

binding weakly to the opioid receptors in the brain; and
affecting Gamma-aminobutyric acid (GABA) a naturally occurring amino acid that inhibits the neurotransmitters in the brain.

The opioid receptors control the production of neurotransmitters from dopamine. When Ultram interacts, this slows down the manufacturing process. Normally, the resulting norepinephrine and serotonin are released into the central and sympathetic nervous system from the adrenal medulla. After you take Ultram, fewer neurotransmitters are released. The result is that the brain does not process the information from the central and sympathetic nervous system about pain either as quickly, or at all.

Ultram was initially developed as immediate-release drug requiring a repeat dose four or six times a day. More recently, an extended-release form has been developed that requires only one tablet a day for relief from light to moderate pain. To achieve its therapeutic effect, a certain minimum level of Ultram in the blood stream must be reached and maintained. The dosage therefore has to be adjusted depending on your body mass and the degree of pain you are experiencing to achieve steady state over the required period of time. There are a number of different factors to take into account. If you are going to take Ultram over several days or longer, you need to have a schedule to first gradually introduce Ultram into your body and then increase its level to steady state. Then, the drug level needs to be managed down again. Unless this process is managed with care, you may not get the relief as quickly as you had hoped and you may experience the adverse side-effects more often.