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Ultram ER may be habit-forming and withdrawal symptoms may occur with abrupt discontinuation of treatment. Symptoms of withdrawal from Ultram ER may include anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, or upper respiratory symptoms. Patients are advised against abrupt discontinuation of treatment with Ultram ER. According to the prescribing information, withdrawal symptoms may be reduced by appropriately tapering Ultram ER under the supervision of a health care provider. Patients should be advised that Ultram ER is intended for single-dose administration in a 24-hour period. The daily dose of Ultram ER should not exceed 300 mg per day. Doses that exceed what is recommended may result in respiratory depression, seizures and death.
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