What Is Ultracet?

Ultracet is a prescription medication for treating patients’ moderate to severe pain. It is a combination medication that contains tramadol and acetaminophen to reduce pain. Tramadol is the narcotic-like substance present in Ultracet. Tramadol is a synthetic version of codeine, meaning the chemical structure is similar; however, it’s meant to have a lower chance of addiction. Tramadol binds to pain receptors, decreasing a person’s awareness of pain. When combined with acetaminophen tablets, tramadol’s potency increases.

Common side effects associated with Ultracet include: 

  • Nausea
  • Vomiting
  • Constipation
  • Lightheadedness
  • Dizziness
  • Drowsiness
  • Sweating

These side effects do not require immediate medical attention and should go away with time, except for constipation, which persists as long as you take the opioid. Let your doctor or pharmacist know if other symptoms persist or worsen.

Serious side effects of Ultracet include mood changes, agitation, hallucinations, severe stomach or abdominal pain, difficulty urinating and signs of your adrenal glands not working well, such as loss of appetite, unusual tiredness and weight loss. If they arise, report these serious side effects to your doctor immediately.

Seek medical attention as soon as possible if you notice any of the following severe Ultracet side effects: fast or irregular heartbeat, severe dizziness, fainting, seizures and signs of an allergic reaction such as rashes, itching, swelling and trouble breathing. Always inform a doctor of any current or recent medications taken. Ultracet may negatively react to certain antidepressants and other opioid agonists, increasing the risks of side effects.

How Is Ultracet Used?

Ultracet should only be taken as directed by your doctor. Ultracet should be taken orally every four to six hours as needed for pain relief. This medication can be taken with or without food. If you have nausea, taking Ultracet with food may be beneficial.

Keep in mind your Ultracet dosage is based on your medical condition and response to treatment. Do not adjust your Ultracet treatment schedule without explicit instruction from your doctor.

This medication works best if taken as the first signs of pain occur. Ultracet may not work as efficiently if you wait until the pain has worsened to use it.

Ultracet Addiction

Taking Ultracet as directed will lower the chances of misuse; however, people who take the medication, with or without a prescription, will eventually develop a tolerance and possibly become dependent. Someone struggling with addiction will have strong cravings for Ultracet due to the chemical imbalance that opioids cause.

Once a person builds a tolerance for Ultracet, the standard dosage will no longer have the same effects, which often results in the person taking more to achieve the feeling of euphoria. Taking Ultracet in higher amounts without medical consent increases the chances of seizures, side effects and addiction.

If someone is addicted to Ultracet, they may mix it with other substances, like alcohol, to strengthen the effects.

Signs, Symptoms and Side Effects of Ultracet Abuse

Side effects that might occur while taking Ultracet include:

  • Constipation
  • Lightheadedness
  • Sweating
  • Nausea
  • Drowsiness
  • Vomiting

Speak with a doctor and discontinue Ultracet use if any severe side effects occur, such as:

  • Severe abdominal pain
  • Loss of appetite
  • Mental/mood changes such as hallucinations or irritability
  • Confusion
  • Slowed breathing
  • Muscle weakness

If side effects persist or worsen, seek medical attention immediately.

Opioids like Ultracet alter how the brain responds to pain signals. When Ultracet is taken for a long period, the natural chemical balance is tampered with, making it hard for the brain to produce pain-blocking chemicals without opioid assistance.

This chemical imbalance usually causes withdrawal symptoms and can affect a person’s long-term recovery.

Ultracet Withdrawal and Detox

If you no longer want to take Ultracet to treat your pain, meet with your doctor to discuss tapering off the medication. Gradually lowering your Ultracet dose over time will give your body time to adjust to less of the medication and avoid severe withdrawal. Do not abruptly stop taking Ultracet, as this will greatly enhance your risk for withdrawal symptoms.

Common Ultracet Withdrawal Symptoms

Possible Ultracet withdrawal symptoms include:

  • Runny nose
  • Sweating
  • Tearing up
  • Yawning
  • Muscle and body aches
  • Trouble sleeping
  • Anxiety
  • Restlessness
  • Agitation
  • Racing heart rate
  • Hypertension
  • Fast breathing
  • Chills and goosebumps
  • Stomach pain and cramping
  • Diarrhea
  • Vomiting
  • Loss of appetite
  • Pupil dilation
  • Difficulties concentrating or thinking clearly
  • Irritability
  • Drug cravings
  • Depression
  • Depersonalization
  • Psychosis

Ultracet Withdrawal Timeline and Symptom Durations

On average, patients experiencing Ultracet withdrawal will notice withdrawal symptoms within 12 hours of their last dose. These withdrawal symptoms usually subside after a few days, although everyone experiences withdrawal differently. This timeline may be shorter or longer based on factors unique to the individual, such as age, genetics, level of Ultracet dependence and more.

Ultracet Overdose Signs

The effects of an Ultracet overdose can take effect within hours. Ultracet is a powerful central nervous system depressant, so it makes sense that the clear sign of an overdose from this medication is severe respiratory depression. Roughly speaking, Ultracet is as potent as codeine and is approximately one-tenth as powerful as morphine.

The tramadol component of Ultracet acts directly on the brainstem. The brainstem controls the autonomic urge to breathe by triggering respiration when carbon dioxide levels in the blood become elevated. High doses of tramadol suppress this mechanism, potentially leading to carbon dioxide toxicity and hypoxia (oxygen deprivation).

Pinpoint pupils and severely decreased levels of consciousness are the other two primary signs of opioid overdose. Together, they make what is called the “opioid overdose triad.” Pupils become maximally constricted and unresponsive even to light. The pupils will eventually become fully dilated as the patient deteriorates due to oxygen deprivation.

A severely decreased level of consciousness is defined as extreme lethargy that quickly progresses to stupor and coma. Other adverse effects of Ultracet overdose can include: 

  • A weak pulse
  • Peeling skin rash
  • Seizures
  • Hallucinations
  • Agitation Rapid heart rate
  • Diarrhea
  • Fainting
  • Poor coordination
  • Nausea
  • Vomiting

Because Ultracet also contains acetaminophen, it is also possible to overdose on that component of the drug. Signs of an acetaminophen overdose include flu-like symptoms in the early stages within the first 24 hours, followed by yellow skin and eyes, blood in the urine, confusion and unresponsiveness within 96 hours. 

An Ultracet overdose is a medical emergency. If you think someone has overdosed on Ultracet, call 911 immediately.

Frequently Asked Questions

Can You Take Ultracet While Pregnant?

The answer falls into somewhat of a gray area, but for the most part, taking Ultracet while pregnant is not advisable. Ultracet’s active ingredients are in two separate FDA pregnancy categories. Tramadol is a category C drug, while acetaminophen is a category B drug throughout each trimester of pregnancy. 

The FDA created categories based on current research to indicate the possible safety or risks of taking drugs while pregnant. Category A drugs are the safest to use during pregnancy. According to available research, category A drugs haven’t shown harm in animal or human studies if used during pregnancy. Category B drugs are considered fairly safe as well. Category C drugs have shown the potential to harm a fetus in animal studies. Category C drugs typically don’t have any well-controlled human studies assessing their safety or risks. Doctors will weigh the possible risks and benefits of a category C drug like tramadol before prescribing it to a pregnant woman.

How Much Ultracet to Overdose?

Ultracet comes in oral tablets containing 37.5 mg of tramadol and 325 mg of acetaminophen. The maximum single dosage of acetaminophen allowed by the Federal Drug Administration (FDA) is 325 mg. Ultracet should not be taken for more than five consecutive days. The initial dose of Ultracet should not exceed two tablets every four to six hours as needed for pain relief. Patients should not take more than eight tablets of Ultracet per day.

The amount of Ultracet necessary to overdose will vary between patients. Factors influencing the likelihood of overdose include the patient’s age, weight, overall physical health, genetic tendencies, kidney and liver function and opioid tolerance. Patients with impaired kidney function should not exceed two tablets every 12 hours. Individuals with impaired liver function may also require reduced doses due to the increased likelihood of liver complications.

How Long Does Ultracet Stay In Your Urine, Hair and Blood?

Some rough estimates of how long Ultracet can be found in hair, urine and blood include:

  • Urine: Ultracet may be found in a urine sample up to one to four days after the last dose.
  • Hair: A 1.5-inch hair sample can contain traces of Ultracet up to 90 days after the last dose.
  • Blood: Ultracet may be found in blood samples up to 4–10 hours after the last dose.

If you or someone you know is struggling with Ultracet addiction or another substance use disorder, seek professional help as soon as possible.

Is Ultracet Safe With Alcohol?

Mixing alcohol with Ultracet dramatically increases the risk of serious complications. The combination of alcohol and tramadol contributes to alcohol and opioid toxicity in the blood and liver. Alcohol and tramadol conflict in the liver, resulting in extended clearance times and elevated plasma concentrations of both substances. This increases the risk of life-threatening respiratory depression, coma and death. Acetaminophen amplifies these risks by further taxing the liver’s metabolic processes. Liver damage is the primary risk factor of the combined use of acetaminophen and alcohol.

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Editor – Theresa Valenzky
Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

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Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.