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These medications may potentially reduce the metabolism of Ultram and increase the risk for serious adverse reactions, including seizures and serotonin syndrome. In patients with hepatic dysfunction, such as advanced cirrhosis of the liver, the metabolism of Ultram is reduced. According to the prescribing information, in patients who have cirrhosis of the liver, adjustment of the Ultram dosing regimen is recommended. The usual recommended dose of Ultram is 50 mg to 100 mg administered as needed for pain every four to six hours. In patients with cirrhosis of the liver, the recommended dose is 50 mg administered as needed for pain every 12 hours.
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