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Renal Dose Adjustments Immediate-release: -CrCl less than 30 mL/min: Dosing interval should be increased to every 12 hours; maximum dose should not exceed 200 mg per day Extended-release: -CrCl less than 30 mL/min: Use is not recommended.
As a result of the metabolism of Ultram in the liver, by CYP 2D6 and CYP 3A4, there are potential drug interactions. Drug interactions are possible with the concomitant administration of Ultram with medications that are CYP 2D6 and CYP 3A4 inhibitors, such as ketoconazole, erythromycin, quinidine, fluoxetine, paroxetine and amitriptyline.
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