Ultram Use in Pregnancy and Breastfeeding

Ultram is also known as tramadol, its generic drug name, and as Ultram ER, its extended release version. Ultram is, in essence, an opiate-acting pain relief medication that can ease moderate to moderately severe pain by blocking the transmission of pain sensations right at the opioid receptors in the brain. There are several possible uses of Ultram since it can be used to treat pain related to any condition at all. However, there are some instances when the many benefits of Ultram should be bypassed for the sake of safety. There are at least two situations where this applies: during pregnancy and during the breastfeeding period. Women who are pregnant or nursing infants are not exempt from the pain conditions that plague the rest of the population. The major difference is that, while majority of the rest of the population can benefit from the efficacy of Ultram in pain relief, pregnant women and nursing mothers have to consider a greater list of precautions and warnings before they can take Ultram.

Precautions and Warnings to Pregnant Women

Ultram, as studies showed, can easily penetrate the placental barrier and affect the fetus. The study showed that there was an umbilical and maternal vein serum concentration ratio of only 0.83. Some studies revealed that there is a big possibility of causing harm to the fetus too. These studies have so far involved only animals, wherein results showed that the drug caused embryotoxicity as well as fetotoxicity. No controlled studies on the effects of the drug on pregnant female humans have been conducted, so the results of the animal studies as well as particular actual cases make up the basis for the FDA’s categorizing of Ultram under pregnancy category C. However, doctors do not readily prescribe Ultram to pregnant women because there are some actual cases wherein the neonate suffered from withdrawal symptoms because the mother was on a long term Ultram treatment plan. The withdrawal symptoms were noticed around 35 hours after the babyw as born. Withdrawal symptoms in babies include trembling, high-pitched crying, and an abnormal pattern of sleeping. Prescibing Ultram for pregnant women can only be done in two conditions: first, that the need for the drug is higher than the risks it poses, and second, that the pregnant woman are informed of all the risks involved and she agrees to the Ultram medication.

Precautions and Warnings to Nursing Mothers

There is strong evidence backing up the fact that Ultram passes into breast milk. Studies determined that detectable levels of tramadol, which is referring to 12 mcg/L, were found in breastmilk collected 10 hours following an Ultram dosage. This means that if a nursing mother consumed Ultram for treatment of her pain, a small percentage of the total dosage are excreted into human milk. This small part of the total dosage is deemed insignificant and is not believed to have any effects on the nursing infant. It also has a relatively shorter half-life of 7 hours. There is, however, one difference when it comes to the effects of Ultram on breastfeeding. Infants who reached their full term are relatively healthier and are thus less prone to side effects of Ultram. Side effects are stronger, however, in cases involving premature infants. If the child experiences breathing dificulties, unusual sleepiness, and limpness, these effects should be brought immediately to a doctor. There are studies backing up the compatibility claim between Ultram and breastfeeding. One particular study showed that even though there are some minor side effects that are detected, the drug is not likely to have an effect on the development of the infant. The drug was also found to increase the production of serum prolactin, although this is not known to have any effects on a mother’s ability to breastfeed. On the other hand, different studies also seem to yield different results, which add to the confusion. In one particular study, seventy five infants who were breastfed by their mothers medicating on Ultram were compared to seventy five infants who were breastfed with milk completely free from Ultram. The study, which is based on the results of a person’s Neurologic and Adaptive Capacity Score, showed that there is no difference between these two groups in terms of development. Due to the confusing results in the studies, health experts took the safer road and refrained from recommending Ultram for use by mothers who are breastfeeding. If pain medications are urgently needed, there are a couple of pain relieving drugs that can also be considered as alternatives.