keep an eye on patients who request lots of refills of the new pain reliever Ultram (tramadol)

A year ago we suggested you keep an eye on patients who request lots of refills of the new pain reliever Ultram (tramadol).

Now there have been enough cases of dependence that the manufacturer recommends avoiding Ultram in patients who are opioid dependent...or have a history of dependence.

They're also finding a greater risk of anaphylactoid reactions in patients who are allergic to codeine and other opioids.

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