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About Nigel Simmons
Expertise
I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised. Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner. I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question. Consider.. would you want me to discuss your care with a friend or relative without your knowledge?

Experience
Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire.
Past/Present clients
Previously Sysop on CompuServe UK Professionals forum.

You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > side effects of ultraset

Topic: Pharmacy

Expert: Nigel Simmons
Date: 5/14/2008
Subject: side effects of ultraset

Question
QUESTION: hi, my doc recently scripted me for ultraset. i am 5'10 and215 lbs, with anatural high tolerance for pain meds and someother stuff. i have arthritis in both my hands, oh yeah,i'm 36 years old. i was on utram a long time ago and it had a bad side effect with me. havent had the problem since,until recently with the ultraset. no where can i find this problem in any literature. hopefully if you can,you will share. the only side effect this has on me is.................................... i cant orgasm. i'd almost live with the pain in order tohave successful sex with my wife. can you help explain this?

ANSWER: Jay

I suspect that the bad experiences you had with Ultram were due to the tramadol it contains. Moving to Ultraset which also contains tramadol (all be it at a slightly lower dose). Given that tramadol has a high possibility of inducing dependency, it would not be my first choice of analgesia. A non-steroidal anti-inflammatory such as ibuprofen, naproxen or diclofenac would be more appropriate, ideally used only when pain is severe to avoid ulceration and bleeding which can develop with regular use. Plain acetaminophen is ideal for low level pain.

With regard to your sexual problems, there is no obvious cause from tramadol or acetaminophen, so these themselves may not be the cause. Most sexual problems (lack of erection, failure to ejaculate/orgasm etc.) have a high psychological component, and the anxiety becomes a self-fulfiling prophecy.

Assuming there is no underlying medical problem which would prevent their use, drugs such as Viagra may be helpful for some individuals, and can be a positive reassurance that normal intercourse can be achieved, However, it may only need to be used for a short time to "kick start" performance and induce a more positive state of mind.

Drugs such as Viagra can also have a duration of action which can persist through the day, and while priapism (permanent erection) is not common, further erections are possible with minimal stimulation. Both could obviously cause embarassment, and priapism can be a serioius problem if not resolved.

Whenever there are sexual problems, it is also important for partners to be supportive and encouraging. Dissatisfaction only reinforces the negative perception. So if everything your wife could do would be helpful. Consider spontaneous love making, sex games etc. As married adults, you can really do as you like in your own home. The one thing to avoid is alcohol, as it can have a very depressant effect, and I would suggest avoiding eating large meals in the hours before lovemaking. Better that your blood flow can be directed to aid an erection rather than digesting a meal.

I hope this helps.

---------- FOLLOW-UP ----------

QUESTION: ok, i understand your explination.naproxen didnt work for my pain. going thru the motions finding something to work. we have been together for 6 years,married for 1.5. this is a very recent problem,its not lack of erection ( because she definately makes that happen), only ejaculation. only happened 3 times, since this week, like i said the only time this ever happened before, was when i was on ultram, again i understand theres no link, but its my only thought. if it persists then viagra or something will be checked into. my wife is fixed, so pregnancy isnt an issue. we have great sex and games. the only thing different in my life is my medication. there is nothing else we can up up with.

Answer
Jay

Firstly, as you can achieve an erection Viagra will be of no additional benefit, so there is no need to explore it further.

Whether there is some unusual reaction to tramadol causing the problem, or just the belief that it caused problems in the past and is doing so again, I can't be sure. However, you could try not taking a dose of Ultraset towards the end of the day and see if that helps. You can always take the dose after intercourse so that your pain is kept in control.

I can't make any promises, but it's worth trying before seeking advice from a doctor.

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