Expert: Nigel Simmons - 4/18/2007

Question
Hi i was given Tramadl/Apap (Ultraset) last week for reaccurring headache and told that i wouldnt have sideeffects on my stomach... I took one pill on two seperate occassions and both time about or even six hours after taking got very sick to my stomach also got even worse headache after the pill wore off. Is it possiable that this med can cause even worse headaches and a sick stomach so long after taking it.. Thanks a ton.
Jen

Answer
Jeanne

Although the literature cites gastro-intestinal problems as rare, I think the problems you are experiencing is because the Tramadol (a synthetic opiate) is causing spasticity of the gut and potentially constipation. The headache is probably a reaction to the pain from the GI problems.

My suggestion would be to use plain Acetaminophen to it's maximum dose (1000mg in 24 hours) as that is often as effective as most combination analgesics. If this does not give sufficient relief, then you could add in a low dosage of a non-steroidal drug such as Ibuprofen.

If your pain persists, then it would be advisible to get a detailed review from a doctor or pain specialist. Other drugs may be appropriate in some cases, but equally physiotherapy or assessing posture and sleeping position may also help things improve.

I hope this helps.