Learn about Ultracet (Tramadol Hydrochloride and Acetaminophen Tablets) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications. CONTENTS: Information is provided about pain prevalence and etiology in renal failure patients. In addition, the use of anti-inflammatory drugs, opioid analgesics and adjuvant drugs for pain management is addressed. Posology. The recommended dosage is one film-coated tablet (corresponding to 75 mg of tramadol hydrochloride and 25 mg of dexketoprofen). Additional doses can be taken as needed, with a minimum dosing interval of 8 hours. This warning has caused concern amongst veterinarians. Many veterinarians (myself included) have prescribed metacam to many cats and have never seen a case of renal failure related to the drug. Review of Data. Nonopioid options. Nonopioids, such as acetaminophen and NSAIDs, have no associated tolerance but have a ceiling effect for analgesia, and NSAIDs are associated with dose-dependent acute renal failure, gastrointestinal ulceration and bleeding, and cardiac events. Tramadol is used primarily to treat mild to severe pain, both acute and chronic. Its analgesic effects take about one hour to come into effect and 2 to 4 h to peak after oral administration with an immediate-release formulation. 1 Use of opioids in Patients with Impaired Renal Function Dr Jane Neerkin, Dr Mary Brennan, Dr Humeira Jamal Great care is required when prescribing opioids to patients with impaired renal function. Learn about Ultram (Tramadol Hcl) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications. Tramadol hydrochloride, USP is a white, bitter, crystalline and odorless powder. It is readily soluble in water and ethanol and has a pKa of 9.41. Tramadol hydrochloride extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.