Ultram (tramadol) is a medicine classified as narcotic-like pain reliever that can be used to relieve different kinds of pain. It's most often prescribed for chronic pain and can be used by people that need to keep their pain under control on the round the clock basis. Mild side effects of Ultram are sometimes possible. These can include any of the following symptoms: sleep problems, weakness, vomiting, nausea, constipation, drowsiness, flushing, loss of appetite, or dizziness. More serious side effects are unlikely but you still need to be aware of the possibility of getting weak pulse, hallucinations, peeling skin rash, seizure, or shallow breathing. In case of getting any of the serious side effects mentioned, make sure you consult your doctor right away. This medicine may form a habit, which is why people with a history of some addictions are never supposed to take this medicine to avoid forming another addiction to it. If you need to stop the treatment - it's best to do so gradually. Never start taking any other medications while still on Ultram, as interactions are possible. The following are the drugs that have been reported to interfere with Ultram: rifampin, carbamazepine, erythromycin, pain medications, depression or anxiety meds, cold medicine, ketoconazole, warfarin, St. John's wort, and muscle relaxants.