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Tramadol can cause side effects that may impair your thinking or reactions. If you miss a dose of Ultracet, take it as soon as possible. Tramadol, like other narcotics used for the treatment of pain, may be abused. Opioids are effective for severe pain and do not because bleeding in the stomach or other parts of the body as can other types of pain relievers. If you feel the medicine is not working as well in relieving your pain. In the morning or walking through the grocery store. Ultram is a centrally acting synthetic analgesic compound that is not recommended if you are taking narcotic analgesics, or have a history of drug dependence, or are chronically using opioids, treatment with Ultram is not recommended, serious side effects can result. In the country.