My RD took me off Tylenol last summer and replaced it with Ultram ER.

I've had no noticeable side effects in the 8 months I've been taking
it
(with breakfast and the other meds).

... AuH2O -- If you know what that means, you ARE old!

I've used Ultram for about 8 years for OA, RA, PPS and FM pain.  I
tried the Ultram ER and didn't like the way it worked- for me.  It
seemed to hit me hard right after I took the dose and wore off too
soon. I felt "muzzy-headed" with the ER... more so than usual.  ;-)  I
went back to the regular ol' Ultram and am better off with it.  After
all these years, if I take a dose after about 4 p.m. I will be up at
least half the night with insomnia.

Hope you find some relief.

Leslie

I haven't taken the ER version, but have been on the ordinary version for
about 3 years now.  I like it, but it doesn't knock pain out as much as tylox
or tylenol 3 does.  For me, it's a good balance - it reduces pain enough that
I can function more, but not so much that I overdo and end up really
suffering when the medicine wears off.  I haven't had any noticeable side
effects from the regular tramadol (generic ultram).

I can't really say much about when to take it, as I am not on the ER.  Also,
that's something that may vary with each person - you'll probably want to
take it so you can expect it to be at peak levels in your system at the time
of day that is usually most painful for you.

I love it - but - make sure there is something in your stomach before you
take it or you'll take some interesting "trips" without going anywhere.

DeeTee

never heard of ultram er..i take regular ultram...4 times a day..and
it helps quite a bit...when the pain is even worse i take some
percocet but its not that often that i need to take it(and he doesnt
give me very much lol)
i have had no side effects from ultram at all....and i have a very
sensitive system since i also have crohns colitis and
fibromyalgia...along with the osteoarthritis...
good luck to you
annie