Works very well for my acute back muscle pull. This is the most debilitating and painful injury I've experienced. I had to take a second one four hours after the first but since then I have had no problem maintaining at least a six hour interval. I haven't experience any insomnia but I have gotten nausia, dizziness, and profuse sweats near the end of the six hour interval between pills. I think this is due to an empty stomach and the ultracet. The prescription doesn't say so but I highly recommend taking this medication with food and keeping at least some food in your stomach. After eating a small snack of cheese crackers (starch) the nausiness went away.
I've seen some posts on this board that refer to taking two pills at once. You should not do this unless it is prescribed to you by the physician. Ultracet's web site explicitly states not to take two pills within a four hour window. If the prescribed medication dosage does not work for you please go back and consult your doctor rather than altering the dosage rate.