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chance of convulsions (seizures) may be increased
- Abdominal or stomach conditions (severe)ˇXTramadol may hide signs of other medical conditions
- Alcohol or drug abuse, or history ofˇXMay increase the serious side effects of tram adol
- Head injuryˇXTramadol can hide signs of other medical conditions


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Tell your doctor if you have any other medical problems, especially:
- Kidney disease or
- Liver diseaseˇXThe chance of side effects may be increased. Your doctor will consider this when deciding on your doses.
- SeizuresˇXT

Inform your doctor if you are taking any of the following:
- Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], s elegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])ˇXThe chance of convulsions (seizures) may be increased
- Carbamazepine (e.g., Tegretol)ˇXMay decrease the effects of tramadol by decrea sing the amount of medicine in the body
- Central nervous system (CNS) depressants (medicines that cause drowsiness)ˇXUsing these medicines with tramadol may increase the chance of serious side ef fects or increase the risk of convulsions (seizures)

Other medical problems
Before taking tramadol,

- tell your doctor and pharmacist if you are allergic to tramadol, codeine, or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescri ption medications you are taking, especially other pain relievers; carbamazepine (Tegretol); MAO inhibitors [phenelzine (Nardil) or tranylcypromine (Parnate)]; medications for depression; quinidine; s leeping pills; tranquilizers; and vitamins.
- tell your doctor if you have or have ever had kidney or liver disease, a history of seizures, or a history of alcohol or drug abuse.

How should this medicine be used?
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Take tramadol exactly as directed.Tramadol comes as a table t to take by mouth. It usually is taken every 4-6 hours as needed. It may be taken with or without food.
Tramadol can be habit-forming. Do not take a larger dose, take it more often, or for a lon ger period than your doctor tells you to.

Side Effects of This Medicine
Although side effects from tramadol are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

- dizziness
- headache
- drowsiness
- blurred vision
- upset stomach
- vomiting
- diarrhea

If you experience any of the following symptoms, call your doctor immediately:

- fast heartbeat
- rednes s, swelling, and itching of the face
- numbness or tingling of the hands and feet
- difficulty breathing
- changes in urination
- seizures

Special warnings about this medication
This medicine may cause some people to become drowsy, dizzy, or lightheaded. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangero us if you are dizzy or are not alert.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help lesse n this problem.

Nausea or vomiting may occur, especially after the first couple of doses. This effect may go away if you lie down for awhile. However, if nausea or vomiting continues, check w ith your medical doctor or dentist. Lying down for a while may also help relieve some other side effects, such as dizziness or lightheadedness, that may occur.






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