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


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Precautions Before Using This Medicine
The presence of other medical problems may affect the use of tramadol. Make sure you tell your doctor if you have any other medical problems, especially:
- Abdominal or stomach conditions (severe )¡XTramadol may hide signs of other medical conditions
- Alcohol or drug abuse, or history of¡XMay increase the serious side effects of tramadol
- Head injury¡XTramadol can hide signs of other medical conditions
- Kidney disease or
- Liver disease¡XThe chance of side effects may be increased. Your doctor will consider this when deciding on your doses.
- Seizures¡XThe chance of convulsions (seizures) may be increased

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

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])¡XThe chance of convulsions (seizures) may be increased
- Carbamazepine (e.g., Tegretol)¡XMay decrease the effects of tramadol by decrea sing the amount of medicine in the body
- Central nervous system (CNS) depressants (medicines that cause drowsiness)¡XUsing these medicines with tramadol may increase the chance of serious side ef fects or increase the risk of convulsions (seizures)

How should this medicine be used?
Tramadol comes as a tablet to take by mouth. It usually is taken every 4-6 hours as needed. It may be taken with or without food. Follow the directions on your prescription label carefully, and ask yo ur doctor or pharmacist to explain any part you do not understand. Take tramadol exactly as directed.

Tramadol can be habit-forming. Do not take a larger dose, take it more often, or for a lo nger period than your doctor tells you to.

Description
Tramadol is used to relieve moderate to moderately severe pain. It also may be used to treat pain caused by surgery and chronic conditions such as cancer or joint pain.

Other medical problems
Before taking tramadol,

- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tramadol, call your doctor.
- if you a re having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol.
- you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
- remember that alcohol can add to the drowsiness caused by this drug.

Special warnings about this medication
This medicine will add to the effects of alcohol and other CNS depressants (medicine that causes drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other aller gies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental an esthetics. Do not drink alcoholic beverages, and check with your medical doctor or dentist before taking any of the medicines listed above while you are using this medicine.


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