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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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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

What Is It
Tramadol is used to relieve pain, including pain after surgery. The effects of tramadol are similar to those of narcotic analgesics. Although tramadol is not classified as a narcotic, it may become ha bit-forming, causing mental or physical dependence.

Tramadol is available only with your doctor's prescription, in the following dosage form:

Precautions Before Using This Medicine
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 you take this medication?
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.

Before Taking 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

When you are taking tramadol, it is especially important that your health care provider know if you are taking any of the following:

- Carbamazepine (e.g., Tegretol)¡XMay decrease the effect s of tramadol by decreasing the amount of medicine in the body
- Central nervous system (CNS) depressants (medicines that cause drowsiness)¡XUsing these medicines with tramadol may increase the ch ance of serious side effects or increase the risk of convulsions (seizures)
- Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e .g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])¡XThe chance of convulsions (seizures) may be increased


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