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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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

What special precautions should I follow?
Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine. Taking tramadol together with medic ines that are used during surgery or dental or emergency treatments may cause increased side effects.

If you think you or someone else may have taken an overdose of tramadol, get emergency h elp at once. Signs of an overdose include convulsions (seizures) and pinpoint pupils of the eyes.

What side effects may occur?
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

Why is this drug prescribed?
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.

Before Using This Medicine
Older adults¡XStudies in older adults show that tramadol stays in the body a little longer than it does in younger adults. Your doctor will consider this when deciding on your doses.

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


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