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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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Cautions
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.

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

Possible Side Effect
Get emergency help immediately if any of the following symptoms of overdose occur:

- Convulsions (seizures); difficulty in breathing; pinpointed pupils of the eyes

Also, check wi th your doctor as soon as possible if any of the following side effects occur:

- Blisters under the skin; blurred vision ; change in walking and balance; convulsions (seizures); difficult urination; dizziness or lightheadedness when getting up from a lying or sitting position; fainting; fast heartbeat; frequent urge to urinate; loss of memory; numbness, tingling, pain, or weakne ss in hands or feet; seeing, hearing, or feeling things that are not there; severe redness, swelling, and itching of the skin; shortness of breath ;

Why is this drug prescribed?
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:

Before Using This Medicine
Children¡XThere is no specific information on the relationship of age to the effects of tramadol in patients less than 16 years of age.

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.


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