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

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Tramadol - Pain Relief
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Tell your doctor if you have any other medical problems, especially:
- Kidney disease or
- Liver disease—The chance of side effects may be increased. Your doctor will consider this when deciding on your doses.
- Seizures—T
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)—May decrease the effect s of tramadol by decreasing the amount of medicine in the body
- Central nervous system (CNS) depressants (medicines that cause drowsiness)—Using 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])—The chance of convulsions (seizures) may be increased

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.

What special precautions should I follow?
Breast-feeding—Tramadol passes into breast milk and may cause unwanted effects in nursing babies. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be su re you have discussed the risks and benefits of the medicine with your doctor.

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.

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

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 )—Tramadol may hide signs of other medical conditions
- Alcohol or drug abuse, or history of—May increase the serious side effects of tramadol
- Head injury—Tramadol can hide signs of other medical conditions
- Kidney disease or
- Liver disease—The chance of side effects may be increased. Your doctor will consider this when deciding on your doses.
- Seizures—The chance of convulsions (seizures) may be increased