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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What Is It
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.

Precautions Before Using This Medicine
Pregnancy—Although studies on birth defects have not been done in pregnant women, tramadol has not been reported to cause birth defects. In animal studies, there were drug-related birth defects observ ed. Studies done in animals given very high (toxic) doses resulted in lower than normal birth weights and some deaths in the fetuses and birth defects in some of the newborns.

How should this medicine be used?
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.

Precautions while Using this Medicine
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.

Other medical problems
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

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