PRECAUTIONS TO BE TAKEN
Tell your doctor your medical history, especially of: kidney disease, liver disease, seizure disorder, lung disease, history of drug or alcohol dependency, any allergies you may have. Limit alcohol as it may add to the dizziness or drowsiness effects caused by the drug. Because drug tramadol may make you dizzy/drowsy, use caution performing tasks requiring alertness such as driving. Caution is advised when using tramadol drug in the elderly because they may be more sensitive to the effects of the drug. Tramadol should be used only when clearly needed during pregnancy. Discuss the risks and benefits of Tramadol with your doctor. Tramadol is excreted into breast milk. Because the effects on a nursing infant are not known, consult your doctor before breast- feeding.

SIDE EFFECTS OF TRAMADOL
Tramadol may cause dizziness, weakness, incoordination, nausea or vomiting, stomach upset, constipation, headache, drowsiness, anxiety, irritability, dry mouth, or increased sweating. If any of these effects persist or worsen, inform your doctor. Notify your doctor if you develop any of these serious effects while taking tramadol drug: chest pain, rapid heart rate, skin rash or itching, mental confusion, disorientation, seizures, tingling of the hands or feet, trouble breathing. In the unlikely event you have an allergic reaction to Tramadol, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, breathing trouble. If you notice other effects not listed above, contact your doctor or pharmacist.

OVERDOSE
If overdose of Tramadol is suspected, contact your local poison control center or emergency room immediately.

DRUG INTERACTIONS
Tell your doctor of all prescription and nonprescription medications you may use, especially of: carbamazepine, narcotic pain relievers (e.g., codeine), drugs used to aid sleep, antidepressants (e.g., SSRI-types such as fluoxetine or fluvoxamine), MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine), psychiatric medicine (e.g., nefazodone), “triptan”-type drugs, anti-anxiety drugs (e.g., diazepam), sibutramine. Also, report use of certain antihistamines (e.g., diphenhydramine) which are also present in many cough-and-cold products. Do not start or stop any medication without doctor or pharmacist approval.

MISSED DOSE
If you miss a dose of Tramadol, take it as soon as rememberher corticosteroids (e.g., prednisone). If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not “double-up” the dose to catch up. Do not start or stop any medication without doctor or pharmacist approval.