Uses:
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.

How To Take This Medication:
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 your 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 longer period than your doctor tells you to.

Side Effects:
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

Precautions:

Before taking tramadol,

• tell your doctor and pharmacist if you are allergic to tramadol, codeine, or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other pain relievers; carbamazepine (Tegretol); MAO inhibitors [phenelzine (Nardil) or tranylcypromine (Parnate)]; medications for depression; quinidine; sleeping pills; tranquilizers; and vitamins.
• tell your doctor if you have or have ever had kidney or liver disease, a history of seizures, or a history of alcohol or drug abuse.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tramadol, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
• remember that alcohol can add to the drowsiness caused by this drug.

Drug Interactions: Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. 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 effects 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 chance of serious side effects or increase the risk of convulsions (seizures)

• Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], 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

Notes:
If you think that this medicine is not working as well after you have been taking it for a few weeks, do not increase the dose. Instead, check with your medical doctor or dentist.

Missed Dosage:
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Storage:

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store tramadol tablets in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.