Before taking tramadol

You should not take tramadol if you have ever been addicted to drugs or alcohol, if you have ever attempted suicide, if you are currently intoxicated (drunk), or if you have recently used any of the following drugs:
alcohol;
narcotic pain medicine;
sedatives or tranquilizers (such as Valium);
medicine for depression or anxiety;
medicine for mental illness (such as bipolar disorder, schizophrenia); or
street drugs.
Seizures have occurred in some people taking tramadol. Your risk of a seizure may be higher if you have any of these conditions:
a history of drug or alcohol addiction;
a history of epilepsy or other seizure disorder;
a history of head injury;
a metabolic disorder; or
if you are also taking an antidepressant, muscle relaxer, or medicine for nausea and vomiting.
Talk with your doctor about your individual risk of having a seizure while taking tramadol.
If you have any of these other conditions, you may need a tramadol dose adjustment or special tests:
kidney disease;
liver disease;
a stomach disorder; or
a history of depression, mental illness, or thoughts of suicide.
FDA pregnancy category C. It is not known whether tramadol will harm an unborn baby. Tramadol may cause serious or fatal side effects in a newborn if the mother uses the medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Tramadol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Tramadol should not be given to a child younger than 18 years of age.

Important information about tramadol

You should not take tramadol if you have ever been addicted to drugs or alcohol.
Seizures (convulsions) have occurred in some people taking tramadol. You may be more likely to have a seizure while taking tramadol if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, or medicine for nausea and vomiting.
Seek emergency medical attention if you think you have used too much of this medicine. A tramadol overdose can be fatal. Overdose symptoms may include drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or coma. Tramadol may be habit-forming.
Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not take more than 300 milligrams of tramadol in one day. Never share tramadol with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
Tramadol may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop using tramadol suddenly, or you could have unpleasant withdrawal symptoms such as anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, or breathing problems. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
Do not crush the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.