Central nervous system (CNS) depression and respiratory depression may occur; risk increases with the coadministration of other CNS depressants. Consult with your doctor or pharmacist before starting new therapy with any prescription, non-prescription or herbal product.
Increased risk of seizures may occur if taken with selective serotonin reuptake inhibitors (SSRIs — fluoxetine, sertraline, paroxetine, etc.), tricyclic antidepressants (such as amitriptyline, nortriptyline, etc.), neuroleptics, or monoamine oxidase inhibitors (MAOIs — phenelzine, etc.). See recommendation above regarding consultation with doctor or pharmacist.
Inform your doctor if you currently experience seizures or have a history of seizures.
Elderly patients with chronic respiratory disorders are at increased risk for adverse reactions.
May impair alertness required for certain tasks (such as operation of machinery, driving, etc.).
Caution in patients with increased intracranial pressure or head injury.
Use caution and reduce dose in patients with liver disease, kidney, thyroid, or adrenal dysfunction.
Tolerance or drug dependence may occur.
Abrupt discontinuation should be avoided.
DRUG INTERACTIONS
Amphetamines, cimetidine, tricyclic antidepressants, SSRIs, linezolid, MAOIs, naloxone, neuroleptics, opioids, quinidine, carbamazepine, warfarin, digoxin.
This drug is metabolized by a specific set of liver enzymes (cytochrome P450 enzymes 2D6). Several other drugs interfere with these liver enzymes, and thus may increase or decrease the clearance of tramadol from the body,
potentially increasing the risk of side effects or decreasing effectiveness. When these drugs are given in combination with tramadol, dosage adjustments may be needed.
As these are too numerous to list, you should always check with your doctor or pharmacist prior to starting a new medication, herbal, or non-prescription product.
FOOD INTERACTIONS
Alcohol
HERBAL INTERACTIONS
Valerian, St. John’s wort, kava kava, gotu kola
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category C. Excreted in breast milk. Consult your doctor.
SPECIAL INFORMATION
Withdrawal symptoms may occur if tramadol is discontinued abruptly. Do not take products which contain alcohol.
