Before using Tramadol

Before using Tramadol :

Some medical conditions may interact with Tramadol . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
if you are pregnant, planning to become pregnant, or are breast-feeding
if you are taking any prescription (especially depression medicines) or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you are allergic to codeine, a codeine-related medicine (eg, hydrocodone, dihydrocodeine, oxycodone), morphine, or a morphine-related medicine (eg, hydromorphone)
if you have a history of alcohol abuse, substance abuse, or suicidal thoughts or behaviors
if you have or recently have had any head injury, brain injury or tumor, increased pressure in the brain, or infection of the brain or nervous system
if you have a history of stomach or intestinal problems, asthma or other lung or breathing problems, epilepsy, seizures, or chronic inflammation or ulceration of the bowels
if you have had recent abdominal surgery
if you have heart problems, liver problems (eg, hepatitis), kidney problems, thyroid problems, enlargement of the prostate gland, or urinary problems

Some MEDICINES MAY INTERACT with Tramadol . Tell your health care provider if you are taking any other medicines, especially any of the following:
Carbamazepine because it may decrease Tramadol 's effectiveness and increase the risk of seizures
Certain medicines for mental or mood disorders (eg, olanzapine, haloperidol), cyclobenzaprine, isoniazid, other opioid pain medicine (eg, codeine, hydrocodone), phenothiazines (eg, promethazine), sleeping medicines (eg, zolpidem), sodium oxybate (GHB), tricyclic antidepressants (amitriptyline), or weight loss medicines (eg, phentermine) because side effects, including excessive drowsiness, trouble breathing, liver problems, or seizures, may be increased
Furazolidone, monoamine oxidase (MAO) inhibitors (eg, phenelzine), nefazodone, selegiline, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because they may cause serious and sometimes fatal reactions, including restlessness, fever, excessive sweating, confusion, twitching, and seizures
Oral anticoagulants (eg, warfarin) because its side effects, including bleeding, may be increased by Tramadol
Digoxin because the risk of side effects, including nausea, vomiting, or slow heartbeat, may be increased by Tramadol

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tramadol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.