Tramadol extended-release tablets

What are Tramadol extended-release tablets?
Tramadol is used to treat pain in adults. The medicine is for pain that lasts for more than a few days. The medicine is not for use on an as needed basis.

What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
�brain tumor
�drug abuse or addiction
�head injury
�heart disease
�if you frequently drink alcohol-containing drinks
�kidney disease or problems going to the bathroom
�kyphoscoliosis
�liver disease
�lung disease, asthma, or breathing problems
�seizures
�stomach problems
�taken isocarboxazid, phenelzine, tranylcypromine, or selegiline in the past 2 weeks
�an unusual reaction to tramadol, other medicines, foods, dyes, or preservatives
�pregnant or trying to get pregnant
�breast-feeding

How should this medicine be used?
Take this medicine by mouth with a glass of water. You may take with food, but always take the medicine either with food or without food. Do not break, crush, or chew the medicine. Do not take a tablet that is not whole. A broken or crushed tablet can be very dangerous. You may get too much medicine. Follow the directions on the prescription label. Take the medicine at the same time each day. Do not take more medicine than you are told to take.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Patients over 65 years old may have a stronger reaction and need a smaller dose.

What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. If you take too much medicine, immediately call your local emergency number or poison control center.

What drug(s) may interact with Tramadol?
Do not take this medicine with any of the following medications:
�MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

�rasagiline

This medicine may also interact with the following medications:
�alcohol or medicines that contain alcohol
�carbamazepine
�digoxin
�erythromycin
�ketoconazole
�medicines for depression, anxiety, or psychotic disturbances
�medicines for pain like pentazocine, buprenorphine, butorphanol, nalbuphine, morphine, and propoxyphene
�medicines for sleep
�naloxone
�phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine
�quinidine
�rifampin
�St. John's wort
�warfarin

What side effects may I notice from receiving Tramadol?
Side effects that you should report to your doctor or health care professional as soon as possible:
�allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
�anxiety
�breathing difficulties, wheezing
�changes in vision
�confusion
�dizziness or fainting spells
�hallucinations
�passing urine more frequently than usual, or not passing urine as often as usual
�redness, blistering, peeling or loosening of the skin, including inside the mouth
�seizures
�slow or fast heartbeat
�unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
�constipation
�diarrhea
�drowsiness
�headache
�insomnia
�nausea, vomiting
�sweating

What should I watch for while taking Tramadol?
Tell your doctor or health care professional if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to the medicine. Tolerance means that you will need a higher dose of the medicine for pain relief. Tolerance is normal and is expected if you take this medicine for a long time.

Do not suddenly stop taking your medicine because you may develop a severe reaction. Your body becomes used to the medicine. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a non-medical reason. If you have pain, you have a medical reason to take pain medicine. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose will be slowly lowered over time to avoid any side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine will cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Where can I keep my medicine?
Keep out of the reach of children.

�