Before taking this medicine

You should not take tramadol if you are allergic to it, or if you have:

• severe asthma or breathing problems;
• a blockage in your stomach or intestines;
• if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications.

Seizures have occurred in some people taking tramadol. Talk with your doctor about your seizure risk, which may be higher if you have:

• a history of head injury, epilepsy or other seizure disorder;
• a history of drug or alcohol addiction;
• a metabolic disorder; or
• if you are also using certain medicines to treat migraine headaches, muscle spasms, depression, mental illness, or nausea and vomiting.

Some medicines can interact with tramadol and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure tramadol is safe for you, tell your doctor if you have:

• liver or kidney disease;
• a stomach disorder; or
• a history of drug abuse, alcohol addiction, mental illness, or suicide attempt.

Tramadol is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

Tramadol may be habit forming and should be used only by the person it was prescribed for. Never share this medicine 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. Selling or giving away tramadol to any other person is against the law.

It is not known whether tramadol will harm an unborn baby. If you use this medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Tramadol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking this medicine.

Do not give this medication to anyone younger than 16 years old without the advice of a doctor. Ultram ER