If you have ever been addicted to drugs or alcohol, tramadol shouldn't be taken. Also, don't take tramadol if you are intoxicated or 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.

Before taking tramadol, tell your doctor if you have allergy to any drugs, or if you have:
- kidney disease;
- liver disease;
- a stomach disorder; or
- a history of depression, mental illness, or suicide attempt.

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 16 years of age.

If you have any of these signs of an allergic reaction get emergency medical help: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using tramadol and call your doctor at once if you have any of these serious side effects:
- seizure (convulsions);
- a red, blistering, peeling skin rash; or
- shallow breathing, weak pulse.

Continue taking tramadol and talk to your doctor if you have any of these less serious side effects:
- dizziness, drowsiness, weakness;
- nausea, vomiting, constipation, loss of appetite;
- blurred vision;
- flushing (redness, warmth, or tingly feeling); or
- sleep problems (insomnia).
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.