Tramadol is a narcotic-like pain reliever. Tramadol is used to treat moderate to severe pain. The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.
You should not take tramadol if you have used alcohol, sedatives, tranquilizers, or narcotic medications within the past few hours. Tramadol can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take tramadol in larger amounts, or for longer than prescribed. Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose. Do not crush the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.
Before taking this medicine
You should not take tramadol if you are allergic to it, or if you have,
1-severe asthma or breathing problems
2-A blockage in your stomach or intestines
3- 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.

How should I take tramadol?
Take tramadol exactly as prescribed. Follow all directions on your prescription label. Tramadol can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Stop taking all other around-the-clock narcotic pain medications when you start taking tramadol.
Tramadol can be taken with or without food, but take it the same way each time. Do not crush, break, or open an extended-release tablet or capsule (ConZip, Ryzolt, Ultram ER). Swallow it whole to avoid exposure to a potentially fatal dose. Never crush or break a tramadol pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of tramadol and similar prescription drugs.
To take tramadol orally disintegrating tablets (Rybix ODT):
1-Keep the tablet in its blister pack until you are ready to take it. Use dry hands to remove the tablet and place it in your mouth.
2-Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.
If you use the tramadol extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.
Do not stop using tramadol suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
What should I avoid?
Do not drink alcohol.
Dangerous side effects or death can occur when alcohol is combined with tramadol. Check your food and medicine labels to be sure these products do not contain alcohol. Tramadol may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

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