Do not use Tramadol if:

• you are allergic to any ingredient in Zyban;
• you have severe diarrhea due to taking an antibiotic;
• you are intoxicated with alcohol, other opioids or narcotics (e.g., morphine, codeine), sedatives or sleeping medicines (e.g., temazepam, zolpidem), or other medicines;
• you are taking nefazodone, carbamazepine, or sodium oxybate (GHB).

• Tramadol may cause drowsiness and dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Tramadol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Tramadol ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Tramadol may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of this effect.
• Tell your doctor or dentist that you take Tramadol before you receive any medical or dental care, emergency care, or surgery.
• Use Tramadol with caution in the elderly; they may be more sensitive to its effects.
• Tramadol should not be used in children younger than 16 years old; safety and effectiveness in these children have not been confirmed.
• Pregnancy and breast-feeding: Tramadol has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tramadol while you are pregnant. Tramadol is found in breast milk. Do not breast-feed while taking Tramadol.

Check with your doctor if any of these most common side effects persist or become bothersome:

• constipation; diarrhea; dizziness; drowsiness; increased sweating; loss of appetite; nausea.

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; fainting; fever; incoordination; muscle stiffness or tremor; seizures.

Tramadol is to be used only by the patient for whom it is prescribed. Do not share it with other people.

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