Cancer Home > Precautions and Warnings With Tramadol ER

Prior to starting treatment, warnings and precautions for tramadol ER should be fully reviewed with your healthcare provider. For example, it is important that your healthcare provider is aware of any other medical conditions you may have, as tramadol ER is not suitable for everyone. Also, tramadol ER may cause potentially dangerous side effects and may not be safe for pregnant or breastfeeding women.

What Should I Tell My Healthcare Provider Before Taking Tramadol ER?

You should talk with your healthcare provider prior to taking tramadol ER (ConZip™, Ultram® ER, Ryzolt®) if you have:
  • Seizures or epilepsy
  • Lung disease of any sort
  • Liver disease, such as cirrhosis, liver failure, or hepatitis
  • Kidney disease, such as kidney failure (renal failure)
  • A head injury or high intracranial pressure
  • A history of drug or alcohol dependence
  • Suicidal thoughts or behaviors
  • Severe abdominal (stomach) pain
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Tramadol ER Warnings and Precautions

Some warnings and precautions to be aware of prior to taking this drug include the following:
  • Tramadol ER can cause a dangerous group of symptoms known as serotonin syndrome. This is most common when tramadol ER is combined with certain other medications (see Tramadol and Serotonin Syndrome for more information).
  • Tramadol ER should not be prescribed to people with suicidal tendencies. This medication can be lethal in the case of an overdose, especially if combined with alcohol.
  • Tramadol ER can cause seizures, especially in people with a history of seizures, who are withdrawing from alcohol or narcotics, who have a head injury, or who take certain medications (see Tramadol and Seizures for more information).
  • Tramadol ER can cause slow and irregular breathing. In severe situations, this may lead to life-threatening complications. This may be especially dangerous in people with lung problems.
  • Tramadol ER has a significant potential for abuse. It is not a good choice for people who have a history of alcohol or drug abuse (see Tramadol Abuse). Do not take the drug more frequently, longer, or at a higher dose than prescribed. If you feel you may be developing a problem with tramadol ER, please seek help from your healthcare provider.
  • The medication can cause problems in people with head injuries or high intracranial pressure. Tramadol ER should only be used with extreme caution in such circumstances.
  • Tramadol ER can interfere with the diagnosis of many conditions that cause severe abdominal (stomach) pain.
  • Tramadol ER can cause dizziness and drowsiness, and may increase the risk of falls in elderly people.
  • Do not drive or operate heavy machinery until you know how tramadol ER affects you. Your reflexes and reaction times may be significantly affected, even if you feel fine.
  • Tramadol ER can potentially interact with several other medications (see Drug Interactions With Tramadol ER).
  • Tramadol ER is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Tramadol and Pregnancy).
  • Tramadol ER passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Tramadol and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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