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Tramadol is contraindicated in known hypersensitivity to tramadol hydrochloride or opioids in acute intoxication with alcohol, hypnotics, analgesics or psychotropic medicines. It should not be administered to patients who are receiving monoamine oxidase inhibitors or within two weeks of their withdrawal.
Safety during pregnancy and lactation has not been established.
Tramadol should not be given to patients with respiratory depression especially in the presence of cyanosis and excessive bronchial secretions.
Tramadol should not be given to patients with increased intracranial pressure or central nervous system depression due to head injury or cerebral disease.
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