Tramalin Special Precautions

Due to use of this drug, nausea, rarely vomiting, drowsiness, lightheadedness, headache and stagger may occur.
It should be used with extreme caution in patients with decreased respiratory reserve and should not be given during an attack of bronchial asthma or in heart failure secondary to chronic lung disease.
Delayed respiratory depression may occur following epidural or intra-tracheal administration.
Patients receiving this drug should be cautioned against engaging in hazardous occupation requiring alertness such as machinery operation or driving.
This drug is not indicated for minor pain.
During long-term treatment with Tramadol HCl, the possibility of dependence cannot be entirely excluded. Therefore, the physician is to decide on the duration of treatment and whether the preparation is to be withdrawn temporarily.
Dosage should be reduced in elderly and debilitated patients.
Care Administration: Patients with concomitant administration of morphine or repeated administration. (As morphine antagonistic action has been reported in animal study, this drug may cause withdrawal symptom).
Patients with cholangia (Oddi's sphincter was constricted in high doses).
Patients with hepatic disorders.
Patients with alcoholism.
Patients with renal disorders.
Patients with hypothyroidism, adrenocortal insufficiency, prostatic hypertrophy, shock, or inflammatory or obstructive bowel disorders.
Patients with myasthenia gravis.
Use in Children: Safety in infants and children has not been established. It is advisable not to use this product. Administration during labor may cause respiratory depression in the newborn infant. Babies born to opioid-dependent mothers may suffer withdrawal symptoms.