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The following information is a summary about Tramadol. It is not intended to replace a doctor''s instructions.

TRAMADOL USES
Tramadol is used for pain relief.

TRAMADOL DIRECTIONS
Take your Tramadol by mouth as prescribed. It is usually taken every 4 to 6 hours as needed. Use Tramadol exactly as prescribed. Do not increase your dose, use it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for an extended period of time, do not suddenly stop using this drug without your doctor''s approval. When used for extended periods, Tramadol may not work as well and may require different dosing. Consult your doctor if Tramadol stops working well.

TRAMADOL SIDE EFFECTS
Tramadol may cause dizziness, weakness, incoordination, nausea or vomiting, stomach upset, constipation, headache, drowsiness, anxiety, irritability, dry mouth, or increased sweating. If any of these effects persist or worsen, inform your doctor. Notify your doctor if you develop any of these serious effects while taking Tramadol: chest pain, rapid heart rate, skin rash or itching, mental confusion, disorientation, seizures, tingling of the hands or feet, trouble breathing. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, breathing trouble. If you notice other effects not listed above, contact your doctor or pharmacist.

TRAMADOL PRECAUTIONS
Tell your doctor your medical history, especially of: kidney disease, liver disease, seizure disorder, lung disease, history of drug or alcohol dependency, any allergies you may have. Limit alcohol as it may add to the dizziness or drowsiness effects caused by Tramadol. Because this drug may make you dizzy/drowsy, use caution performing tasks requiring alertness such as driving. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. Tramadol should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Tramadol is excreted into breast milk. Because the effects on a nursing infant are not known, consult your doctor before breast- feeding.

TRAMADOL DRUG INTERACTIONS
Tell your doctor of all prescription and nonprescription meds you may use, especially of: carbamazepine, narcotic pain relievers (e.g., codeine), drugs used to aid sleep, antidepressants (e.g., SSRI-types such as fluoxetine or fluvoxamine), MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine), psychiatric medicine (e.g., nefazodone), "triptan"-type drugs, anti-anxiety drugs (e.g., diazepam), sibutramine. Also, report use of certain antihistamines (e.g., diphenhydramine) which are also present in many cough-and-cold products. Do not start or stop any medicine without doctor or pharmacist approval.

TRAMADOL OVERDOSE
If overdose is suspected, contact your local poison control center or emergency room immediately.

TRAMADOL NOTES
Do not share Tramadol with others. Medical examinations including the nose are generally performed during prolonged use of this product to check for side effects. Inform all your doctors you use (or have used) Tramadol.

MISSED DOSE
If you miss a dose, use Tramadol as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

TRAMADOL STORAGE
Store Tramadol at room temperature between 36 and 77 degrees F (2 -25 degrees C) away from light and moisture.