May cause hypersensitivity to the active substance or other components of the drug. The drug is contraindicated for those with acute alcohol intoxication, intoxication with sleeping pills, analgesic or psychotropic drugs, severe liver failure, severe renal failure (creatinine clearance less than 10 ml/min), people suffering from frequent seizures of epilepsy. According to experts, the use of the drug is also contraindicated during treatment with MAO inhibitors and for at least 14 days after their discontinuation.

Experts do not recommend using this to treat opioid addiction. It is prohibited during pregnancy or breastfeeding. The drug is contraindicated for persons under 14 years of age.

The doses of this drug and the duration of treatment are determined by the attending physician, after passing a number of examinations, taking into account the intensity of the patient's pain syndrome:

• • As a rule, adults and children over 14 years of age are prescribed the drug in the amount of 1 capsule (50 mg), it should be taken with liquid, regardless of food intake>
• • If the patient has severe pain, then, according to the doctor's decision, one dose can reach 100 mg.
• • Experts warn, the daily dose of the drug should not exceed 8 capsules (400 mg).
• • The drug should not be used for longer than prescribed by the specialist.
• • All those people who have liver/kidney disorders and are older, then the doctor prescribes individual dosages for them.
• • For example, in case of moderate liver failure, it is recommended to reduce the dose of the drug and extend the intervals between doses.

And in patients with moderate renal insufficiency, it is recommended to extend the interval between doses.

Sweating, headache, dizziness, rarely weakness, lethargy, decreased reaction speed, sleep disorders, nightmares, euphoria, hallucinations, anxiety, emotional instability, depression, amnesia, paresthesia, drowsiness, epileptic seizures may be observed. , shock, respiratory depression, coordination and speech disorder, fainting, confusion, anxiety.

It will not be ruled out that vision disturbance, taste, mydriasis will occur.

From the gastrointestinal tract, nausea, vomiting, dry mouth, change in appetite, constipation, flatulence, epigastric pain, diarrhea, increased activity of liver enzymes and other symptoms may appear.

Tachycardia, palpitations, decrease in blood pressure to collapse (orthostatic collapse), rarely bradycardia, increase in blood pressure are also not excluded.

As for allergic reactions, urticaria, itching, rash, bullous rash, angioedema, anaphylactic reactions may occur.

Urinary tracts may be disturbed, difficult urination, dysuria, urinary incontinence may occur, and in the case of women, menstrual cycle disorders, fatigue.

Vomiting, miosis, circulatory disorders, depression of consciousness (even coma), convulsions, depression of the respiratory center, complete cessation of breathing.

As a rule, the treatment is aimed at ensuring the patency of the respiratory tract, maintaining breathing, and the work of the cardiovascular system. Experts note that the antidote for respiratory depression is naloxone, and for convulsions, benzodiazepine.

Tramadol is poorly excreted by dialysis in those with this problem, so separate use of hemodialysis or hemofiltration is not sufficient for them.

Due to the composition of tramadol, it easily penetrates the placental barrier, therefore its use during pregnancy is not encouraged. If opioid analgesic therapy is indicated during pregnancy, use should be limited.

It is necessary to know that Tramadol cannot be used during breastfeeding, because Tramadol hydrochloride penetrates into breast milk.

It is not recommended to use Tramadol if you are going to drive a vehicle or work with mechanisms that require full attention and quick mental and motor reactions.