Belcetra Warnings

Convulsions have been reported in patients receiving tramadol at the recommended dose levels. The risk may be increased when doses of tramadol exceed the recommended upper dose limit. Concomitant use of tramadol increases the seizure risk in patients taking: Selective serotonin re-uptake inhibitors (SSRIs and anorectic agent); Tricyclic antidepressants (TCAs) and other tricyclic compounds (eq. cyclobenzaprine, promethazine); other opioid.
Administration of tramadol may enhance the seizure risk in patients taking: MAO (Monoamine Oxidase) inhibitor; Neuroleptic; Other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections).
Serious anaphylactoid reactions have been reported in patients receiving therapy with tramadol.
When excessive tramadol is administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
This drug should be used with caution and in reduced dosages when administered to patients receiving CNS depressants. Tramadol increases the risk of CNS and respiratory depression in these patients.
This drug should be used with caution in patients with increased intracranial pressure or head injury. The respiratory depressant effects of opioids include carbon dioxide retention and secondary elevation of cerebrospinal fluid pressure and may be markedly exaggerated in these patients.
If person with consumption more than 3 cups of alcohol beverage every day take this drug or other analgesics, consult physician or pharmacist. If the person take this drug, liver damage may occur.
Tramadol may induce psychic and physical dependence of the morphine-type (μ-opioid).