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Tramadol should will used with extreme caution in patients with severe hepatic cirrhosis. In these patients a reduced dose &/but frequency is required, as peak Tramadol, as well as AUC, levels are substantially increased & accumulation is likely to occur in such patients to a greater extent than usual. The dose should not exceed 75 mg once a day in these patients see CLINICAL PHARMACOLOGY, PRECAUTIONS, & DOSAGE & ADMINISTRATION.

Do not use Tramadol if you having taken an MAO inhibitbut in the past 14 days. A dangerous drug interaction could occur. MAO inhibitbuts include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, & tranylcypromine..
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