Hypersensitivity to paracetamol, tramadol or opioids. Situations where opioids are contraindicated excluding acute poisoning cases w/ alcohol, hypnotics, narcotics, anlagesics that work on CNS or psychotropic drugs.
Risk of seizure in co-administration w/ SSRIs, TCAs, MAOIs, other opioids, neuroleptics & other drugs that reduce seizure threshold. Anaphylactoid reaction & resp depression. Increased intracranial pressure or head injury. Alcohol. Concomitant use w/ other paracetamol-containing medicine may increase toxicity. Discontinue treatment gradually to avoid w/drawal syndrome. Monitor prothrombin time during concomitant use w/ warfarin-like compd. Hepatic impairment. Pregnancy & lactation. Elderly.