Seizures have been reported in patients receiving tramadol w/in the recommended dosage range. Seizure risk is increased w/ doses of tramadol above the recommended range. Enhanced seizure risk in patients taking MAOIs, neuroleptics or other drugs that reduce seizure threshold. Risk of convulsions may also increase in patients w/ epilepsy, history of seizures or in patients w/ recognized risk of seizure (eg, head trauma, metabolic disorders, alcohol & drug w/drawal, CNS infections). Patients w/ history of anaphylactoid reaction to codeine & other opioids may be at increased risk. Patients at risk for resp depression; known to be CYP2D6 ultra rapid metabolizers. May impair ability to drive or operate machinery. Hepatic impairment. Pregnancy & lactation. Childn <16 yr.