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Paracetamol + Tramadol HCl (Nutram) should not be given to patients who have previously demonstrated hypersensitivity reactions to tramadol, paracetamol and any other components of the drug.
Other contraindications include: Patients who are addicted to drugs affecting the CNS such as alcohol, hypnotics, centrally-acting analgesics and anti-psychotic drugs; Patients with epilepsy not controlled by treatment; Patients at risk of mental fog caused by head injury or brain lesion; Patients with severe respiratory depression, and those with a history of aspirin-sensitive asthma; Patients with hematological abnormality and patients with peptic ulcer disease. Paracetamol + Tramadol HCl should be avoided if renal impairment is severe.
