If you are:
FDB Contraindicated or Not Recommended: FDA C;NEONATE SEIZURE/WITHDRAWAL SYN/FETAL DEATH REPORTED;SMALL TERATOGENIC RISK
Precaution: EFFECT ON INFANT UNKNOWN, MONITOR FOR SEDATION.
An adult over 60:
management or monitoring precaution: General-Dosage reduction may be needed, depending on renal and hepatic status. Neuro/Psych-Lowers seizure threshold; may be acceptable in patients with well-controlled seizures in whom alternative agents have not been effective. Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs
Giving Tramadol HCL ER to a child under 12:
Severe Precaution: Risk of slowed or difficult breathing. Caution with CYP 2D6 ultra rapid metabolizers. Not recommended age <16 years per manufacturer.