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Tramadol is a medication which is used to obtain relief from severe or moderate pain. These extended release tablets can be used by individuals who require pain relief medication 24X7 for a long period of time. The class in which Tramadol belongs is known as opiate agonists that work by altering the way in which the body is able to sense pain. The long acting or extended release tablet is taken orally before or after meals every 4 to 6 hours as is required. Make sure that the same time is maintained every day and it might be taken before or after meals, just the way it has been mentioned by the physician. If not, it could lead to severe side effects. The doctor may start by giving you a reduced dose of Tramadol, before gradually enhancing the medication. The medicine should be taken within 3 or 5 days. These extended release tablets should be swallowed whole, without being chewed, crushed or split. The powder from the crushed tablet should not be inhaled. If the medication is not taken as recommended, it could lead to fatal side effects, or even death. Tramadol is a habit forming drug and this is why it should be taken in strict accordance with the doctor's prescription. If you think that you require additional medication, it is best to get in touch immediately with your doctor. The same should be done if you notice an unusual change in your mood or behavior. The medication should not be discontinued without prior information to your physician who might gradually reduce the dosage. Sudden discontinuation of Tramadol may lead to after effects like sweating, panic, problems with sleep, nausea, shaking, sneezing, burning or tingling sensation in the feet or hands, chills and hallucination or diarrhea. This is why the medication is not meant for everyone. Before taking the drug, it is best to inform the pharmacist whether you are allergic towards it or any cough or opiate medications. Inform them about any allergies towards other extended release medications. You may even approach the pharmacist by trying to know about the Tramadol ingredients. If you are on non prescription or prescription medications, or nutritional and vitamin supplements, it is best to inform your doctor about them. Several groups of medications may interfere with the functioning of Tramadol and this is why it is best to mention everything to your doctor beforehand. The physician may even change the medicine, if so required. In case you forget a dosage, and you are required to take Tramadol on a regular basis, opt for the missed dose upon remembering. However, if the time for the subsequent dosage is approaching, do not opt for the missed dose and carry on with your usual dosing schedule. Never take double dose to compensate for missed dose. The side effects of Tramadol include hives, rashes, weakness, dizziness, sleepiness, agitation, nervousness, headaches and others. If these persist, see the doctor immediately. Tramadol should be stored away from children. Discard the medicine if it has expired. Make sure that others do not take your medication.