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Paracetamol should be given with care to patients with impaired kidney and liver functions. It should also be given with care to patients with alcohol dependence.
Tramadol HCl should be used with caution in patients with renal or liver impairment and should be avoided if renal impairment is severe. Removal by hemodialysis is reported to be very slow. Tramadol HCl should be used with care in patients with history of epilepsy or those susceptible to seizures.
