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Be aware that Tramadol may interact with some medicines. Consult with your health care provider in case you are taking any other drugs, especially any of the following: carbamazepine because it may decrease Tramadol 's effectiveness and increase the risk of seizures; Or you have been told you should not have sexual intercourse for health reasons. Phentermine is similar to amphetamine. It stimulates the nervous system, elevates blood pressure, and increases heart rate. Sleeping pills, tranquilizers, sedatives, and antihistamines may increase drowsiness. Use them only under the supervision of your doctor. You have a history of alcohol abuse, substance abuse, or suicidal thoughts or behaviors; you have or recently have had any head injury,brain injury or tumor, increased pressure in the brain, or infection of the brain or nervous system; Or you have been told you should not have sexual intercourse for health reasons. Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.