While tramadol is an effective pain reliever, it is not suitable for everyone. Who-should-avoid-tramadol? Individuals with a history of seizures, respiratory disorders, liver or kidney disease, and substance abuse should be cautious, as tramadol can worsen these conditions. Pregnant and breastfeeding women are also advised to avoid it due to potential risks to the baby. Additionally, tramadol interacts with certain medications, increasing the risk of serious side effects like serotonin syndrome. If you have underlying health conditions or take other medications, consult your doctor before using tramadol to ensure safe and effective pain management.