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Inflammatory bowel disease (IBD) is characterized by gut inflammation

24 Although this evidence supports the use of tramadol in this instance, care should be taken when combining other medicines with tramadol that are likely to alter its elimination, reduce seizure threshold or increase drowsiness

Hirano, T., et al

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These are clear signs of degradation or contamination, regardless of what the date on the label says

If its been more than four days, though, skip the missed dose and carry on with your normal dosing schedule