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Withdrawal symptoms can arise in breastfed infants when maternal administration of the opioid analgesic is stopped, or when breast-feeding is stopped.The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors on amounts of tramadol and M1 from tramadol hydrochloride tablets are complex. Use