betty that is a side effect of Tramadol and you should not need to take Tylenol with it. But you have to be very careful this medication can be a real hard on to get off of. And more so if it is not prescribed myself I would not take it even if it was prescribed do to the short term use and people having such a hard time getting off of it. Chuck1957 and again these are normal side effects of this medication so it does not really agree with you check with your doctor. Chuck1957
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