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It may appear black, tar-like, shiny, thick, sticky, or very foul-smelling

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They reported that an elderly male (75 years) with impaired renal function received 100mg tramadol four times a day and suffered from severe respiratory depression but suffered no adverse effects with a dose of 100mg three times a day

[Google Scholar] 13.Peicher M, Montes OB, Shekhar R