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According to http://www.drugs.com/sfx/tramadol-side-effects.html if you vomit you should contact your doctor immediately. It's listed under "severe" side effects. But I'd say they just say that to "cover their butt" legally. I'd definately contact your doctor to ask him about it though...some medications can make you sick like that if you take them on an empty stomach. I'm not sure if you should take that med with food or not though...but it probably wouldn't hurt to try eating before taking it.