10 Tramadol 50mg Tablets
Tramadol is an opioid pain medication used to treat moderate to moderately severe pain. When taken by mouth in an immediate-release formulation, the onset of pain relief usually occurs within an hour. It is often combined with Paracetamol (acetaminophen) as this is known to improve the efficacy of Tramadol in relieving pain.
TRAMADOL 50mg, 100 mg, 200 mg, & 300 mg tablets
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist or nurse.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor or pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1.What TRAMADOL is and what it is used for
2.What you need to know before you take TRAMADOL
3.How to take TRAMADOL
4.Possible side effects
5.How to store TRAMADOL
6.Contents of the pack and other information
1. What TRAMADOL is and what it is used for.
This medicine is used to treat moderate to severe pain in adults and children over 12 years.
It belongs to a group of painkiller medicines called opiate analgesics.
2. What you need to know before you take TRAMADOL
Do not take TRAMADOL:
- If you are allergic to tramadol or any of the other ingredients of this medicine (listed in section 6).
- If you are taking linezoid (an antibiotic used to treat severe bacterial infections such as MRSA)
- In acute poisoning with alcohol, sleeping pills, pain relievers or other psychotrop medicines (medicines that affect mood and emotions).
- If you are taking, or have taken in the last two weeks, MAOIs (medicines used to treat depression).
- If you are suffering from severe liver disease or severe kidney disease.
- If you are suffering from epilepsy, not adequately controlled by treatment.
- If you are breastfeeding, in the case of long-term treatment.
If you are not sure, it is important to ask your doctor or pharmacist for advice.
Warning and precautions
Talk to your doctor or pharmacist or nurse before taking TRAMADOL
Tell your doctor if you are addicted to another drug, are being treated for withdrawal from another drug or are dependent on another drug.This medicine may cause a psychic or physical dependence (addiction) with long-term use. In patients with a tendency to become addicted to drugs, this medicine should only be used for very short periods and under strict medical supervision.
Tramadol is transformed in the liver by an enzyme. Some people have a variation of this enzyme and this can affect people in different ways. In some people, they may not get enough pain relief but other people are more likely to get serious side effects. If you notice any of the following side effects, you must stop taking this medicine and seek immediate medical advice: slow or shallow breathing, confusion, sleepiness, small pupils, feeling or being sick, constipation, lack of appetite.
This medicine should be used with caution in the case of:
- reduced consciousness
- brain trauma or any brain disorder such as infection or tumour
- state of shock (cold sweat may be a sign of it)
- breathing difficulties
- a history of epileptic seizures
- kidney or liver disorders
- an increase in normal brain pressure causing symptoms such as headache and vomiting (increased intracranial pressure)
Epileptic fits have been reported in patients taking tramadol at the recommended dose level. The risk may be increased when doses of tramadol exceed the recommended upper daily dose limit (400 mg).
If you are not sure, do not hesitate to consult your doctor or pharmacist for advice.
Children and adolescents
The use of this medicine is not recommended in children under 12 years of age.
Use in children with breathing problems
Tramadol is not recommended in children with breathing problems, since the symptoms of tramadol toxicity may be worse in these children.
Other medicines and TRAMADOL:
Tell your doctor or pharmacist if you are taking, have recently taken or might take any of the following medicines as they may interact with your TRAMADOL.
- Carbamazepine (used for the treatment of epilepsy)
- Buprenorphine, nalbuphine, pentazocine (other painkillers)
- Naltrexone (used for alcohol or drug abuse).
This medicine may cause seizures at therapeutic doses and in particular when taking high doses and in combination with other medicines including:
- bupropion (used to help stopping smoking)
- mefloquine (a treatment for malaria)
The risk of side effects increases
- if you are taking medicines which may cause convulsions (fits), such as certain antidepressants or antipsychotics. The risk of having a fit may increase if you take TRAMADOL at the same time. Your doctor will tell you whether TRAMADOL is suitable for you.
- if you are taking certain antidepressants. TRAMADOL may interact with these medicines and you may experience symptoms such as involuntary, rhythmic contractions of muscles, including the muscles that control movement of the eye, agitation, excessive sweating, tremor, exaggeration of reflexes, increased muscle tension, body temperature above 38°C.
This medicine may also interact with the following medicines:
- morphine-like drugs such as cough medicines or substitution treatments such as methadone
- other painkillers
- warfarin (a blood thinner)
- benzodiazepines and other treatments for anxiety
- some treatments for high blood pressure
- antihistamines (for allergies) that cause sleepiness
- thalidomide (for certain cancers and skin conditions)
- barbiturates (sleeping pills)
- neuroleptics, phenothiazine, butyrophenine (to treat mental illness)
- baclophene (a muscle relaxant)
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
TRAMADOL with food and drink and alcohol
Drinking alcohol is not recommended during treatment.
Pregnancy and breast-feeding and fertility
This medicine should not be taken during pregnancy unless absolutely necessary.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Tramadol is excreted into breast milk. For this reason, you should not take TRAMADOL more than once during breast-feeding, or alternatively, if you take TRAMADOL more than once, you should stop breast-feeding.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
TRAMADOL® may cause drowsiness. Do not drive or do other activities where you need to be alert (for example using any tools or machines), until you know how the medication affects you. Do not take with alcohol or drugs that make you sleepy.
The medicine can affect your ability to drive as it may make you sleepy or dizzy.
- Do not drive while taking this medicine until you know how it affects you.
- It is an offence to drive if this medicine affects your ability to drive.
- However, you would not be committing an offence if:
- The medicine has been prescribed to treat a medical or dental problem and
- You have taken it according to the instructions given by the prescriber or in the information provided with the medicine and
- It was not affecting your ability to drive safely
Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine.
3. How to take TRAMADOL
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The dosage should be adjusted to the intensity of your pain and your individual pain sensitivity. In general the lowest pain-relieving dose should be taken.
Adults and children over 12 years of age – the usual starting dose is 100 mg, once daily.
The usual dose after this is 200 mg, once daily. If there is not enough pain relief, the maximum dose is up to 300 or 400 mg, once daily.
Elderly patients (up to 75 years of age) – no dose adjustment is needed.
Elderly patients (above 75 years of age)
In elderly patients (above 75 years) the excretion of tramadol may be delayed. If this applies to you, your doctor may recommend prolonging the dosage interval.
Severe liver or kidney disease (insufficiency)/dialysis patients
Patients with severe liver and/or kidney insufficiency should not take TRAMADOL. If in your case the insufficiency is mild or moderate, your doctor may recommend prolonging the dosage interval.
These are oral tablets. Swallow the tablets whole with a glass of water, preferably in the evening. TRAMADOL may be taken with food or drink. Do not chew or crush them. TRAMADOL tablets should be taken once every 24 hours.
Strictly follow your doctor’s advice at all times.
If you take more TRAMADOL than you should
Contact your doctor immediately.
If you forget to take TRAMADOL
Do not take a double dose to make up for a forgotten tablet.
If you stop taking TRAMADOL
You should not suddenly stop taking this medicine unless your doctor tells you to. If you want to stop taking your medicine, discuss this with your doctor first, particularly if you have been taking it for a long time. Your doctor will advise you when and how to stop, which may be by lowering the dose gradually to reduce the chance of developing unnecessary side effects (withdrawal symptoms).
Rarely when some people stop taking TRAMADOL after long-term use, they get withdrawal symptoms. They may feel agitated, anxious, nervous or shaky. They may become over-active and have difficulty sleeping. These effects usually disappear in a few days. Tell your doctor if this happens to you.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. All medicines can cause allergic reactions, although serious allergic reactions are very rare. Tell your doctor straight away if you get any sudden wheeziness, difficulty in breathing, swelling of the eyelids, face or lips, rash or itching (especially affecting your whole body).
Serious side effects
If you notice any of these symptoms, stop taking the tablets and consult your doctor straight away.
- fits (convulsions),
- breathing difficulties,
- rash or allergic reaction of any kind
The following side effects have also been reported:
Very common : may affect more than 1 in 10 people
- feeling sick (nausea),
Common : may affect up to 1 in 10 people
- dry mouth,
Uncommon : may affect up to 1 in 100 people
- gastrointestinal irritation (a feeling of pressure in the stomach and wind),
- cardiac and vascular problems (increased heart rate, low blood pressure on standing, feeling unwell with drop in blood pressure),
- skin reactions (itching, rash, hives).
Rare : may affect up to 1 in 1,000 people
- muscle weakness,
- changes in appetite,
- feelings of numbness, itch or pins and needles, tremors,
- slow heart rate or breathing,
- increase in blood pressure,
- blurred vision,
- difficulty in passing urine,
- mood changes (such as feeling unusually happy),
- changes in activity (such as being less active), and changes in thought,
- hallucinations (seeing or hearing things),
- trouble with sleep, nightmares,
- allergic reactions,
- worsening of asthma,
- dependence (side effects that occur when you stop taking the drug),
- epileptic fits,
- in a few isolated cases increases in liver enzymes,
Not Known: Cannot be estimated from the available data
- Low levels of blood sugar.
5. How to store TRAMADOL
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the box. The expiry date refers to the last day of that month.
Blisters: Do not store above 30°C.
HDPE Bottles: This medicinal product does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What TRAMADOL contains
- The active substance in TRAMADOL is tramadol hydrochloride 100 mg, 200 mg and 300 mg as prolonged released tablets
- The other ingredients are:
polyvinyl acetate, povidone, sodium lauryl sulphate and silica (Kollidon® SR), xanthan gum, hydrogenated vegetable oil ( from cotton seed), magnesium stearate (vegetable origin), silica colloidal anhydrous, hydroxypropyl distarch phosphate (E1442) (Contramid®).
What TRAMADOL looks like and contents of the pack
This medicine is presented as white to off-white, plain, bevelled edge, round, biconvex prolonged release tablets in the following pack sizes:
PVC/PVDC blisters with Aluminium backing foil (containing 5, 10, 15, 20, 30, 50, 60 or 100 prolonged-release tablets) or
PVC/PE/PCTFE blisters with Aluminium backing foil (containing 5, 10, 15, 30, 60 or 100 prolonged-release tablets) or
HDPE Bottles containing 100 prolonged-release tablets
Not all pack sizes may be marketed