In this leaflet:

1.    What Sevredol tablets are and what they are used for

2.    What you need to know before you take Sevredol tablets

3.    How to take Sevredol tablets

4.    Possible side effects

5.    How to store Sevredol tablets

6.    Contents of the pack and other information

These tablets have been prescribed for you by your doctor to relieve severe pain. They contain the active ingredient morphine which belongs to a group of medicines called strong analgesics or ‘painkillers’.

2. What you need to know before you take Sevredol tablets

Do not take Sevredol tablets if:

•    you are allergic to morphine or any of the other ingredients of the tablets (see section 6);

•    you have breathing problems, such as obstructive airways disease or respiratory depression. Your doctor will have told you if you have these conditions. Symptoms may include breathlessness, coughing or breathing more slowly or weakly than expected;

•    you have a head injury that causes a severe headache or makes you feel sick. This is because the tablets may make these symptoms worse or hide the extent of the head injury;

•    you have a condition where the small bowel (part of your gut) does not work properly (paralytic ileus), your stomach empties more slowly than

it should (delayed gastric emptying) or you have severe pain in your abdomen;

•    you have recent onset liver disease;

•    you are taking a type of medicine known as a monoamine oxidase inhibitor (examples include tranylcypromine, phenelzine, isocarboxazid, moclobemide and linezolid), or you have taken this type of medicine in the last two weeks;

•    the patient is under three years of age.

Warnings and precautions

Tell your doctor or pharmacist before

taking these tablets if you:

•    have breathing problems, such as impaired lung function or severe bronchial asthma. Your doctor will have told you if you have these conditions. Symptoms may include breathlessness and coughing;

•    have an under-active thyroid gland (hypothyroidism), kidney or longterm liver problems as you may need a lower dose;

•    have a severe headache or feel sick as this may indicate that the pressure in your skull is increased;

•    suffer from, or have ever suffered from epilepsy, seizures, fits or convulsions;

•    have low blood pressure;

•    have a severe heart problem after long-term lung disease (severe cor pulmonale);

•    have inflammation of the pancreas (which causes severe pain in the abdomen and back) or problems with your gall bladder;

•    have an inflammatory bowel disorder;

•    have prostate problems;

•    have poor adrenal gland function (your adrenal gland is not working properly which may cause symptoms including weakness, weight loss, dizziness, feeling or being sick);

•    are or have ever been addicted to alcohol or drugs;

•    have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating, upon stopping taking alcohol or drugs.

If you are going to have an operation, please tell the doctor at the hospital that you are taking these tablets.

Other medicines and Sevredol tablets Please tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription. If you take these tablets with some other medicines, the effect of these tablets or the other medicine may be changed.

Sevredol tablets must not be used together with a monoamine oxidase inhibitor, or if you have taken this type of medicine in the last two weeks (see section 2 ‘Do not take...’).

Tell your doctor or pharmacist if you are taking:

•    medicines to help you sleep (for example tranquillisers, hypnotics or sedatives);

•    medicines to treat psychiatric or mental disorders (such as phenothiazines);

•    muscle relaxants;

•    medicines to treat high blood pressure;

•    cimetidine to treat stomach ulcers, indigestion or heartburn;

•    certain types of medicines to stop you feeling or being sick;

•    medicines used to prevent or relieve the symptoms of an allergy (antihistamines);

•    other strong analgesics or ‘painkillers’(such as buprenorphine, nalbuphine or pentazocine);

•    rifampicin to treat tuberculosis;

•    ritonavir to treat HIV;

•    medicines to treat Parkinson’s disease;

•    gabapentin to treat epilepsy or neuropathic pain (pain due to nerve problems).

Also tell your doctor if you have recently been given a general anaesthetic.

Taking Sevredol tablets with alcohol

Drinking alcohol during your treatment with these tablets may make you sleepy. If you are affected you should avoid drinking alcohol.

Pregnancy and breastfeeding Do not take these tablets if you are pregnant or breastfeeding.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

These tablets may cause a number of side effects such as drowsiness which could affect your ability to drive or use machinery (see section 4 for a full list of side effects). These are usually most noticeable when you first start taking the tablets, or when changing to a higher dose. If you are affected you should not drive or use machinery.

This 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 while you have this medicine in your body over a specified limit unless you have a defence (called the ‘statutory defence’).

•    This defence applies when:

•    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 and in the information provided with the medicine.

•    Please note that it is still an offence to drive if you are unfit because of the medicine (i.e. your ability to drive is being affected).

Details regarding a new driving offence concerning driving after drugs have been taken in the UK may be found here:

https://www.gov.uk/drug-driving-law Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine.

Sevredol tablets contain lactose and sunset yellow (E110)

These tablets contain lactose which is a form of sugar. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking these tablets.

The 20 mg tablets contain sunset yellow (E110) which may cause allergic reactions.

3. How to take Sevredol tablets

Always take the tablets exactly as your doctor has told you. The label on your medicine will tell you how many tablets to take and how often.

Swallow your tablets whole with a glass of water.

You must only take the tablets by mouth. The tablets should never be crushed and injected as this may lead to serious side effects, which may be fatal.

Adults

The usual starting dose is one tablet every 4 hours. Your doctor will decide how many tablets you should take. Children

Only the 10 mg and 20 mg strength tablets are suitable for children.

Children should not be given the 50 mg tablets.

Children 3 to 5 years of age

The usual dose is 5 mg every four hours.

Children 6 to 12 years of age

The usual dose is 5 - 10 mg every four hours.

If you find that you are still in pain whilst taking these tablets, discuss this with your doctor.

Do not exceed the dose recommended by your doctor. You should check with your doctor or pharmacist if you are not sure.

If you take more Sevredol tablets than you should or if someone accidentally swallows your tablets

Call your doctor or hospital straight away. People who have taken an overdose may feel very sleepy, sick or dizzy. They may also have breathing difficulties leading to unconsciousness or even death and may need emergency treatment in hospital. When seeking medical attention make sure that you take this leaflet and any remaining tablets with you to show to the doctor.

If you forget to take Sevredol tablets If you miss a dose you should take it as soon as you remember and then carry on as before. Do not take two doses within 4 hours. Do not take a double dose to make up for a forgotten tablet.

If you stop taking Sevredol tablets You should not suddenly stop taking these tablets unless your doctor tells you to. If you want to stop taking your tablets, discuss this with your doctor first. They will tell you how to do this, usually by reducing the dose gradually so you do not experience unpleasant effects. Withdrawal symptoms such as agitation, anxiety, shaking or sweating may occur if you suddenly stop taking these tablets.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, these tablets can cause side effects, although not everybody gets them.

This medicine can cause allergic reactions, although serious allergic reactions are uncommon. Tell your doctor immediately if you get any sudden wheeziness, difficulties in breathing, swelling of the eyelids, face or lips, rash or itching especially those covering your whole body.

The most serious side effect, although uncommon, is a condition where you breathe more slowly or weakly than expected (respiratory depression). Tell you doctor immediately if this happens to you.

As with all strong painkillers, there is a risk that you may become addicted or reliant on these tablets.

In patients treated with Sevredol tablets, the following side effects have been reported

Very common (May affect more than 1 in 10 people)

•    Feeling sick.

•    Constipation (your doctor can prescribe a laxative to overcome this problem).

Common (May affect up to 1 in 10 people)

•    Dry mouth, loss of appetite, abdominal pain or discomfort.

•    Vomiting (being sick). (This should normally wear off after a few days. However your doctor can prescribe an anti-vomiting medicine if it continues to be a problem).

•    Drowsiness (this is most likely when you start taking your tablets or when your dose is increased but should wear off after a few days).

•    Dizziness, headache, confusion, difficulty in sleeping.

•    A feeling of unusual weakness.

•    Involuntary muscle contractions.

•    Rash or itchy skin.

•    Sweating.

Uncommon (May affect up to 1 in 100

people)

•    Indigestion, changes in taste.

•    A condition where the bowel does not work properly (ileus).

•    Vertigo, (a feeling of dizziness or ‘spinning’), fainting, seizures, fits or convulsions.

•    Agitation, mood changes, hallucinations, a feeling of extreme happiness.

•    Unusual muscle stiffness.

•    Difficulty in breathing (possibly due to fluid on the lungs) or wheezing.

•    Tingling or numbness.

•    Difficulty in passing urine.

•    Low blood pressure, facial flushing (redness of the face).

•    Palpitations.

•    Swelling of the hands, ankles or feet.

•    Hives.

•    A worsening in liver function tests (seen in a blood test).

•    Blurred vision.

•    Muscle spasms.

Frequency not known (Frequency cannot be estimated from the available data):

•    Unpleasant or uncomfortable mood, abnormal thoughts.

•    An increased sensitivity to pain.

•    Reduction in size of the pupils in the eye.

•    A fast or slow heartbeat.

•    High blood pressure.

•    Decreased cough reflex.

•    Colicky abdominal pain or discomfort, an increase in the severity of symptoms associated with inflammation of the pancreas.

•    Absence of menstrual periods, decreased sexual drive, impotence.

Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:

www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.

Keep this medicine out of the sight and reach of children.

Do not use any tablets after the expiry date which is stated on the blister and carton. EXP 08 2020 means that you should not take the tablets after the last day of that month i.e. August 2020.

Do not store your tablets above 30^oC. Do not throw away medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6. Contents of the pack and other information

What Sevredol tablets contain

The active ingredient is morphine sulfate. Each tablet contains 10 mg, 20 mg or 50 mg of morphine sulfate. The other ingredients are:

•    Lactose

•    Pregelatinised maize starch

•    Povidone

•    Magnesium stearate

•    Talc

•    Macrogol

•    Hypromellose (E464) (10 mg and 50 mg tablets only)

•    T itanium dioxide (E171)

•    Polyvinyl alcohol (E1203) (20 mg tablet only)

The tablets also contain the following colourants:

10 mg - Brilliant blue (E133)

20 mg - Erythrosine (E127) and sunset yellow (E110)

50 mg - Quinoline yellow (E104), indigo carmine (E132) and iron oxide (E172)

What Sevredol tablets look like and the contents of the pack

The tablets have a score line on one side. ‘IR’ and the strength (e.g. 10,

20 etc) are on either side of the score line. The tablets are coloured as follows: 10 mg - blue, 20 mg - pink, 50 mg -pale green.

In each box there are 56 tablets.

SEVREDOL TABS PIL UK 5966-9 V2.indd 3 # 25/11/2015 10:24