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Zydol Sr 100mg Prolonged Release Tablets

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2. What you need to know before you take ZYDOL SR


PACKAGE LEAFLET: INFORMATION FOR THE USER

ZYDOL® SR 100MG PROLONGED RELEASE TABLETS ZYDOL® SR 150MG PROLONGED RELEASE TABLETS ZYDOL® SR 200MG PROLONGED RELEASE TABLETS

tramadol hydrochloride

These products are available as any of the above name but will be referred to as ZYDOL SR throughout this leaflet.

Read all of this leaflet carefully before you start taking this medicine.

-    Keep this leaflet. You may need to read it again.

-    If you have any further questions, ask your doctor or your pharmacist.

-    This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

-    If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or your pharmacist.

In this leaflet:

1.    What ZYDOL SR is and what it is used for

2.    What you need to know before you take ZYDOL SR

3.    How to take ZYDOL SR

4.    Possible side effects

5.    How to store ZYDOL SR

6.    Contents of the pack and other information

1. What ZYDOL SR is and what it is used for

Tramadol - the active substance in ZYDOL SR - is a painkiller belonging to the class of opioids that acts on the central nervous system. It relieves pain by acting on specific nerve cells of the spinal cord and brain. ZYDOL SR is used for the treatment of moderate to severe pain.

ZYDOL SR with food and alcohol

Do not drink alcohol during treatment with ZYDOL SR as its effect may be intensified. Food does not influence the effect of ZYDOL SR.

Pregnancy, breast-feeding and fertility

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.

There is very little information regarding the safety of tramadol in human pregnancy. Therefore you should not use ZYDOL SR if you are pregnant.

Chronic use during pregnancy may lead to withdrawal symptoms in newborns.

Generally, the use of tramadol is not recommended during breastfeeding. Small amounts of tramadol are excreted into breast milk. On a single dose it is usually not necessary to interrupt breast-feeding. Please ask your doctor for advice.

Driving and using machines

ZYDOL SR may cause drowsiness, dizziness and blurred vision and therefore may impair your reactions. If you feel that your reactions are affected, do not drive a car or other vehicle, do not use electric tools or operate machinery, and do not work without a firm hold!

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 ZYDOL SR


Do not take ZYDOL SR,

-    if you are allergic to tramadol or any of the other ingredients of this medicine (listed in section 6);

-    in acute poisoning with alcohol, sleeping pills, pain relievers or other psychotropic medicines (medicines that affect mood and emotions);

-    if you are also taking MAO inhibitors (certain medicines used for treatment of depression) or have taken them in the last 14 days before treatment with ZYDOL SR (see “Other medicines and ZYDOL SR”);

-    if you are an epileptic and your fits are not adequately controlled by treatment; as a substitute in drug withdrawal.

Warnings and precautions

Talk to your doctor before taking ZYDOL SR

-    if you think that you are addicted to other pain relievers (opioids);

-    if you suffer from consciousness disorders (if you feel that you are going to faint);

-    if you are in a state of shock (cold sweat may be a sign of this);

-    if you suffer from increased pressure in the brain (possibly after a head injury or brain disease);

-    if you have difficulty in breathing;

-    if you have a tendency towards epilepsy or fits because the risk of a fit may increase;

-    if you suffer from a liver or kidney disease.

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). Please note that ZYDOL SR may lead to physical and psychological addiction.

When ZYDOL SR is taken for a long time, its effect may decrease, so that

higher doses have to be taken (tolerance development). In patients with a

tendency to abuse medicines or who are dependent on medicines, treatment with ZYDOL SR should only be carried out for short periods and under strict medical supervision.

Please also inform your doctor if one of these problems occurs during ZYDOL SR treatment or if they applied to you in the past.

Other medicines and ZYDOL SR

Tell your doctor or pharmacist if you are taking, have recently taken or might

take any other medicines.

ZYDOL SR should not be taken together with MAO inhibitors (certain medicines for the treatment of depression).

The pain-relieving effect of ZYDOL SR may be reduced and the length of time

it acts may be shortened, if you take medicines which contain

-    carbamazepine (for epileptic fits);

-    pentazocine, nalbuphine or buprenorphine (pain killers);

-    ondansetron (prevents nausea).

Your doctor will tell you whether you should take ZYDOL SR, and what dose.

The risk of side effects increases,

-    if you take tranquillizers, sleeping pills, other pain relievers such as morphine and codeine (also as cough medicine), and alcohol while you are taking ZYDOL SR. You may feel drowsier or feel that you might faint. If this happens tell your doctor.

-    if you are taking medicines which may cause convulsions (fits), such as certain antidepressants or antipsychotics. The risk having a fit may increase if you take ZYDOL SR at the same time. Your doctor will tell you whether ZYDOL SR is suitable for you.

-    if you are taking certain antidepressants ZYDOL SR 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 38C.

-    if you take coumarin anticoagulants (medicines for blood thinning), e.g. warfarin, together with ZYDOL SR. The effect of these medicines on blood clotting may be affected and bleeding may occur.

ZYDOL SR contains lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. This is because the tablets contain lactose Always take this medicine exactly as your doctor has told you. You should 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.

Unless otherwise prescribed by your doctor, the usual dose is:

Adults and adolescents from the age of 12 years One ZYDOL SR 100 mg prolonged-release tablet twice daily (equivalent to 200 mg tramadol hydrochloride per day), preferably in the morning and evening.

One ZYDOL SR 150 mg prolonged-release tablet twice daily (equivalent to 300 mg tramadol hydrochloride per day), preferably in the morning and evening.

One ZYDOL SR 200 mg prolonged-release tablet twice daily (equivalent to 400 mg tramadol hydrochloride per day), preferably in the morning and evening.

Your doctor may prescribe a different, more appropriate dosage strength of ZYDOL SR if necessary.

Do not take more than 400 mg tramadol hydrochloride daily, except if your doctor has instructed you to do so.

Children

ZYDOL SR is not suitable for children below the age of 12 years. Elderly patients

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 ZYDOL SR. If in your case the insufficiency is mild or moderate, your doctor may recommend prolonging the dosage interval.

How and when should you take ZYDOL SR?

ZYDOL SR tablets are for oral use.

Always swallow ZYDOL SR tablets whole, not divided or chewed, with sufficient liquid, preferably in the morning and evening. You may take the tablets on an empty stomach or with meals.

How long should you take ZYDOL SR?

You should not take ZYDOL SR for longer than necessary. If you need to be treated for a longer period, your doctor will check at regular short intervals (if necessary with breaks in treatment) whether you should continue to take ZYDOL SR tablets and at what dose.

If you have the impression that the effect of ZYDOL SR is too strong or too weak, talk to your doctor or pharmacist.

If you take more ZYDOL SR than you should

If you have taken an additional dose by mistake, this will generally have no negative effects. You should take your next dose as prescribed.

If you (or someone else) swallow a lot of ZYDOL SR tablets at the same time you should go to hospital or call a doctor straight away. Signs of an overdose include very small pupils, being sick, a fall in blood pressure, a fast heart beat, collapse, unconsciousness, fits and breathing difficulty or shallow breathing.

If you forget to take ZYDOL SR

If you forget to take the tablets, pain is likely to return. Do not take a double dose to make up for forgotten individual doses, simply continue taking the tablets as before.