Zydol

Moderate to severe pain Tramadol hydrochloride Grunenthal How does it work?

Zydol capsules, soluble tablets and injection all contain the active ingredient tramadol hydrochloride, which is a type of medicine called an opioid painkiller. (NB. Tramadol is also available without a brand name, ie as the generic medicine.)

Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.

Tramadol mimicks the action of our natural endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain. Therefore, even though the cause of the pain may remain, less pain is actually felt.

Tramadol also works by enhancing the activity of neurotransmitters in the brain and spinal cord. Neurotransmitters are chemical compounds that act as chemical messengers between the nerve cells. Tramadol enhances the effect of the neurotransmitters serotonin and noradrenaline, and this action also helps relieve pain.

Tramadol is a fairly strong painkiller that is used in the management of moderate to severe pain. It is given by injection when administration by mouth is not possible, for example for pain following surgery. The injection is given into a muscle or vein, or via a drip into a vein (intravenous infusion).

Zydol capsules and soluble tablets are taken by mouth up to six times a day, depending on the severity of the pain. Zydol soluble tablets should be dissolved in at least 50ml of water before taking. These forms of tramadol should not be taken more often than every four hours and you should not exceed the dose prescribed by your doctor.

For more prolonged pain relief, modified release forms of tramadol that can be taken once or twice a day are available. See the products linked at the end of this factsheet for more information.

What is it used for? Warning! Use with caution in Not to be used in

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe .

The manufacturer states that this medicine should not be taken at the same time as, or within two weeks of, MAOI antidepressants such as phenelzine or tranylcypromine.

There may be an increased risk of convulsions or seizures if tramadol is taken with the following medicines:

If tramadol is taken with SSRI antidepressants such as fluoxetine, or triptans for migraine such as sumatriptan, there may also be an increased risk of other side effects, as all these medicines enhance the activity of serotonin in the brain.

There may be an increased risk of drowsiness and sedation if tramadol is taken with any of the following (which can also cause drowsiness):

Carbamazepine may decrease the blood level of tramadol, which may make it less effective at relieving pain.

Tramadol may enhance the anti-blood-clotting effect of anticoagulant medicines such as warfarin. If you are taking warfarin your blood clotting time (INR) should be monitored when you start and stop treatment with tramadol.

Other medicines containing the same active ingredient