Lopenta 50 mg Tablet

Centrally acting opioid analgesic (also noradrenaline reuptake inhibitor) for:

• Moderate to severe acute pain (immediate-release)
• Severe chronic pain needing long-term opioid treatment, including diabetic nerve pain (extended-release)

Immediate-release (adults): 50–100 mg every 4–6 hours as needed; day 1 may allow a second dose after 1 hour; max 600 mg on day 1, then 600 mg/day (usually much less).

Extended-release: 50 mg twice daily, adjusted by 50 mg twice daily every 3 days; max 500 mg/day.

• Moderate liver impairment: start 50 mg no more than every 8 hours.
• Not for under 18 years.
• Do not crush or chew ER tablets; taper slowly when stopping.

• Significant respiratory depression, acute or severe asthma
• Paralytic ileus, bowel obstruction
• Use with MAO inhibitors (or within 14 days)
• Severe liver or kidney impairment
• Acute alcohol or sedative poisoning

Very common: nausea, dizziness, drowsiness, headache.

Common: vomiting, constipation, itching, dry mouth, sweating, tiredness, anxiety, sleep problems.

Serious: breathing depression (especially with sedatives/alcohol), dependence and addiction, withdrawal symptoms, seizures, serotonin syndrome, low blood pressure.

• Controlled medicine — risk of misuse, addiction and overdose; keep secure.
• Do not drive or drink alcohol.
• Epilepsy, head injury, COPD, sleep apnoea, elderly: caution.
• Stopping suddenly causes withdrawal — taper.

Avoid in pregnancy (newborn opioid withdrawal; breathing depression at delivery). Do not breastfeed.

• Benzodiazepines, alcohol, other opioids, sedatives, gabapentin/pregabalin — profound sedation, breathing depression, death
• MAO inhibitors (contraindicated); SSRIs, SNRIs, tricyclics, triptans (serotonin syndrome)
• Mixed opioid agonist/antagonists (buprenorphine, nalbuphine) reduce effect

Pinpoint pupils, extreme drowsiness, slow/shallow breathing, coma. Emergency — naloxone reverses it.

Store below 30°C, securely, out of reach of children and others.