Opalgic 50 mg Capsule

Opioid-type painkiller for moderate to severe pain:

• Pain after surgery or injury
• Back pain, osteoarthritis pain and other pain not controlled by simpler painkillers
• Nerve pain (with other treatments)

(Tramadol is a controlled medicine and should be used only on prescription.)

Adults and children over 12 years: 50–100 mg every 4–6 hours as needed; maximum 400 mg in 24 hours. Modified-release: 100–200 mg twice daily.

Elderly over 75 years: maximum 300 mg/day.

Kidney or liver impairment: longer gaps between doses (e.g. every 12 hours).

Injection: 50–100 mg every 4–6 hours IM/slow IV (in hospital).

• Use the lowest effective dose for the shortest time.
• Do not stop suddenly after long use — reduce gradually.

• Allergy to tramadol or opioids
• Acute poisoning with alcohol, sleeping pills, painkillers or psychiatric drugs
• Use of MAO inhibitors within 2 weeks
• Uncontrolled epilepsy
• Children under 12 years; under 18 years after tonsil/adenoid removal
• Severe breathing problems

Very common/common: nausea, dizziness, drowsiness, headache, constipation, vomiting, dry mouth, sweating, tiredness.

Less common: palpitations, confusion, mood changes, itching.

Serious: seizures (high doses or with other drugs), serotonin syndrome (with antidepressants), slow/shallow breathing, low blood sugar, dependence and withdrawal, misuse.

• Drowsiness — do not drive; avoid alcohol.
• Risk of addiction and misuse; keep securely.
• Epilepsy or seizure risk, head injury, raised brain pressure, breathing problems: use with great care.
• Some people (ultra-rapid metabolisers) can get dangerously high active levels.

Avoid in pregnancy (risk of withdrawal in the newborn with long use). Not recommended while breastfeeding (single doses may be acceptable on advice).

• SSRIs, SNRIs, tricyclics, MAO inhibitors, triptans, linezolid (serotonin syndrome, seizures)
• Alcohol, benzodiazepines, other opioids, sedatives (breathing depression)
• Carbamazepine (reduces effect, seizure risk)
• Warfarin (raised INR)
• Ondansetron (reduces pain relief)

Pinpoint pupils, vomiting, slow breathing, drowsiness, seizures, collapse. Emergency — naloxone may be given in hospital.

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