Sustained Release Tablets
Consumer Medicine Information
What is in this leaflet?
This leaflet answers some common questions about Tramal® SR
It does not contain all the available information.
It does not replace talking to your doctor or pharmacist.
Keep this leaflet. You may need to read it again.
All medicines have risks and benefits. If you have any concerns or want more information about your medicine, ask your doctor or pharmacist.
What Tramal® SR is used forTRAMAL® SR is used to relieve moderate to severe pain. It belongs to the group of medicines called analgesics (pain relievers).
TRAMAL® SR tablets are designed to release the pain reliever gradually over several hours.
Your doctor may have prescribed Tramal® SR for another reason. Ask your doctor why this medicine has been prescribed for you.
Tramal® SR tablets are not usually addictive. However, rarely, addiction to tramadol has been reported
TRAMAL® SR is available only on a doctor’s prescription.
Before you use Tramal® SR
When you must not use this medicine
Do not use TRAMAL® SR if:
- you have an allergy to any of the ingredients (see Product description below)
- you have an allergy to any other medicines known as opioid analgesics, eg. morphine or codeine.
- you have taken large amounts of alcohol or other substances which can affect your level of consciousness
- you are taking medicine for depression containing a “monoamine oxidase inhibitor” also known as MAOI, or have taken any within the past two weeks. Examples of MAOI-containing medicines are Nardil®, Parnate®.
- you are having treatment for withdrawal from narcotics
Do not take Tramal® SR if the packaging is torn or shows signs of tampering
Do not take Tramal® SR if any tablets look damaged or discoloured
Do not take Tramal® SR if it is after the expiry date which is printed on the carton box.
Do not give Tramal® SR to a child under the age of 12 years. Safety and effectiveness in children younger than 12 years have not been established.
Before you start to take it
You must tell your doctor if:
- you are known to be sensitive to opioids
- you have any health problems including:
- any lung or breathing problems
- fits or convulsions, or take medicines for epilepsy
- any disorder of the kidney, liver or pancreas
- any stomach problems
- severe headaches or have had a head injury
- you have, or have had, any drug or alcohol dependence
- you have galactose intolerance, or lactase deficiency or glucose-galactose malabsorption.
- you are pregnant or intend to become pregnant. Tramal® SR is not recommended for use during pregnancy. Talk to your doctor about the risks and benefits of using Tramal® SR during pregnancy.
- you are breast feeding or plan to breast feed. TRAMAL® SR is not recommended for use during breast feeding. Talk to your doctor about the risks and benefits of using TRAMAL® SR during pregnancy.
- you are driving or operating machinery. TRAMAL® SR may make you drowsy or dizzy. Ask your doctor for advice about whether it is safe for you to drive or operate machinery while taking TRAMAL® SR.
If you have not told your doctor about any of the above, tell him/her before you start taking this medicine.
Use in children
TRAMAL® SR is not recommended for children under 12 years.
Use in elderly
Patients over 75 years may need a reduced daily dose of TRAMAL® SR compared to younger adults.
Taking other medicines
Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop. Some medicines may interfere with TRAMAL® SR. These include:
- carbamazepine (eg. Tegretol®)
- coumarin derivatives (eg. Warfarin: some Brand names are Coumadin®, or Marevan®)
- medicine for irregular or rapid heart beat
- medicines for depression, sleeplessness or mental conditions such as selective serotonin reuptake inhibitors (SSRI’s), serotonin-noradrenaline reuptake inhibitors (SNRI’s), tricyclic anti-depressants, quinidine, phenothiazines or anti-psychotics
- some antibiotics.
These medicines may be affected by TRAMAL® SR, or may affect how well it works. You may need different amounts of your medicine, or you may need to take different
medicines. Other interactions not listed above may also occur.
Your doctor or pharmacist has more information on medicines to be careful with or avoid while taking TRAMAL® SR.
How to take TRAMAL® SR
TRAMAL® SR tablets should be swallowed whole with water. They maybe taken, before, with, or after food.
They must NOT be chewed, crushed or dissolved. This will release all the analgesic quite quickly. Side-effects may then occur.
How much to take
The recommended dosage of TRAMAL® SR is either:
- two TRAMAL®SR 50 tablets twice a day (morning and evening)
- one or two TRAMAL® SR 100 mg tablet(s) twice a day (morning and evening)
- one TRAMAL® SR 150 mg or 200 mg tablet twice a day (morning and evening).
As all patients respond to treatment differently, your doctor may start you on a lower dose.
Do not take more than eight of the 50 mg tablets per day.
Do not take more than four of the 100 mg tablets per day
Do not take more than two of the 150 mg or of the 200 mg tablets per day.
If you forget to take it
If you forget to take one dose, take the dose when you remember. The following dose should be taken after twelve hours, or as prescribed by your doctor.
Do not take a double dose to make up for the dose that you missed.
How long to take it
This differs between individuals depending on how severe your pain is, how you respond to TRAMAL® SR, and the cause of your pain. Ask your doctor for advice on how long you need to take TRAMAL® SR tablets.
TRAMAL® (capsules and injection) dosage forms are also available and they provide moderate to severe pain relief.
Things to be careful of
- take only as your doctor has told you.
- if you feel that you do not need as much TRAMAL® SR as your doctor has prescribed for you, talk to your doctor.
- tell your doctor if your pain is not helped or gets worse. Do not take increased amounts or extra doses of TRAMAL® SR unless your doctor advises you to.
- Do not give your medicine to anyone else, even if they have similar symptoms to you. Your medicine is for your use only, it may harm other people.
If you take too much (overdose)
In the event of overdose, you should contact your nearest Poisons Information Centre (tel: 131 126), doctor or hospital emergency department immediately. Overdosage with TRAMAL® SR may result in decrease in breathing and fits or convulsions.
Side effects of TRAMAL® SR
All medicines can cause unwanted effects, and some side-effects have been reported with TRAMAL® SR. Side-effects reported with TRAMAL® SR are usually minor and temporary, but some may be serious.
The most common side-effects of TRAMAL® SR are:
- sedation, fatigue
- nausea, vomiting
- dry mouth.
The following side-effects are less common:
- changes in appetite
- skin reactions
- sudden onset of low blood pressure, collapse
- muscle weakness
- respiratory depression
- improvement of mood
- sleep disturbance
- blurred vision
- difficulty in passing urine
- Serotonin Syndrome: signs of this vary and are not specific; they may include sweating, agitation, muscle twitching, spontaneous muscle contraction, tremor, high body temperature. Serotonin Syndrome may result from interaction of tramadol with other medicines which increase serotonin effects, for example, the SSRI antidepressants.
This is not a complete listing. Occasionally, other side-effects may be experienced. Tell your doctor immediately if you experience any of the following side-effects, as urgent medical treatment may be required:
- skin rash (red spots or patches), itching hives, skin lumps
- swelling or puffiness of the eyelids, face or lips
- chest tightness, wheezing or pain in the chest
- heart palpitations, faintness or collapse
If you experience any side-effects that have not been mentioned here, consult your doctor or pharmacist as soon as possible.
You should remember that all medicines carry some risks. It is possible that some risks might not yet have been detected despite many years of experience with the medicine.
Can TRAMAL® SR be addictive?
When used as prescribed by your doctor, addiction to TRAMAL® SR is very unlikely.
If you are taking TRAMAL® SR for a prolonged period of time, your body may become used to the medicine and mild withdrawal symptoms may occur if you suddenly stop taking the medicine.
It is important therefore to take TRAMAL® SR only as directed by your doctor.
After using Tramal® SR
- Keep TRAMAL® SR in a safe place, where children cannot reach it.
- Store in a cool, dry place, below 30°C.
- Keep away from direct sunlight.
- Do not use TRAMAL® SR after the use-by-date printed on the label of the pack.
If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any Tramal® SR that is left over.
What it looks like
TRAMAL® SR tablets are sealed in a blister foil pack.
The active medicine in TRAMAL® SR is called tramadol hydrochloride. It is specially made up into tablets that allow the body to absorb the tramadol over a long period, so that dosing need be only twice a day.
TRAMAL® SR is available as four distinct strengths of tablet. Each strength of tablet contains a different amount of the active ingredient,tramadol hydrochloride.
TRAMAL® SR Tablet 50mg
Pale yellow, round. One side imprinted with GRUNENTHAL logo. Other side engraved with “T0”. Available in packs of 20 or 60 tablets.
TRAMAL® SR Tablet 100 mg
White, round. One side imprinted with GRUNENTHAL logo. Other side engraved with "T1" Available inpacks of 20 or 60 tablets
TRAMAL® SR Tablet 150 mg
Pale orange. One side imprinted with GRUNENTHAL logo. Other side engraved with "T2" Available inpacks of 20 or 60 tablets
TRAMAL® SR Tablet 200 mg
Deep orange to brown. One side imprinted with GRUNENTHAL logo. Other side engraved with "T3"
Available in packs of 20 or 60 tablets
TRAMAL® SR tablets also contain the inactive ingredients:
- silica-colloidal anhydrous
- microcrystalline cellulose
- magnesium stearate
- lactose monohydrate
- macrogol 6000
- propylene glycol
- titanium dioxide
- quinoline yellow aluminium lake CI47005 (150 and 200 mg tablets)
- iron oxide red CI77491 (150 and 200 mg tablets)
- iron oxide yellow CI77492 (50 mg and 200 mg tablets only)
- iron oxide black CI77499 (200 mg tablets).
TRAMAL® SR is made by Grunenthal GmbH in Germany and supplied in Australia by:
Seqirus (Australia) Pty Ltd
ABN 26 160 735 035
63 Poplar Road
Date of Preparation of this Information:
Date of Update of this Information:
AUST R 121845: Tablets 50 mg
AUST R 75947: Tablets 100mg
AUST R 75948: Tablets 150mg
AUST R:75949: Tablets 200mg
TRAMAL® SR is a registered trademark of Grunenthal GmbH used by Seqirus as authorised user.
Published by MIMS July 2017