tramadol hydrochloride capsules
CONSUMER MEDICINE INFORMATION
Limitations for use
Tramedo should only be used when your doctor decides that other treatment options
are not able to effectively manage your pain or you cannot tolerate them.
Hazardous and harmful use
Tramedo poses risks of abuse, misuse and addiction which can lead to overdose and
death. Your doctor will monitor you regularly during treatment.
Life threatening respiratory depression
Tramedo can cause life-threatening or fatal breathing problems (slow, shallow, unusual
or no breathing), even when used as recommended. These problems can occur at any time
during use, but the risk is higher when first starting Tramedo and after a dose increase,
if you are older, or have an existing problem with your lungs. Your doctor will monitor
you and change the dose as appropriate.
Use of other medicines while using Tramedo
Using Tramedo with other medicines that can make you feel drowsy such as sleeping
tablets (e.g. benzodiazepines), other pain relievers, antihistamines, antidepressants,
antipsychotics, gabapentinoids (e.g. gabapentin and pregabalin), cannabis and alcohol
may result in severe drowsiness, decreased awareness, breathing problems, coma and
Your doctor will minimise the dose and duration of use; and monitor you for signs
and symptoms of breathing difficulties and sedation. You must not drink alcohol while
What is in this leaflet
This leaflet answers some common questions about Tramedo. It does not contain all
the available information. It does not take the place of talking to your doctor or
All medicines have benefits and risks. Your doctor has weighed the risks of you taking
Tramedo against the benefits expected for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet. You may need to read it again.
What Tramedo is used for
Tramedo is used to relieve severe pain and belongs to a group of medicines called
opioid analgesics (pain relievers).
Your doctor may have prescribed Tramedo for another reason. Ask your doctor why Tramedo
has been prescribed for you.
Tramedo is available only with a doctor's prescription.
Tramedo is for use in adults and children over 12 years of age. It should not be used
in children under the age of 12 years or following the removal of tonsils and/or adenoids
in people under 18.
Before you take Tramedo
When you must not take it
Do not take Tramedo if you:
have a known allergy to tramadol or any of the ingredients listed at the end of this
have an allergy to other medicines known as opioid analgesic, e.g. morphine or codeine
have respiratory disease or slow or shallow breathing
have taken large amounts of alcohol or other substances which can affect your level
of consciousness. Some examples of these substances include sleeping pills, pain relievers
or other psychotropic medicines (medicines that affect mood and emotions)
are taking medicine for depression containing a monoamine oxidase inhibitor (MAOI)
or have taken a MAOI within the past two weeks.
have uncontrolled epilepsy or if your epilepsy is not well controlled by treatment
are younger than 12 years old or if you are between 12 – 18 years of age and are recovering
from an operation to remove your tonsils and/or adenoids.
Some of the symptoms of an allergic reaction may include
shortness of breath
wheezing or difficulty breathing
swelling of the face, lips, tongue or other parts of the body
rash, itching or hives on the skin.
Do not take this medicine if you are lactose or galactose intolerant.
This medicine contains lactose.
Do not take this medicine after the expiry date printed on the pack or if the packaging
is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
You can become addicted to Tramedo even if you take it exactly as prescribed. Tramedo
may become habit forming causing mental and physical dependence. If abused it may
become less able to reduce pain.
As with all other opioid containing products, your body may become used to you taking
Tramedo. Taking it may result in physical dependence. Physical dependence means that
you may experience withdrawal symptoms if you stop taking Tramedo suddenly, so it
is important to take it exactly as directed by your doctor.
Tolerance to Tramedo may develop, which means that the effect of the medicine may
decrease. If this happens, more may be needed to maintain the same effect.
Continue taking your medicine for as long as your doctor tells you. If you stop having
this medicine suddenly, your pain may worsen and you may experience some or all of
the following withdrawal symptoms:
nervousness, restlessness, agitation, trouble sleeping or anxiety
body aches, weakness or stomach cramps
loss of appetite, nausea, vomiting or diarrhoea
increased heart rate, breathing rate or pupil size
watery eyes, runny nose, chills or yawning
Very rarely, some patients have experienced the following withdrawal reactions:
tingling or numbness (pins and needles)
ringing in your ears
confusion, delusions or paranoia.
Tramedo given to the mother during labour can cause breathing problems and signs of
withdrawal in the newborn.
If you are not sure whether you should start taking Tramedo, talk to your doctor.
Before you start to take it
You must tell your doctor if:
you have a known allergy to tramadol or any of the ingredients listed at the end of
you are known to be sensitive to opioids
you drink alcohol
you have or have had any of the following medical conditions:
any lung or breathing problems
sleep-related breathing disorders
any condition that may affect how your kidney or liver work
any stomach problems
a severe headache or feel sick due to a head injury
any fits or convulsions or take medicine for epilepsy
you have or have had any problems with drug or alcohol dependence
you are pregnant or plan to become pregnant. Tramedo is not recommended for use during
pregnancy. Talk to your doctor about the risks and benefits of using Tramedo during
you are breastfeeding or wish to breastfeed. Tramedo is not recommended for use during
breastfeeding, as it passes into breast milk and may affect your baby
If you have not told your doctor about any of the above, tell them before you start
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any
that you get without a prescription from a pharmacy, supermarket or health food shop.
Some medicines and Tramedo may interfere with each other. These include:
carbamazepine (e.g. Tegretol®)
coumarin derivatives (e.g.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
Your doctor can tell you what to do if you are taking any of these medicines.
If you are not sure whether you are taking any of these medicines, check with your
doctor or pharmacist.
Your doctor and pharmacist have more information on medicines to be careful with or
avoid while taking Tramedo.
How to take Tramedo
Follow all directions given to you by your doctor and pharmacist carefully.
They may differ from the information contained in this leaflet.
If you do not understand the instructions on the pack, ask your doctor or pharmacist.
How much to take
Your doctor will decide the right dose for you. This may depend on your condition,
age, other medicines you are taking and how you respond to Tramedo.
An initial dose of, one Tramedo capsule may provide sufficient pain relief, followed
by one or two capsules two to three times a day as required.
For more severe pain, two Tramedo capsules are usually required for the first dose,
followed by one or two capsules every four to six hours as required.
Patients over 75 years of age may require a lower daily dose.
Do not take more than eight Tramedo capsules in 24 hours.
Tramedo is not recommended for use in children below 12 years of age.
How to take it
Swallow the capsules whole with a glass of water.
When to take it
Tramedo can be taken with or without food.
How long to take it for
Keep taking Tramedo for as long as your doctor tells you to.
Your length of treatment will depend on the medical condition for which you require
Tramedo and your response to it.
If you forget to take it
If you forget to take a dose, take it as soon as you remember.
The next dose should then be taken after four or six hours, or as prescribed by your
Do not take a double dose to make up for the dose you missed.
This may increase the chance of you getting an unwanted side effect.
If you are not sure what to do, ask your doctor or pharmacist.
If you take too much (overdose)
If you or someone else receive too much (overdose), and experience one or more of
the symptoms below, call triple zero (000) for an ambulance. Keep the person awake
by talking to them or gently shaking them every now and then. You should follow the
above steps even if someone other than you have accidentally used Tramedo that was
prescribed for you. If someone takes an overdose, they may experience one or more
of the following symptoms:
Slow, unusual or difficult breathing
Drowsiness, dizziness or unconsciousness
Slow or weak heartbeat
Nausea or vomiting
Convulsions or fits
If you think you or someone else may have taken too much Tramedo, you should immediately:
phone the Poisons Information Centre (by calling 13 11 26), or
contact your doctor, or
go to the Emergency Department at your nearest hospital.
You should do this even if there are no signs of discomfort or poisoning.
When seeking medical attention, take this leaflet and remaining medicine with you
to show the doctor. Also tell them about any other medicines or alcohol which have
While you are taking Tramedo
Things you must do
If you become pregnant while taking Tramedo, tell your doctor immediately.
If you are about to be started on any new medicine, remind your doctor and pharmacist
that you are taking Tramedo.
Tell any other doctors, dentists and pharmacists who treat you that you are taking
If you are going to have surgery (including dental surgery), tell the surgeon or anaesthetist
that you are taking this medicine.
If your pain is not as severe and you feel that you do not need as much Tramedo as
your doctor prescribed, consult your doctor.
If you feel that your pain gets worse or is not relieved at the dose prescribed, do
not take extra doses without checking with your doctor.
Your doctor will advise you on what to do.
If you are about to have any blood tests, tell your doctor that you are taking this
It may interfere with the results of some tests.
Visit your doctor regularly so they can check on your progress.
Things you must not do
Do not use this medicine to treat any other conditions unless your doctor tells you
Do not give this medicine to anyone else, even if they have the same conditions as
Things to be careful of
Be careful when driving or operating machinery until you know how this medicine affects
This medicine may cause dizziness, light-headedness, tiredness, drowsiness in some
people. If you have any of these symptoms, do not drive, operate machinery or do anything
else that could be dangerous.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you
are taking Tramedo.
Tramedo relieves pain in most people, but it may have unwanted side effects in some
All medicines can have side effects. Sometimes they are serious, most of the time
they are not. You may need medical treatment if you get some of the side effects.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
Common side effects:
nausea or vomiting
Less common side effects:
changes in appetite
sudden onset of low blood pressure, collapse
improvement in mood
difficulty in passing urine.
Serotonin Syndrome: signs of this vary and are not specific: they may include sweating,
agitation, muscle twitching, tremor, spontaneous muscle contraction, high body temperature.
Serotonin Syndrome may result from interaction of tramadol with other medicines which
increase serotonin effects, for example, the SSRI antidepressants.
The above list includes common and mild side effects of Tramedo.
See your doctor immediately or go to Accident and Emergency at the nearest hospital
if you notice any of the following:
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
The side effects listed above are very serious and may require urgent medical attention
Tell your doctor if you notice anything that is making you feel unwell.
This is not a complete list of all possible side effects.
Other side effects not listed above may also occur in some people.
After taking Tramedo
Keep your capsules in the pack/bottle until it is time to take them.
If you take the capsules out of the pack/bottle they may not keep well.
Keep your capsule in a cool dry place where the temperature stays below 30°C.
Do not store Tramedo or any other medicine in the bathroom or near a sink. Do not
leave it on a window sill or in the car.
Heat and dampness can destroy some medicines.
Keep medicines where children cannot reach them.
A locked cupboard at least one-and-a-half metres above the ground is a good place
to store medicines.
If you no longer need to use this medicine or it is out of date, take it to any pharmacy
for safe disposal.
Do not use this medicine after the expiry date.
What it looks like
Tramedo 50 mg capsules are white and orange in colour.
The capsules have "TL 50" on the white part and a Greek alpha symbol on the orange
part, printed in black ink.
Each blister pack and bottle contains 20 capsules.
The active ingredient in Tramedo is tramadol hydrochloride.
Each Tramedo capsule contains 50 mg of tramadol hydrochloride.
The capsules also contain the following inactive ingredients:
sodium starch glycollate
titanium dioxide E171
TekPrint SW-9008 Black Ink
sunset yellow FCF CI15985 (E110)
quinoline yellow CI47005 (E104)
allura red AC CI16035 (E129).
Tramedo contains sugars (as lactose) and traces of galactose and sulfites.
Tramedo is made in Australia by:
Alphapharm Pty Ltd
Level 1, 30 The Bond
30-34 Hickson Road
Millers Point NSW 2000
Australian registration numbers:
AUST R 114197 (blister pack)
AUST R 114181 (bottle)
This leaflet was prepared in