Zydol XL

Side effects

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.

- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Dizziness
- Drowsiness
- Headache
- Sweating
- Awareness of your heartbeat (palpitations)
- Increased heart rate (tachycardia)
- A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension)
- Skin reactions such as rash and itch
- Blurred vision
- Dry mouth
- False perceptions of things that are not really there (hallucinations)
- Nightmares
- Confusion
- Changes in mood
- Slow, shallow breathing (respiratory depression)
- Muscle weakness
- Difficulty passing urine

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:

- antipsychotic medicines
- bupropion
- mefloquine
- SSRI antidepressants (eg fluoxetine)
- tricyclic antidepressants (eg amitriptyline).

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):

- alcohol
- antipsychotics, eg haloperidol
- barbiturates, eg phenobarbital, amobarbital
- benzodiazepines, eg diazepam, temazepam
- other opioids, eg morphine, codeine
- sedating antihistamines, eg chlorphenamine, hydroxyzine
- sleeping tablets, eg zopiclone
- tricyclic antidepressants, eg amitriptyline.

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

Dromadol SR	Larapam SR	Mabron
Tramake	Tramake Insts	Zamadol
Zamadol 24hr	Zamadol SR	Zydol
Zydol SR

Tramadol capsules and injection are also available without a brand name, ie as the generic medicine.

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