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PALEXIA 25 MG FILM-COATED TABLETS

Active substance(s): TAPENTADOL HYDROCHLORIDE

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Package leaflet: Information for the user
PALEXIA® 25 mg film-coated tablets

Tapentadol
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
 Keep this leaflet. You may need to read it again.
 If you have any further questions, ask your doctor or pharmacist.
 This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even
if their signs of illness are the same as yours.
 If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects
not listed in this leaflet (see section 4).
What is in this leaflet:
1.
What PALEXIA is and what it is used for
2.
What you need to know before you take PALEXIA
3.
How to take PALEXIA
4.
Possible side effects
5.
How to store PALEXIA
6.
Contents of the pack and other information

1.

What PALEXIA is and what it is used for

The full name of your medicine is ‘PALEXIA 25 mg film-coated tablets’. It is referred to as ‘PALEXIA’ in
the rest of this leaflet.
Tapentadol - the active substance in PALEXIA - is a strong painkiller which belongs to the class of opioids.
PALEXIA is used in adults for the treatment of moderate to severe pain of recent onset that can only be
adequately managed with an opioid painkiller.

2.

What you need to know before you take PALEXIA

Do not take PALEXIA
 if you are allergic to tapentadol or any of the other ingredients of this medicine (listed in section 6)
 if you have asthma or if your breathing is dangerously slow or shallow (respiratory depression,
hypercapnia)
 if you have no bowel movement as shown by severe constipation and bloating which may be
accompanied by pain or discomfort in the lower stomach
 if you have poisoning with alcohol, sleeping pills, pain relievers or medicines that affect mood and
emotions (see ‘Other medicines and PALEXIA’).
Warnings and precautions
Talk to your doctor or pharmacist before taking PALEXIA if you:



have slow or shallow breathing
suffer from increased pressure in the brain or are not fully conscious
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have had a head injury or brain tumors
have had an epileptic fit or if you are at risk of having epileptic fits
suffer from liver or kidney problems (see ‘How to take PALEXIA’)
suffer from a pancreatic disease including inflammation of the pancreas (pancreatitis) or disease of
the bile duct (biliary tract disease)
are taking PALEXIA with medicines referred to as mixed opioid agonist/antagonists (e.g.,
pentazocine, nalbuphine) or partial mu-opioid agonists (e.g. buprenorphine)
have a tendency to abuse medicines or if you are dependent on medicines, as PALEXIA may lead to
addiction. In this case, you should only take these tablets for short periods of time and under strict
medical supervision.

Other medicines and PALEXIA
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Your doctor will tell you which medicines are safe to take with PALEXIA.
 Your breathing may become dangerously slow or shallow (respiratory depression) if you are taking
certain sleeping pills or tranquilizers (e.g. barbiturates, benzodiazepines), or pain relievers such as
morphine and codeine (also as cough medicine) in combination with PALEXIA. If this happens tell
your doctor.
 Your consciousness may be decreased, you may feel drowsier or feel you might faint, if you take
PALEXIA with sedatives (such as benzodiazepines), antipsychotics (medicines that affect the state
of mind or emotions), H1-antihistamines, opioids or alcohol. If this happens tell your doctor.
 If you are taking a type of medicine that affects serotonin levels (e.g. certain medicines to treat
depression), speak to your doctor before taking PALEXIA as there have been cases of “serotonin
syndrome”. Serotonin syndrome is a rare, but life-threatening condition. The signs include
confusion, restlessness, fever, sweating, uncoordinated movement of arms, legs or eyes,
uncontrollable jerking of muscles, muscle twitches and diarrhoea. Your doctor can advise you on
this.
 PALEXIA may not work as well if taken with opioid like medicines (e.g. those containing
pentazocine, nalbuphine or buprenorphine). Tell your doctor if you are currently being treated with
one of these medicines.
 Taking PALEXIA with products (e.g. rifampicin, phenobarbital or St John’s Wort) that affect the
enzymes required to remove PALEXIA from the body, may affect how well PALEXIA works or
may cause side effects. The effects may occur especially when the other medication is started or
stopped.
 PALEXIA should not be taken together with monoamine oxidase inhibitors (MAOIs - certain
medicines for the treatment of depression). Tell your doctor if you are taking or have taken MAO
inhibitors during the last 14 days.
Please keep your doctor informed about all medicines you are taking.
Taking PALEXIA with food, drink and alcohol
Do not drink alcohol whilst you are taking PALEXIA, because some side effects such as drowsiness may be
increased. You can take PALEXIA with or without food.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your
doctor or pharmacist for advice before taking this medicine.
Do not take PALEXIA:
 if you are pregnant, unless your doctor has instructed you to do so
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if you become pregnant during treatment with PALEXIA. Check with your doctor.
during childbirth, as it could lead to dangerously slow or shallow breathing (respiratory depression)
in the newborn
if you are breast-feeding, as it may pass into the breast milk.

Driving and using machines
If you feel drowsy, dizzy, have blurred vision or a slow reaction time whilst taking PALEXIA, then do not
drive, use tools or machinery.
Any such effects are more likely to occur when you start taking PALEXIA, when the dose of PALEXIA is
changed, or when you drink alcohol or take tranquilizers.
Please ask your doctor before driving a car or using machinery.
PALEXIA contains lactose.
Lactose is a type of sugar. If you have been told by your doctor that you have an intolerance to some sugars,
talk to your doctor before taking this medicine.

3.

How to take PALEXIA

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.
Your doctor will change the dose and time between doses of PALEXIA according to your pain level and
your needs. Generally, the lowest pain-relieving dose should be taken.
Adults
The usual dose is 1 tablet every 4 to 6 hours.
Daily doses greater than 700 mg tapentadol on the first day of treatment and daily doses greater than 600 mg
tapentadol on the following days of treatment are not recommended.
Your doctor may prescribe a different, more appropriate dose or timing of dosing, if this is necessary for
you. If you feel that the effect of these tablets is too strong or weak, talk to your doctor or pharmacist.
How and when should you take PALEXIA
PALEXIA is for oral use.
Swallow the tablets with a glass of water. You may take the tablets either on an empty stomach or with food.
How long should you take PALEXIA
Do not take the tablets for longer than your doctor has told you.
Elderly patients
In elderly patients (above 65 years) usually no dose adjustment is necessary. However, your doctor may
adjust your dose or time between doses if required.
Patients with liver or kidney problems (insufficiency)
Do not take PALEXIA if you have severe liver or kidney problems.
If you have moderate liver problems, your doctor will adjust your dose or time between doses.
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If you have mild liver problems or mild to moderate kidney problems, a dose adjustment is not required.
Children and adolescents
PALEXIA is not recommended for children and adolescents below the age of 18 years.
If you take more PALEXIA than you should
Taking too much PALEXIA may be life-threatening.
Immediate medical advice should be sought in the event of an overdose, even if you feel well.
Very high doses of PALEXIA may cause the following:
 pin-point pupils in the eyes
 being sick (vomiting)
 drop in blood pressure
 fast heart beat
 altered consciousness, collapse or deep unconsciousness (coma)
 epileptic fits
 dangerously slow or shallow breathing or stopping breathing.

If you forget to take PALEXIA
If you forget to take the tablets, your pain is likely to return. Do not take a double dose to make up for a
forgotten dose; simply continue taking the tablets as before.
If you stop taking PALEXIA
If you interrupt or stop treatment too soon, your pain is likely to return. If you wish to stop treatment, please
tell your doctor first before stopping treatment.
Generally there will be no withdrawal effects when treatment is stopped. However, on uncommon
occasions, people who have been taking the tablets for some time may feel unwell if they suddenly stop
taking them.
Symptoms may be:
 feeling restless, irritable, anxious, weak or sick (nausea), loss of appetite, being sick (vomiting),
diarrhoea
 watery eyes, runny nose, increase in size of the pupils in the eyes (dilated pupils)
 difficulty in sleeping, yawning
 sweating, shivering
 muscle or joint pain, backache, abdominal cramps
 increase in blood pressure, breathing or heart rate.
If you experience any of these complaints after stopping PALEXIA, please contact your doctor.
Do not stop taking this medicine unless your doctor tells you to. If your doctor wants you to stop taking your
tablets, he/she will tell you how to do this. This may include a gradual reduction of the dose.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.
Important side effects or symptoms to look out for and what to do if you are affected:
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This medicine may cause allergic reactions including swelling beneath the skin, hives and in severe
cases difficulty in breathing, a fall in blood pressure, collapse, or shock (rare). Symptoms may be
wheeziness, difficulty breathing, swelling of the eyelids, face or lips, or rash or itching, which may
cover your whole body.
Another serious side effect is a condition where you breathe more slowly or weakly than expected
(uncommon). It mostly occurs in elderly and weak patients.

If you are affected by these important side effects contact a doctor immediately.
Other side effects that may occur:
Very common (may affect more than 1 in 10 people)
 feeling sick (nausea), being sick (vomiting)
 dizziness, drowsiness, headache.
Common (may affect up to 1 in 10 people)
 decreased appetite, constipation, diarrhoea, indigestion
 anxiety, confusion, hearing, seeing or sensing things that are not really there (hallucinations), sleep
problem, abnormal dreams
 trembling, feeling hot (flushing), dry mouth
 itching, increased sweating, rash
 muscle cramps, feeling of weakness, tiredness or exhaustion (fatigue), feeling of body temperature
change.
Uncommon (may affect up to 1 in 100 people)
 feeling depressed, very happy (euphoria), nervous, restless, or excitable (agitated), low awareness of
time, place or identity (disorientation)
 lack of attention, forgetfulness, almost fainting, sedation, uncoordinated movements, muscle
twitches, difficulty in speaking
 numbness, abnormal sensations of the skin (e.g. tingling, prickling)
 abnormal vision
 faster heart beat, palpitations, decreased blood pressure, less oxygen in the blood, shortness of
breath
 stomach discomfort
 skin reactions (hives)
 feeling of heaviness
 delay in passing urine, passing urine more often than usual
 drug withdrawal effects (see ‘If you stop taking PALEXIA’)
 water retention (oedema)
 feeling strange, drunk, irritable or relaxed.
Rare (may affect up to 1 in 1,000 people)
 epileptic fits
 thinking abnormal, impaired consciousness, uncoordinated movements, slower heart beat
 delayed emptying of the stomach (impaired gastric emptying).
In general, the likelihood of having suicidal thoughts and behaviour is increased in patients suffering from
chronic pain. In addition, certain medicines for the treatment of depression (which have an impact on the
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neurotransmitter system in the brain) may increase this risk, especially at the beginning of treatment.
Although tapentadol also affects neurotransmitters, data from human use of tapentadol do not provide
evidence for an increased risk.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not
listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the
safety of this medicine.

5.

How to store PALEXIA

Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and the blister. The expiry date
refers to the last day of that month.
This medicinal product does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw
away medicines you no longer use. These measures will help protect the environment.

6.

Contents of the pack and other information

What PALEXIA contains
The active ingredient is tapentadol.
One (1) tablet contains 20 mg tapentadol (as hydrochloride).
The other ingredients are:
 Tablet core: microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, povidone K30,
magnesium stearate.
 Tablet coat: polyvinylalcohol, titanium dioxide (E 171), macrogol 3350, talc, yellow iron oxide (E
172), red iron oxide (E172).
What PALEXIA looks like and contents of the pack
PALEXIA 25 mg film-coated tablets are slightly brownish-orange round shaped film-coated tablets of
6.35 mm diameter, marked with Grünenthal logo on one side and “L1” on the other side.
PALEXIA film-coated tablets are packed in blisters.
In the UK, PALEXIA is available in boxes of 28 and 56 tablets.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Grünenthal Ltd, Regus Lakeside House, 1 Furzeground Way, Stockley Park East, Uxbridge, Middlesex
UB11 1BD, United Kingdom.
Manufacturer:
Grünenthal GmbH, Zieglerstrasse 6, 52078, Aachen, Germany.

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Other formats of this leaflet

A service is available to listen to or request a copy of this leaflet in Braille, large print or audio.
Please call free of charge: 0800 198 5000 (UK only)
Please be ready to give the following information:
 Product name: PALEXIA 25 mg film-coated tablets
 Reference number: PL 21727/0063
This leaflet was last revised in 01/2015.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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