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ZYDOL SOLUTION FOR INJECTION
Zydol® 50 mg/ml Solution for Injection
Read all of this leaflet carefully before you start taking this
medicine beacause 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 (section 4).
In this leaflet:
hat ZYDOL® Solution for Injection is and what it is used for
2. What you need to know before you take ZYDOL® Solution for
3. H ow to take ZYDOL® Solution for Injection
4. P ossible side effects
5. H ow to store ZYDOL® Solution for Injection
6. C ontents of the pack and other information
1. What ZYDOL Solution for Injection is and what it is used for
Tramadol - the active substance in ZYDOL Solution for Injection - is
a painkiller belonging to the class of opioids that acts on the central
nervous system. It relieves pain by acting on specific nerve cells of
the spinal cord and brain.
ZYDOL Solution for Injection is used for the treatment of moderate
to severe pain.
2. What you need to know before you take ZYDOL Solution for
Do not take ZYDOL Solution for Injection
- if you are allergic to tramadol or any of the other ingredients of this
medicine (listed in section 6);
- in acute poisoning with alcohol, sleeping pills, pain relievers or other
psychotropic medicines (medicines that affect mood and emotions);
- if you are also taking MAO inhibitors (certain medicines used for
treatment of depression) or have taken them in the last 14 days
before treatment with ZYDOL Solution for Injection (see “Other
medicines and ZYDOL Solution for Injection”);
- if you are an epileptic and your fits are not adequately controlled
- a s a substitute in drug withdrawal.
Warnings and precautions
Talk to your doctor before taking ZYDOL Solution for Injection
- if you think that you are addicted to other pain relievers (opioids);
- if you suffer from consciousness disorders (if you feel that you are
going to faint);
- if you are in a state of shock (cold sweat may be a sign of this);
- if you suffer from increased pressure in the brain (possibly after a
head injury or brain disease);
- if you have difficulty in breathing;
- if you have a tendency towards epilepsy or fits because the risk of
a fit may increase;
- if you suffer from a liver or kidney disease;
Epileptic fits have been reported in patients taking tramadol at the
recommended dose level. The risk may be increased when doses of
tramadol exceed the recommended upper daily dose limit (400 mg).
Please note that ZYDOL Solution for Injection may lead to physical
and psychological addiction. When ZYDOL Solution for Injection
is taken for a long time, its effect may decrease, so that higher
doses have to be taken (tolerance development). In patients with a
tendency to abuse medicines or who are dependent on medicines,
treatment with ZYDOL Solution for Injection should only be carried
out for short periods and under strict medical supervision.
Please also inform your doctor if one of these problems occurs
during ZYDOL Solution for Injection treatment or if they applied to
you in the past.
Other medicines and ZYDOL Solution for Injection
Tell your doctor or pharmacist if you are taking, have recently taken
or might take any other medicines.
ZYDOL Solution for Injection should not be taken together with MAO
inhibitors (certain medicines for the treatment of depression).
The pain-relieving effect of ZYDOL Solution for Injection may be
reduced and the length of time it acts may be shortened, if you take
medicines which contain
- c arbamazepine (for epileptic fits);
- o ndansetron (prevents nausea).
Your doctor will tell you whether you should take ZYDOL Solution for
Injection, and what dose.
The risk of side effects increases,
- if you are taking tranquillizers, sleeping pills, other pain relievers
such as morphine and codeine (also as cough medicine), and
alcohol while you are taking ZYDOL Solution for Injection. You may
feel drowsier or feel that you might faint. If this happens tell your
- if you are taking medicines which may cause convulsions (fits),
such as certain antidepressants or antipsychotics. The risk having
a fit may increase if you take ZYDOL Solution for Injection at the
same time. Your doctor will tell you whether ZYDOL Solution for
Injection is suitable for you.
- if you are taking certain antidepressants ZYDOL Solution for
Injection may interact with these medicines and you may
experience symptoms such as involuntary, rhythmic contractions of
muscles, including the muscles that control movement of the eye,
agitation, excessive sweating, tremor, exaggeration of reflexes,
increased muscle tension, body temperature above 38˚C.
- if you are taking coumarin anticoagulants (medicines for blood
thinning), e.g. warfarin, together with ZYDOL Solution for Injection.
The effect of these medicines on blood clotting may be affected
and bleeding may occur.
Taking ZYDOL Solution for Injection with food and alcohol
Do not drink alcohol during treatment with ZYDOL Solution for
Injection as its effects may be intensified.
Pregnancy, breast-feeding and fertility
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. There is very little information
regarding the safety of tramadol in human pregnancy. Therefore
you should not use ZYDOL Solution for Injection if you are pregnant.
Chronic use during pregnancy may lead to withdrawal symptoms
Generally, the use of tramadol is not recommended during breastfeeding. Small amounts of of tramadol are excreted into breast
milk. After a single dose it is usually not necessary to interupt
Based on human experience tramadol is suggested not to influence
female or male fertility
Driving and using machines
ZYDOL Solution for Injection may cause drowsiness, dizziness and
blurred vision and therefore may impair your reactions. If you feel
that your reactions are affected, do not drive a car or other vehicle,
do not use electric tools or operate machinery.
The medicine can affect your ability to drive as it may make you
sleepy or dizzy.
• Do not drive while taking this medicine until you know how it
• It is an offence to drive if this medicine affects your ability to drive.
• However, you would not be committing an offence if:
- The medicine has been prescribed to treat a medical or dental
- You have taken it according to the instructions given by the
prescriber or in the information provided with the medicine and
- It was not affecting your ability to drive safely
Talk to your doctor or pharmacist if you are not sure whether it is
safe for you to drive while taking this medicine.
ZYDOL contains sodium
This medicinal product contains less than 1 mmol sodium (23 mg)
per ml, i.e. essentially ‘sodium-free’.
3. How to use ZYDOL Solution for Injection
This medicine should always be used exactly as prescribed by your
doctor. Check with your doctor or pharmacist if you are not sure.
The dosage should be adjusted to the intensity of your pain and
your individual pain sensitivity. In general the lowest pain-relieving
dose should be received. Normally, daily doses up to 8 ml of ZYDOL
solution for injection (equivalent to 400 mg tramadol hydrochloride)
will be sufficient. Exceptionally, if clinically required, your doctor
may direct to use a higher daily dose.
Unless otherwise prescribed by your doctor, the usual dose is:
Adults and adolescents from the age of 12 years:
Depending on your pain you will receive 1-2 ml of ZYDOL Solution
for Injection (equivalent to 50 – 100 mg tramadol hydrochloride).
Depending on your pain the effect lasts for about 4-8 hours.
Your doctor may prescribe a different, more appropriate dosage of
ZYDOL Solution for Injection.
For medical and healthcare professionals further information on
administration is given in the ‘User leaflet – Information for the
ZYDOL Solution for Injection is not suitable for children below the
age of 12 years.
In elderly patients (above 75 years) the excretion of tramadol may
be delayed. If this applies to you, your doctor may direct to prolong
the dosage interval.
GI ZYDOL 100MG AMP PATIENT
148 X 297 MM
Bez. der Vorgängerdatei:
Severe liver or kidney disease (insufficiency)/dialysis patients
Patients with severe liver and/or kidney insufficiency should not
receive ZYDOL Solution for Injection. If in your case the insufficiency
is mild or moderate, your doctor may recommend prolonging the
How and when should you receive ZYDOL Solution for Injection?
ZYDOL Solution for Injection will be injected slowly usually into a
blood vessel under the surface of the arm or injected into muscle
(usually the buttocks) or under the skin. Alternatively, ZYDOL
Solution for Injection will be diluted and infused into a vein.
For medical and healthcare professionals further information
on administration is given in a separate leaflet ‘User leaflet –
Information for the health professional’.
How long should you have ZYDOL Solution for Injection?
You should not receive ZYDOL Solution for Injection for longer than
necessary. If you need to be treated for a longer period, your doctor
will check at regular short intervals (if necessary with breaks in
treatment) whether you should continue to receive ZYDOL Solution
for Injection and at what dose.
If you have the impression that the effect of ZYDOL Solution for
Injection is too strong or too weak, talk to your doctor or pharmacist.
If you receive more ZYDOL Solution for Injection than you
If you have received an additional dose by mistake, this will
generally have no negative effects. You should receive your next
dose as prescribed.
If you (or someone else) received a very high dose of ZYDOL Solution
for Injection you should go to hospital or call a doctor straight away.
Signs of an overdose include very small pupils, being sick, fall in
blood pressure, fast heartbeat, collapse, unconsciousness, fits and
breathing difficulties or shallow breathing.
If you miss a dose of ZYDOL Solution for Injection
If you do not receive your ZYDOL Solution for Injection or infusion,
pain is likely to return. You should not receive a double dose to
make up for forgotten individual doses, simply continue receiving
ZYDOL Solution for Injection as before.
If you stop receiving ZYDOL Solution for Injection
If treatment with ZYDOL Solution for Injection is interrupted or
finished too soon, pain is likely to return. If you wish to stop treatment
on account of unpleasant effects, please tell your nurse or doctor.
Generally there will be no after-effects when treatment with ZYDOL
Solution for Injection is stopped. However, on rare occasions, people
who have been treated with ZYDOL Solution for Injection for some time
may feel unwell if the treatment is abruptly stopped. They may feel
agitated, anxious, nervous or shaky. They may be hyperactive, have
difficulty sleeping and have stomach or bowel disorders. Very few
people may get panic attacks, hallucinations, unusual perceptions
such as itching, tingling and numbness, and “ringing” in the ears
(tinnitus). Further unusual CNS symptoms, i.e. confusion, delusions,
change of perception of the own personality (depersonalisation),
and change in perception of reality (derealisation) and delusion of
persecution (paranoia) have been seen very rarely. If you experience
any of these complaints after stopping ZYDOL Solution for Injection,
please tell your nurse or doctor.
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.
You should see a doctor immediately if you experience
symptoms of an allergic reaction such as swollen face,
tongue and/or throat, and/or difficulty swallowing or hives
together with difficulties in breathing.
The most common side effects during treatment with ZYDOL
Solution for Injection are nausea and dizziness, which occur in more
than 1 in 10 people.
Very common: may affect more than 1 in 10 people
• feeling sick (nausea)
Common: may affect up to 1 in 10 people
• headaches, drowsiness
• constipation, dry mouth, being sick (vomiting)
• sweating (hyperhidrosis)
Uncommon: may affect up to 1 in 100 people
• effects on the heart and blood circulation (pounding of the heart,
fast heartbeat, feeling faint or collapse). These adverse effects
may particularly occur in patients in an upright position or under
• urge to be sick (retching), stomach trouble (e.g. feeling of
pressure in the stomach, bloating), diarrhoea
• skin reactions (e.g. itching, rash)
Rare: may affect up to 1 in 1,000 people
• allergic reactions (e.g. difficulty in breathing, wheezing, swelling
of skin) and shock (sudden circulation failure) have occurred in
very rare cases.
• slow heartbeat
• increase in blood pressure
• abnormal sensations (e.g. itching, tingling, numbness), trembling,
epileptic fits, muscle twitches, uncoordinated movement,
transient loss of consciousness (syncope), speech disorders.
• Epileptic fits have occurred mainly at high doses of tramadol or
when tramadol was taken at the same time as other medicines
which may induce fits.
• changes in appetite
• hallucination, confusional state, sleep disorders, delirium, anxiety
Psychological complaints may appear after treatment with
ZYDOL Solution for Injection. Their intensity and nature may
vary (according to the patient’s personality and length of
therapy). These may appear as a change in mood (mostly high
spirits, occasionally irritated mood), changes in activity (usually
suppression, occasionally increase) and decreased cognitive and
sensory perception (changes in senses and recognition, which
may lead to errors in judgment).
• Drug dependence may occur. If ZYDOL Solution for Injection is
taken over a long period of time dependence may occur, although
the risk is very low. When treatment is stopped abruptly, signs
of withdrawal may appear (see “If the use of ZYDOL Solution for
Injection solution is stopped”).
blurred vision, excessive dilation of the pupils (mydriasis),
constriction of the pupils (miosis)
• slow breathing, shortness of breath (dyspnoea)
• Worsening of asthma has been reported, however it has not
been established whether it was caused by tramadol. If the
recommended doses are exceeded, or if other medicines that
depress brain function are taken at the same time, breathing may
• weak muscles
• passing urine with difficulty or pan, passing less urine than normal
Very rare: may affect up to 1 in 10,000 people
• increase in liver enzyme values
Not known: frequency cannot be estimated from the available data
• decrease in blood sugar level
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 ZYDOL Solution for Injection
Keep 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 label. The expiry date refers to the last day of that
month. Do not store above 30˚C.
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 ZYDOL Solution for Injection contains
The active substance is tramadol hydrochloride.
The other ingredients are: sodium acetate and water for injection
What ZYDOL Solution for Injection looks like and contents of
ZYDOL Solution for Injection is a clear colourless solution.
ZYDOL Solution for Injection is supplied in boxes of five ampoules,
each containing 2 ml solution.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Regus Lakeside House
1 Furzeground Way
Stockley Park East
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:
ZYDOL SOLUTION FOR INJECTION PL 21727/0002
This leaflet was last revised:
07 July 2016
ZYDOL® is a registered trademark
GI ZYDOL 100MG AMP PATIENT
148 X 297 MM
Bez. der Vorgängerdatei:
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.