{"id":25435,"date":"2022-09-17T07:45:46","date_gmt":"2022-09-17T07:45:46","guid":{"rendered":"https:\/\/zeepedia.com\/?p=25435"},"modified":"2022-09-19T06:59:02","modified_gmt":"2022-09-19T06:59:02","slug":"tramadol-retard-hexal","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/tramadol-retard-hexal\/","title":{"rendered":"Tramadol Retard Hexal &#8211; Tramadol hydrochloride uses, dose and side effects"},"content":{"rendered":"\n<p>100 mg, 150 mg, 200 mg&nbsp;prolonged-release tablet&nbsp;er<br>tramadol hydrochloride<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Tramadol Retard Hexal is and what it is used for<\/h2>\n\n\n\n<p>Tramadol hydrochloride, the active substance in Tramadol\u00a0Retard\u00a0Hexal, is an analgesic drug in the\u00a0opioid\u00a0drug group that acts on the\u00a0central nervous system.\u00a0Its pain-relieving effects depend on the effect on specific nerve cells in the spinal cord and brain.<\/p>\n\n\n\n<p>Tramadol&nbsp;Retard&nbsp;Hexal is used:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>in the treatment of moderate to severe pain.<\/li><\/ul>\n\n\n\n<p>Tramadol hydrochloride contained in Tramadol\u00a0Retard\u00a0Hexal may also be approved to treat other conditions not mentioned in this product information.\u00a0Ask your doctor, pharmacist, or another healthcare professional if you have any further questions, and always follow their instructions.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What you need to know before using Tramadol Retard Hexal<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not use Tramadol Retard Hexal<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>if you are allergic to tramadol or any of the other ingredients of this medicine (listed in section 6)<\/li><li>if you have\u00a0acute\u00a0alcohol poisoning or poisoning with sleeping pills, centrally acting painkillers,\u00a0opioids,\u00a0or other psychotropic drugs (drugs that affect your mood or emotional state)<\/li><li>if you are also taking\u00a0MAO inhibitors\u00a0(a special type of medicine used to treat depression or\u00a0Parkinson&#8217;s disease\u00a0) or have taken any such medicine within the last 14 days before starting treatment with Tramadol\u00a0Retard\u00a0Hexal (see &#8220;Other medicines and Tramadol\u00a0Retard\u00a0Hexal&#8221;) &#8220;)<\/li><li>if you have\u00a0epilepsy\u00a0and your seizures are not controlled by treatment<\/li><li>as a treatment for withdrawal symptoms in drug addiction.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and precautions<\/h2>\n\n\n\n<p>Talk to your doctor before using Tramadol&nbsp;Retard&nbsp;Hexal<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you think you may already be dependent on other painkillers (\u00a0opioids\u00a0)<\/li><li>if you have any effects on your consciousness (for example, if you feel unusually dizzy)<\/li><li>if you are in a state of shock (<a href=\"https:\/\/zeepedia.com\/medical\/diseases\/cold\/\">cold<\/a> sweat can be an indication of this)<\/li><li>if you have breathing difficulties<\/li><li>if you have increased pressure in the brain (e.g. after a head injury or brain disease)<\/li><li>if you have any liver or kidney disease<\/li><li>if you are sensitive to opiates<\/li><li>if you have\u00a0epilepsy\u00a0or if you have seizures<\/li><li>if you suffer from depression and take antidepressants because some of them can interact with tramadol (see &#8220;Other medicines and Tramadol\u00a0Retard\u00a0Hexal&#8221;). There is a small risk that you may get a so-called serotonin syndrome, which can occur after taking tramadol in combination with certain antidepressants or tramadol alone.\u00a0Seek immediate medical attention if you experience any of the symptoms of this serious syndrome (See section 4 \u201cPossible side effects\u201d).<\/li><\/ul>\n\n\n\n<p>If any of the above applies to you, talk to your doctor before you start taking this medicine.<\/p>\n\n\n\n<p>Sleep-related breathing disorders: Tramadol\u00a0Retard\u00a0Hexal can cause sleep-related breathing disorders such as\u00a0sleep apnea\u00a0(breathing pauses during sleep) and sleep-related\u00a0hypoxemia\u00a0(low oxygen content in the blood).\u00a0The symptoms can be breathing pauses during sleep, awakenings during the night due to shortness of breath, difficulty maintaining sleep, or severe drowsiness during the day.\u00a0Contact a doctor if you or someone else notices these symptoms.\u00a0The doctor may consider lowering your\u00a0dose.<\/p>\n\n\n\n<p>Epileptic seizures have been reported in patients taking tramadol at recommended\u00a0doses.\u00a0This risk may increase if the recommended maximum daily\u00a0dose\u00a0of 400 mg tramadol hydrochloride is exceeded or if you simultaneously take medicines that lower the seizure threshold (see &#8220;Other medicines and Tramadol\u00a0Retard\u00a0Hexal&#8221;).<\/p>\n\n\n\n<p>Please note that psychological and physical dependence may develop in patients using Tramadol&nbsp;Retard&nbsp;Hexal.&nbsp;During prolonged treatment with Tramadol&nbsp;Retard&nbsp;Hexal, the effects of the drug may decrease, which may lead to the need to use a higher&nbsp;dose&nbsp;(development of tolerance).&nbsp;For this reason, Tramadol&nbsp;Retard&nbsp;Hexal may only be used for shorter periods and under strict medical supervision in patients who are at risk of developing drug dependence.<\/p>\n\n\n\n<p>Also, inform your doctor if any of these problems develop while you are taking Tramadol\u00a0Retard\u00a0Hexal and if you have had any such problems in the past.<\/p>\n\n\n\n<p>Tramadol is converted into the liver by an\u00a0enzyme.\u00a0Some people have a variation of this\u00a0enzyme\u00a0and it can affect different people in different ways.\u00a0Some people may not get enough pain relief, while others are at greater risk of serious\u00a0side effects.\u00a0If you experience any of the following\u00a0side effects, stop taking this medicine and see a doctor immediately: slow or shallow breathing, confusion, sleepiness, small\u00a0pupils, nausea or vomiting, constipation, and poor appetite.<\/p>\n\n\n\n<p>Talk to your doctor if you experience any of the following symptoms while using Tramadol&nbsp;Retard&nbsp;Hexal:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>extreme tiredness, loss of appetite, severe abdominal pain, nausea, vomiting, or low\u00a0blood pressure.\u00a0This can be a sign of adrenal cortex failure (low levels of\u00a0cortisol\u00a0).\u00a0Contact a doctor if you experience these symptoms.\u00a0The doctor will decide if you need to take hormone replacement.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Children and young people<\/h2>\n\n\n\n<p>Tramadol&nbsp;Retard&nbsp;Hexal is not suitable for use in children under 12 years of age.<\/p>\n\n\n\n<p>Tramadol is not recommended for children and adolescents with respiratory problems because the symptoms of tramadol poisoning may be worse in these children and adolescents.<\/p>\n\n\n\n<p><strong>Older<\/strong><\/p>\n\n\n\n<p>Patients over 75 years of age should be closely monitored as&nbsp;elimination&nbsp;of tramadol may take longer (see section 3 &#8220;How to use Tramadol&nbsp;Retard&nbsp;Hexal&#8221;).<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Tramadol Retard Hexal<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you are using, have recently used, or might be using other medicines.<\/p>\n\n\n\n<p>Do not take Tramadol&nbsp;Retard&nbsp;Hexal at the same time as&nbsp;<strong>MAO inhibitors<\/strong>&nbsp;(medicines used to treat depression or&nbsp;Parkinson&#8217;s disease&nbsp;) or if you have taken these medicines within the last 14 days before treatment with Tramadol&nbsp;Retard&nbsp;Hexal.&nbsp;Life-threatening interactions, e.g.&nbsp;effects on the&nbsp;central nervous system&nbsp;as well as respiratory and cardiovascular function cannot be excluded.<\/p>\n\n\n\n<p>The pain-relieving effect of Tramadol&nbsp;Retard&nbsp;Hexal can be reduced and the treatment effects can be shortened if you take medicines that contain any of the following active substances:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>carbamazepine<\/strong>&nbsp;(used to treat seizures)<\/li><li><strong>pentazocine, nalbuphine or buprenorphine<\/strong>&nbsp;(pain relievers)<\/li><li><strong>ondansetron<\/strong>&nbsp;(used to treat nausea)<\/li><\/ul>\n\n\n\n<p>The risk of&nbsp;side effects&nbsp;increases<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you take sedative medicines, such as\u00a0<strong>benzodiazepines\u00a0or similar medicines<\/strong>\u00a0(\u00a0<strong>sedatives, sleeping pills<\/strong>\u00a0).\u00a0Concomitant use of Tramadol\u00a0Retard\u00a0Hexal and sedative drugs or drugs for sleep problems such as\u00a0benzodiazepines\u00a0or similar drugs increases the risk of drowsiness, breathing difficulties (\u00a0respiratory depression\u00a0),\u00a0coma,\u00a0and can be life-threatening.\u00a0Because of this, concomitant use should only be considered when other treatment options are not possible.\u00a0If the doctor prescribes Tramadol\u00a0Retard\u00a0Hexal at the same time as sedative drugs, the\u00a0dose should and the duration of treatment is limited by the doctor.\u00a0Tell the doctor if you are taking any sedative medication and follow the doctor&#8217;s dosage recommendations carefully.\u00a0It may be helpful to inform friends or relatives to be aware of the signs and symptoms described above.\u00a0Contact a doctor if you experience any of these symptoms.<\/li><li>if you take Tramadol\u00a0Retard\u00a0Hexal at the same time as other\u00a0medicines that\u00a0also\u00a0impair brain function,\u00a0e.g.\u00a0other pain relievers such as morphine and\u00a0codeine\u00a0(also as <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/cough-in-children\/\">cough<\/a> medicine) and alcohol\u00a0while taking Tramadol\u00a0Retard\u00a0Hexal.\u00a0You may feel sleepier or faint.\u00a0If this happens, talk to your doctor.<\/li><li>if you are taking medicines that can cause seizures, such as certain antidepressants or antipsychotic medicines.\u00a0The risk of having a seizure may increase if you take Tramadol\u00a0Retard\u00a0Hexal at the same time.\u00a0Your doctor will tell you if Tramadol\u00a0Retard\u00a0Hexal is suitable for you.<\/li><li>if you are taking certain antidepressants.\u00a0Tramadol\u00a0Retard\u00a0Hexal may affect these medicines and you may experience serotonin syndrome (see section 4 &#8220;Possible side effects&#8221;).<\/li><li>if you are simultaneously taking\u00a0medicines that prevent the blood from clotting normally\u00a0(so-called coumarin derivatives, such as\u00a0warfarin\u00a0).\u00a0The anti-coagulant\u00a0effects of these medicines can be enhanced and larger bleeding can occur under small areas of the skin (\u00a0ecchymosis\u00a0).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Tramadol Retard Hexal with food and alcohol<\/h2>\n\n\n\n<p>Do not drink alcohol while using this medicine because alcohol can increase the effect of Tramadol&nbsp;Retard&nbsp;Hexal.&nbsp;Food does not affect the effect of Tramadol&nbsp;Retard&nbsp;Hexal (see section 3 &#8220;How to take Tramadol&nbsp;Retard&nbsp;Hexal&#8221;).<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy, breastfeeding, and fertility<\/h2>\n\n\n\n<p>If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Pregnancy<\/strong>There is very little information regarding the safety of tramadol hydrochloride during pregnancy in humans.\u00a0Therefore, you should not take Tramadol\u00a0Retard\u00a0Hexal if you are pregnant. Long-term use of Tramadol\u00a0Retard\u00a0Hexal during pregnancy can lead to withdrawal symptoms in the newborn after delivery.<\/li><li>Breast-feeling tramadol is excreted in breast milk.\u00a0You should therefore not take Tramadol\u00a0Retard\u00a0Hexal more than once during breastfeeding.\u00a0Alternatively, if you take Tramadol\u00a0Retard\u00a0Hexal more than once, you should stop breastfeeding.<\/li><li>FertilityHuman experience suggests that tramadol hydrochloride does not affect female or male\u00a0fertility.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Driving ability and use of machinery<\/h2>\n\n\n\n<p>You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires increased attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0A description of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0Discuss with a doctor or pharmacist if you are unsure.<\/p>\n\n\n\n<p>Tramadol&nbsp;Retard&nbsp;Hexal can cause, among other things<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>drowsiness and dizziness<\/li><li>visual disturbances (blurred vision)<\/li><\/ul>\n\n\n\n<p>and can therefore reduce your ability to react.&nbsp;Do not drive or use tools or machines if this happens to you or if you feel that your ability to react is impaired.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Tramadol Retard Hexal contains lactose<\/h2>\n\n\n\n<p>If you have an intolerance to certain sugars, you should consult your doctor before taking this medication.<\/p>\n\n\n\n<p><strong>Tramadol&nbsp;Retard&nbsp;Hexal contains&nbsp;sodium<\/strong><\/p>\n\n\n\n<p>This medicine contains less than 1 mmol (23 mg)\u00a0of sodium\u00a0per\u00a0prolonged-release tablet, i.e. it is almost &#8220;sodium-free&#8221;.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to use Tramadol Retard Hexal<\/h2>\n\n\n\n<p>Always use this medicine as directed by your doctor.&nbsp;Ask your doctor or pharmacist if you are unsure.<\/p>\n\n\n\n<p>Does\u00a0one should be adjusted to the severity of your pain and your pain sensitivity.\u00a0Usually, you should take the lowest\u00a0dose\u00a0that provides pain relief.<\/p>\n\n\n\n<p>The usual\u00a0dose\u00a0is unless otherwise prescribed by a doctor:<\/p>\n\n\n\n<p><strong>Adults and young people over 12 years of age<\/strong><\/p>\n\n\n\n<p>Usual dose: Usual starting dose is\u00a0<strong>1 tablet of<\/strong>\u00a0100 mg\u00a0<strong>twice daily<\/strong>, morning and evening.<\/p>\n\n\n\n<p>If this does not provide sufficient pain relief, your doctor may increase the&nbsp;dose&nbsp;to 150 mg twice daily or 200 mg twice daily.<\/p>\n\n\n\n<p>At least 8 hours must pass between each\u00a0dose.<\/p>\n\n\n\n<p>As a general rule, you should not take more than the smallest possible&nbsp;dose&nbsp;needed to control your pain.<\/p>\n\n\n\n<p>Do not take more than a total of 400 mg tramadol hydrochloride daily unless there are specific medical reasons for this.<\/p>\n\n\n\n<p><strong>Use for children under 12 years of age<\/strong><\/p>\n\n\n\n<p>Use for children under 12 is not recommended.<\/p>\n\n\n\n<p><strong>Older<\/strong><\/p>\n\n\n\n<p>For elderly patients (over 75 years), it may take longer for tramadol to disappear from the body.\u00a0If this concerns you, your doctor may advise you to extend the time between\u00a0doses.<\/p>\n\n\n\n<p><strong>Severe&nbsp;<\/strong><strong>liver or kidney failure\/dialysis patients<\/strong><\/p>\n\n\n\n<p>Patients with severe liver and\/or\u00a0kidney failure\u00a0should not take Tramadol\u00a0Retard\u00a0Hexal.\u00a0If you have mild or moderate liver and\/or\u00a0kidney failure, your doctor may recommend you extend the time between\u00a0doses.<\/p>\n\n\n\n<p><em>Note!<\/em><\/p>\n\n\n\n<p>The recommended&nbsp;dosages&nbsp;above are guidelines only.&nbsp;If you are taking the drug to manage&nbsp;chronic&nbsp;pain, you should always, if possible, strictly follow the planned treatment schedule.<\/p>\n\n\n\n<p><strong>This is how you take your medicine<\/strong><\/p>\n\n\n\n<p>The prolonged-release tablets&nbsp;should be swallowed whole together with a sufficient amount of liquid (e.g. a glass of water).<\/p>\n\n\n\n<p>The tablets must not be split, broken, or chewed.<\/p>\n\n\n\n<p>The notch (of the identification mark) is not intended for splitting the tablet.<\/p>\n\n\n\n<p>You can take one&nbsp;prolonged-release tablet&nbsp;on an empty stomach or with food.<\/p>\n\n\n\n<p>It is important that you do not continue taking Tramadol\u00a0Retard\u00a0Hexal for longer than is necessary.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you have taken too much Tramadol Retard Hexal<\/h2>\n\n\n\n<p>This normally has no negative consequences for you.&nbsp;Continue taking Tramadol&nbsp;Retard&nbsp;Hexal as usual when your pain returns.<\/p>\n\n\n\n<p>If you have taken too much\u00a0of\u00a0the drug, the following signs may occur: reduced\u00a0pupils, vomiting, low\u00a0blood pressure, circulatory failure, disturbances in consciousness (with\u00a0coma\u00a0in extreme cases), epileptic-like convulsions (seizures), and shallow breathing (with respiratory arrest in extreme cases).<\/p>\n\n\n\n<p>If you have ingested too much medicine or if, for example,\u00a0a child has ingested the medicine by mistake, contact a doctor or hospital for an assessment of the risk and advice.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to take Tramadol Retard Hexal<\/h2>\n\n\n\n<p>You may notice that the pain returns.\u00a0Do not take a double\u00a0dose\u00a0to compensate for a missed\u00a0dose, but continue to take the medicine as\u00a0prescribed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop taking Tramadol Retard Hexal<\/h2>\n\n\n\n<p>You should not suddenly stop taking this medicine unless your doctor tells you to.&nbsp;If you want to stop taking your medicine, you should first discuss it with your doctor, especially if you have been taking it for a long time.&nbsp;The doctor will tell you when and how to stop, which can be done by gradually lowering the&nbsp;dose&nbsp;to reduce the risk of developing unnecessary&nbsp;side effects&nbsp;(withdrawal symptoms).<\/p>\n\n\n\n<p>Withdrawal symptoms may include excitement, anxiety, nervousness, tremors, overactivity, difficulty sleeping, and gastrointestinal upset.\u00a0Very few patients may have panic attacks, hallucinations, abnormal sensory sensations such as\u00a0itching, tingling and numbness, and ringing in the ears.\u00a0Additional unusual\u00a0central nervous system\u00a0symptoms, i.e. confusion, delusions, altered perception of one&#8217;s personality (depersonalization), altered perception of reality (derealization), and persecutory mania (\u00a0paranoia\u00a0), have been seen in very rare cases.\u00a0If you experience any of these problems after you stop taking Tramadol\u00a0Retard\u00a0Hexal, talk to your doctor.<\/p>\n\n\n\n<p>If you have any further questions about this medicine, ask your doctor or pharmacist.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n<p><strong>You should see a doctor immediately if you experience symptoms of an\u00a0allergic reaction<\/strong>, e.g.\u00a0swelling of the face, tongue,<strong> and\/or throat and\/or difficulty swallowing or\u00a0hives\u00a0along with difficulty breathing.<\/strong><\/p>\n\n\n\n<p><strong>Very common<\/strong>&nbsp;(may affect more than 1 in 10 users):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>nausea<\/li><li>dizziness.<\/li><\/ul>\n\n\n\n<p><strong>Common<\/strong>&nbsp;(may affect up to 1 in 10 users):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>headache<\/li><li>drowsiness<\/li><li>fatigue<\/li><li>vomiting, constipation, dry mouth<\/li><li>sweating.<\/li><\/ul>\n\n\n\n<p><strong>Uncommon<\/strong>&nbsp;(may affect up to 1 in 100 users):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>effects on the regulation of blood circulation (palpitations, increased\u00a0pulse, attacks of weakness, and circulatory failure).\u00a0These\u00a0side effects\u00a0usually occur in connection with an upright position and physical activity.<\/li><li>nausea<\/li><li>stomach upset (eg upset stomach, bloating)<\/li><li>diarrhea<\/li><li>skin symptoms (e.g.\u00a0itching, rash, rapid reddening of the skin).<\/li><\/ul>\n\n\n\n<p><strong>Rare<\/strong>&nbsp;(may affect up to 1 in 1,000 users):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>allergic reactions (eg difficulty breathing, wheezing, swelling of the skin) and shock reactions (sudden circulatory failure)<\/li><li>hallucinations, confusion,\u00a0delirium, anxiety, sleep disturbances, and nightmares<\/li><li>psychological symptoms may occur after treatment with Tramadol\u00a0Retard\u00a0Hexal, and the\u00a0intensity\u00a0and nature may vary between different individuals (depending on the personality and how long the user has been going on).\u00a0These symptoms can be mood swings (usually elation, sometimes irritation), changes in the level of activity (usually decreased, sometimes increased), and changes in the cognitive abilities and senses (disturbances in sensory sensations and the ability to recognize, which can lead to inappropriate decisions).<\/li><li>drug dependence may occur<\/li><li>appetite changes<\/li><li>abnormal sensation in the skin (eg, tingling, crawling, numbness)<\/li><li>tremors<\/li><li>shallow breathing;\u00a0can occur if the prescribed\u00a0dose\u00a0is exceeded or if other drugs that inhibit brain function are used at the same time<\/li><li>epileptic seizures;\u00a0occurred mainly after the use of high\u00a0doses\u00a0of tramadol or with the simultaneous use of other drugs that can cause seizures<\/li><li>involuntary muscle twitches<\/li><li>impaired coordination<\/li><li>fainting<\/li><li>speech disorders<\/li><li>blurred vision, pupil constriction,\u00a0pupil\u00a0dilation<\/li><li>slow\u00a0heart rate\u00a0(\u00a0bradycardia\u00a0)<\/li><li>high\u00a0blood pressure<\/li><li>slow breathing, shortness of breath (\u00a0dyspnea\u00a0);\u00a0shallow breathing may occur if the prescribed\u00a0dose\u00a0is exceeded or if other drugs that inhibit brain function are used at the same time<\/li><li>worsening of\u00a0asthma\u00a0has been reported although it was not possible to establish a causal relationship with the use of the active substance tramadol<\/li><li>muscle weakness<\/li><li>difficulty urinating, pain when urinating, or passing less urine than normal.<\/li><\/ul>\n\n\n\n<p><strong>Very rare<\/strong>&nbsp;(may affect up to 1 in 10,000 users):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>elevated liver enzymes.<\/li><\/ul>\n\n\n\n<p><strong>Has been reported<\/strong>&nbsp;(occurring in an unknown number of users):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>serotonin syndrome, which may manifest as altered mental status (eg, restlessness, hallucinations,\u00a0coma\u00a0) and other symptoms such as <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/cold\/\">fever<\/a>, increased heart rate, unstable\u00a0blood pressure, involuntary twitching, muscle stiffness, lack of coordination of movements, and\/or gastrointestinal symptoms (e.g. nausea, vomiting, diarrhea) (see section 2 &#8220;What you need to know before you take Tramadol\u00a0Retard\u00a0Hexal&#8221;).<\/li><li>low <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/diabetes-type-1\/\">blood sugar<\/a><\/li><li>hiccup.<\/li><\/ul>\n\n\n\n<p>Tramadol&nbsp;Retard&nbsp;Hexal is associated with a risk of addiction.<\/p>\n\n\n\n<p>Withdrawal symptoms may develop when treatment is stopped (see section 3 &#8220;If you stop taking Tramadol&nbsp;Retard&nbsp;Hexal&#8221;).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to store Tramadol Retard Hexal<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Use before the expiry date which is stated on the carton and blister card after EXP.&nbsp;The expiration date is the last day of the specified month.<\/p>\n\n\n\n<p>No special storage instructions.<\/p>\n\n\n\n<p>Medicines must not be thrown into the drain or among the household waste.\u00a0Ask the pharmacist how to dispose of medicines that are no longer used.\u00a0These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Contents declaration<\/h2>\n\n\n\n<p>The active substance is tramadol hydrochloride.<br>100 mg:<br>Each\u00a0prolonged-release tablet\u00a0contains 100 mg tramadol hydrochloride.<br><br>150 mg:<br>Each\u00a0prolonged-release tablet\u00a0contains 150 mg of tramadol hydrochloride.<\/p>\n\n\n\n<p><br>200 mg:<br>Each&nbsp;prolonged-release tablet&nbsp;contains 200 mg tramadol hydrochloride.<\/p>\n\n\n\n<p>Other ingredients are:<\/p>\n\n\n\n<p><em>Outer layer<\/em>:\u00a0<a href=\"https:\/\/zeepedia.com\/medical\/diseases\/lactose-intolerance\/\">lactose<\/a> monohydrate, calcium hydrogen phosphate dihydrate, corn starch, microcrystalline cellulose, sodium starch glycolate (type A), magnesium stearate,\u00a0colloidal\u00a0anhydrous silica<\/p>\n\n\n\n<p><em>Depot layer<\/em>:\u00a0lactose\u00a0monohydrate, hypromellose, povidone K25, magnesium stearate,\u00a0colloidal\u00a0anhydrous silicon dioxide, hydrogenated castor oil, quinoline yellow (E104), indigo carmine (E132), aluminum hydroxide.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Appearance and package sizes of the medicine<\/h2>\n\n\n\n<p>100 mg&nbsp;prolonged-release tablets&nbsp;are flat, round, two-layered tablets with beveled edges.&nbsp;The outer layer is white and the depot layer is green.&nbsp;The tablets are marked with &#8220;TR\/100 R&#8221; on one side.<\/p>\n\n\n\n<p>150 mg&nbsp;prolonged-release tablets&nbsp;are flat, round, two-layered tablets with beveled edges.&nbsp;The outer layer is white and the depot layer is green.&nbsp;The tablets are marked with &#8220;TR\/150 R&#8221; on one side.<\/p>\n\n\n\n<p>200 mg&nbsp;prolonged-release tablets&nbsp;are flat, round, two-layered tablets with beveled edges.&nbsp;The outer layer is white and the depot layer is green.&nbsp;The tablets are marked with &#8220;TR\/200 R&#8221; on one side.<\/p>\n\n\n\n<p><em>Package sizes<\/em><\/p>\n\n\n\n<p>Tramadol\u00a0Retard\u00a0Hexal is available in packs of 10, 20, 30, 50, 60, and 100\u00a0prolonged-release tablets\u00a0in a PP\/aluminum blister.<\/p>\n\n\n\n<p>Not all pack sizes may be marketed.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder:<\/h2>\n\n\n\n<p>HEXAL A\/S<\/p>\n\n\n\n<p>Edvard Thomsens Vej 14<\/p>\n\n\n\n<p>2300 Copenhagen S<\/p>\n\n\n\n<p>Denmark<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tramadol hydrochloride, the active substance in Tramadol\u00a0Retard\u00a0Hexal, is an analgesic drug in the\u00a0opioid\u00a0drug group that acts on the\u00a0central nervous system\u00a0.\u00a0Its pain-relieving effects depend on the effect on specific nerve cells in the spinal cord and brain.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,22500],"tags":[5337,5339,5340,26266,26270,26269,5338,26267,14539,26268],"class_list":["post-25435","post","type-post","status-publish","format-standard","hentry","category-medicines","category-t","tag-tramadol-hydrochloride","tag-tramadol-hydrochloride-side-effects","tag-tramadol-hydrochloride-tablet","tag-tramadol-retard-hexal","tag-tramadol-retard-hexal-side-effects","tag-tramadol-retard-hexal-tablet","tag-what-is-tramadol-hydrochloride","tag-what-is-tramadol-retard-hexal","tag-what-tramadol-hydrochloride-is-used-for","tag-what-tramadol-retard-hexal-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25435","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=25435"}],"version-history":[{"count":5,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25435\/revisions"}],"predecessor-version":[{"id":25479,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25435\/revisions\/25479"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=25435"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=25435"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=25435"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}