Simgesic tablet 37.5/325mg Tablets

Tramadol and paracetamol together relieve moderate to severe pain when a doctor decides this combination is needed.

• Tramadol is an opioid painkiller that changes how the brain and nerves respond to pain.
• Paracetamol is a painkiller that works in a different way.

Combining them gives pain relief from two different actions.

Take it exactly as your doctor tells you, for the shortest time possible.

• Swallow tablets whole with enough liquid. Do not break or chew them.
• Leave at least the time between doses your doctor tells you, and never take more than the daily limit.
• Do not take any other medicine containing paracetamol or tramadol.
• Do not stop suddenly after taking it for a while. Your doctor will lower the dose slowly to avoid withdrawal symptoms.
• If you miss a dose, do not take a double dose. Carry on as before.

Common side effects include:

• feeling sick, dizziness, drowsiness
• being sick, constipation, diarrhoea, tummy pain, dry mouth
• headache, sweating, itching, shaking
• confusion, sleep problems, mood changes

Get medical help straight away if you have:

• slow or shallow breathing, extreme sleepiness or small pupils
• rash, swelling of the face or throat, or trouble breathing
• agitation, fever, fast heartbeat, sweating or stiff, twitching muscles
• fits (seizures) or fainting
• unusual or long-lasting bleeding

Do not take it, and check with your doctor, if you:

• have severe liver problems or epilepsy that is not well controlled
• take, or took in the last 14 days, an MAOI medicine
• have been drinking heavily, or take sleeping pills or other sedating medicines

Also tell your doctor if you:

• have kidney or liver problems, asthma or lung disease, a head injury, or depression
• have ever misused alcohol or drugs
• take antidepressants, other opioids, benzodiazepines, carbamazepine, warfarin or flucloxacillin

It is not recommended for children under 12.

No special temperature storage is needed. Keep it locked away, out of the sight and reach of children and others, as it can be fatal to someone it was not prescribed for.

Addiction: tramadol is an opioid and can cause dependence and addiction. Only take it as prescribed and never share it.

Paracetamol overdose: too much can cause serious liver damage, even if you feel well. Get urgent help after taking too much.

Alcohol and driving: avoid alcohol. It can make you drowsy, so do not drive or use machines if affected.

Pregnancy and breastfeeding: do not take it while pregnant or breastfeeding unless your doctor advises.