Patient leaflet - Marol 200 mg prolonged-release tablets
What Marol Tablets are and what they are used for
The name of your medicine is Marol 100 mg, 150 mg or 200 mg Prolonged-release Tablets.
This medicine has been prescribed for you for the treatment of moderate to severe pain. It contains tramadol hydrochloride which belongs to a class of medicines called opioids, which are ‘pain relievers’.
This medicine has been prescribed to you and should not be given to anyone else.
Opioids can cause addiction and you may get withdrawal symptoms if you stop taking it suddenly. Your prescriber should have explained how long you will be taking it for and when it is appropriate to stop, how to do this safely.
Marol Prolonged-release tablets are referred to as Marol tablets below.
What you need to know before you take Marol Tablets
Do not take Marol Tablets:
- If you are allergic to tramadol hydrochloride 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 Marol Tablets (see “Other medicines and Marol Tablets”).
- If you are epileptic and your fits are not adequately controlled by treatment.
- As a substitute in drug withdrawal.
Warnings and precautions:
Talk to your doctor or pharmacist before taking Marol Tablets if:
- You are or have ever been addicted to opioids, alcohol, prescription medicines, or illegal drugs
- You have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating, when you have stopped taking alcohol or drugs
- You feel you need to take more Marol Tablets to get the same level of pain relief, this may mean you are becoming tolerant to the effects of this medicine or are becoming addicted to it. Speak to your prescriber who will discuss your treatment and may change your dose or switch you to an alternative pain reliever
- You suffer from depression and you are taking antidepressants as some of them may interact with tramadol (see ‘Other medicines and Marol Tablets’)
- You suffer from consciousness disorders (if you feel that you are going to faint)
- You are in a state of shock (cold sweat may be a sign of this)
- You suffer from increased pressure in the brain (possibly after a head injury or brain disease)
- You suffer from a liver or kidney disease
- You have difficulty in breathing
- You have a tendency towards epilepsy or fits because the risk of a fit may increase.
Do not use Marol Tablets for acute post-operative pain because of the increased risk of dependency and developing serious breathing problems.
If you are going to have an operation, or have just had an operation, please tell the doctor at the hospital if you are taking Marol Tablets. Your doctor may adjust your dose.
Taking this medicine regularly, particularly for a long time, can lead to addiction. Your prescriber should have explained how long you will be taking it for and when it is appropriate to stop, how to do this safely. Rarely, increasing the dose of this medicine can make you more sensitive to pain. If this happens, you need to speak to your prescriber about your treatment.
Tolerance, dependence, and addiction
This medicine contains tramadol which is an opioid medicine. Repeated use of opioids can result in the drug being less effective (you become accustomed to it, known as tolerance). Repeated use of Marol Tablets can also lead to dependence, abuse and addiction, which may result in life-threatening overdose. The risk of these side effects can increase with a higher dose and longer duration of use. Dependence or addiction can make you feel that you are no longer in control of how much medicine you need to take or how often you need to take it.
The risk of becoming dependent or addicted varies from person to person. You may have a greater risk of becoming dependent on or addicted to Marol Tablets if:
- You or anyone in your family have ever abused or been dependent on alcohol, prescription medicines or illegal drugs (“addiction”).
- You are a smoker.
- You have ever had problems with your mood (depression, anxiety, or a personality disorder) or have been treated by a psychiatrist for other mental illnesses.
If you notice any of the following signs whilst taking Marol Tablets, it could be a sign that you have become dependent or addicted:
- You need to take the medicine for longer than advised by your doctor.
You need to take more than the recommended dose.
PACKAGE LEAFLET: INFORMATION FOR THE USER
Marol 100 mg, 150 mg and 200 mg
Prolonged Release Tablets (Tramadol hydrochloride)
What is in this leaflet:
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How to take Marol Tablets
Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Before starting treatment and regularly during treatment, your doctor will discuss with you what you may expect from using Marol Tablets, when and how long you need to take it, when to contact your doctor, and when you need to stop it (see also section 2).
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 taken.
Unless otherwise prescribed by your doctor, the recommended dose is:
Adults and adolescents from the age of 12 years:
One Marol 100mg Tablet twice daily (equivalent to 200 mg tramadol hydrochloride per day), preferably in the morning and evening. One Marol 150mg Tablet twice daily (equivalent to 300 mg tramadol hydrochloride per day), preferably in the morning and evening. One Marol 200mg Tablet twice daily (equivalent to 400 mg tramadol hydrochloride per day), preferably in the morning and evening. Your doctor may prescribe a different, more appropriate dosage strength of Marol Tablets if necessary.
Do not take more than 400 mg tramadol hydrochloride daily, except if your doctor has instructed you to do so.
Use in children
Marol Tablets are not suitable for children below the age of 12 years. Elderly patients
In elderly patients (above 75 years) the excretion of tramadol may be delayed. If this applies to you, your doctor may recommend prolonging the dosage interval.
Severe liver or kidney disease (insufficiency)/dialysis patients Patients with severe liver and/or kidney insufficiency should not take Marol Tablets. If in your case the insufficiency is mild or moderate, your doctor may recommend prolonging the dosage interval. How and when you should take Marol Tablets:
Marol Tablets are for oral use.
Always swallow Marol Tablets whole, not divided or chewed, with sufficient liquid, preferably in the morning and evening. You may take the tablets on an empty stomach or with meals.
How long should you take Marol Tablets:
You should not take Marol Tablets 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 take Marol Tablets and at what dose. If you have the impression that the effect of Marol Tablets is too strong or too weak, talk to your doctor or pharmacist. If you take more Marol Tablets than you should:
If you have taken an additional dose by mistake, this will generally have no negative effects. You should take your next dose as prescribed.
If you (or someone else) swallow a lot of Marol Tablets at the same time you should go to hospital or call a doctor straight away. Signs of an overdose include very small pupils, being sick, a fall in blood pressure, a fast heartbeat, collapse, unconsciousness, fits and breathing difficulty or shallow breathing.
If you forget to take Marol Tablets
If you forgot to take the tablets, pain is likely to return. Do not take a double dose to make up for forgotten individual doses, simply continue taking tablets as before.
If you stop taking Marol Tablets
Do not suddenly stop taking this medicine. If you want to stop taking this medicine, discuss this with your prescriber first. They will tell you how to do this, usually by reducing the dose gradually so that any unpleasant withdrawal effects are kept to a minimum. Withdrawal symptoms such as restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, shaking, shivering or sweating may occur if you suddenly stop taking this medicine. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
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 Marol Tablets are nausea and dizziness, which occur in more than 1 in 10 people. Very Common (may affect more than 1 in 10 people)
- Dizziness
- Feeling sick (nausea).
Common (may affect up to 1 in 10 people)
- Headache, drowsiness
- Fatigue
- 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 physical strain.
- 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 and nightmares
Psychological complaints may appear after treatment with Tramadol. 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 (being less aware and less able to make decisions, which may lead to errors in judgment).
- 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 slow down.
- Weak muscles
- Passing urine with difficulty or pain, passing less urine than normal (dysuria).
Very rare (may affect up to 1 in 10,000 people)
- Hepatic enzyme increased.
Not known (frequency cannot be estimated from the available data)
- Decrease in blood sugar level
- Dependence and addiction (see section “How do I know if I am addicted?”)
- Hiccups
- Serotonin syndrome, that can manifest as mental status changes (e.g. agitation, hallucinations, coma), and other effects, such as fever, increase in heart rate, unstable blood pressure, involuntary twitching, muscular rigidity, lack of coordination and/or gastrointestinal symptoms (e.g. nausea, vomiting, diarrhoea) (see section 2 ‘What you need to know before you take Marol Tablets’).
Drug Withdrawal
When you stop taking Marol Tablets, you may experience drug withdrawal symptoms, which include restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, shaking, shivering or sweating.
How do I know if I am addicted?
If you notice any of the following signs whilst taking Marol Tablets, it could be a sign that you have become addicted.
- You need to take the medicine for longer than advised by your prescriber
- You feel you need to use more than the recommended dose
- You are using the medicine for reasons other than prescribed
- When you stop taking the medicine you feel unwell, and you feel better once taking the medicine again
If you notice any of these signs, it is important you talk to your prescriber.
Reporting of side effects
If you get any of the 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 or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
How to store Marol Tablets
Keep this medicine out of the sight and reach of children. Store this medicine in a safe and secure storage space, where other people cannot access it. It can cause serious harm and be fatal to people when it has not been prescribed for them.
Do not use this medicine after the expiry date which is stated on the blister and / or bottle and the carton after “EXP”. 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 to protect the environment.
Contents of the pack and other information
What Marol Tablets contain:
The active substance is: tramadol hydrochloride
- 1 Marol 100 mg tablet contains 100 mg tramadol hydrochloride
- 1 Marol 150 mg tablet contains 150 mg tramadol hydrochloride
- 1 Marol 200 mg tablet contains 200 mg tramadol hydrochloride The other ingredients are: calcium hydrogen phosphate dihydrate (E341), hydroxypropyl cellulose (E463), colloidal anhydrous silica (E551), and magnesium stearate (E470b).
What Marol Tablets look like and contents of the pack
Marol 100mg Tablets are off white, round biconvex tablets Marol 150mg Tablets are off white, capsule shaped tablets Marol 200mg Tablets are off white, capsule shaped tablets All the strengths are available in either clear or opaque coloured blister packs and pots of 10, 20, 30, 50, 60, 90, 100, 120, and 180 tablets but not all pack sizes may be marketed.
Marketing Authorisation Holder:
Morningside Healthcare Ltd.
Unit C, Harcourt Way
Leicester, LE19 1WP, UK
Manufacturer:
Morningside Pharmaceuticals Ltd.
5 Pavilion Way Loughborough LE11 5GW, UK
Morningside Pharmaceuticals Ltd. & Aspire Pharma Ltd. Second Floor, Boss Court, 7 Barton Close, Grove Park, Leicester, LE19 1SJ, UK
Aspire Pharma Ltd.
Unit 4, Rotherbrook Court, Bedford Road, Petersfield, GU32 3QG, UK This leaflet was last revised in March 2025.
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