Morphine is used to treat severe pain or severe coughing. Nausea, vomiting or constipation may occur with this medicine. Your doctor may be able to prescribe medicines to take with morphine to help with these side effects. Morphine can cause drowsiness. Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert.

About morphine

Type of medicine	Analgesic
Used for	Pain relief or severe cough
Also called	Oramorph; Sevredol; Morcap; MST Continus; MXL; Zomorph
Available as	Tablet and modified release tablet Capsule and modified release capsule Oral liquid Injection Suppository

Morphine is used to relieve severe pain and severe coughs; it works on the nerves and brain to reduce the pain you feel or the need to cough.

Before taking morphine

Before taking morphine make sure your doctor or pharmacist knows:

• If you suffer from liver problems.
• If you suffer from kidney problems.
• If you have problems with drug or alcohol dependence
• If you suffer from phaeochromocytoma.
• If you suffer from breathing problems.
• If you suffer from prostate problems.
• If you suffer from thyroid problems.
• If you suffer from epilepsy.
• If you suffer from hypotension (low blood pressure).
• If you have recently suffered a serious head injury.
• If you have been constipated for more than a week, with or without tummy pain and bloatedness.
• If you are pregnant, trying for a baby or breast-feeding.

How to take morphine

• Take exactly as directed by your doctor.
• Some capsules can be opened and the contents sprinkled onto soft food such as yogurt. Check with your pharmacist before trying this, as it does not apply to all capsules.
• If you are taking the modified release tablets that release drug slowly to give a more even effect, they should not be crushed or broken, swallow them whole or you may absorb too much drug too quickly from the gut.

Getting the most from your treatment

• Alcohol will increase any feelings of drowsiness. Avoid alcoholic drinks
• Morphine can cause constipation. Constipation can often be eased by eating plenty of fibre, such as wholegrain cereals, fruit, green leafy vegetables and drinking 6-8 glasses of water each day.
• Because morphine is a controlled drug, if you are planning a trip abroad, check with the government department HM Revenue and Customs to see if you need any documentation for your medicine. HM Revenue and Customs (HMRC) has a list of medicines that contain controlled drugs and can tell you the amount that you are allowed to take abroad. If you need to pack more of your medicine than you are allowed you will need to apply in writing for a licence from the Home Office before you travel.

Can morphine cause problems

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

Common side-effects	What can I do if I experience this
Nausea and vomiting	It usually passes after a few days; as you adjust to the medicine. Your doctor may be able to prescribe a medicine to ease nausea.
Drowsiness	Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert.
Constipation	Try to eat a well balanced diet containing fibre and drink 6-8 glasses of water each day. Your doctor may be able to prescribe a laxative.
Dry mouth	If you experience this, try chewing sugar-free gum, sucking sugar-free sweets or pieces of ice.
Sweating	Use a cold/wet flannel or sponge placed on the forehead.
Dizziness, particularly when getting up from a sitting or lying position	Getting up slowly should help.
Problems passing water (urinating)	If this occurs speak with your doctor.

How to store morphine

• Keep all medicines out of the reach of children.
• Store in a cool, dry place, away from direct heat and light.

Paracetamol is used to relieve mild to moderate pain and is also useful in controlling fever (high temperature). Never take more than the prescribed dose. Taking too much paracetamol can cause liver damage. If you suspect that you or someone else has taken an overdose of paracetamol go to the accident and emergency department of your local hospital at once. Always take the container with you, if possible, even if it is empty. Do not take more than 4 doses of paracetamol in any 24 hour period. Do not take with any other paracetamol products. Paracetamol is contained in many over-the-counter preparations including cold and flu remedies. Before taking any 'over the counter' medicines check with a pharmacist whether they contain paracetamol and if it is safe for you to take with your prescribed medication.

About paracetamol

Type of medicine	Analgesic
Used for	Pain and high temperature
Also called	Alvedon; Anadin Paracetamol; Calpol Fast Melts; Calpol Infant; Calpol; Calpol Six Plus; Disprol; Disprol Infant; Fennings; Galpamol; Hedex; Infadrops; Mandanol; Mandanol Infant; Medinol Over 6; Medinol Paediatric; Medinol Under 6; Miradol; Paldesic; Panadol
Available as	Tablet, capsule, soluble tablet, oral liquid and suppository

Paracetamol is used to relieve mild to moderate pain and is also useful in controlling fever (high temperature).

Before taking paracetamol

Before taking paracetamol make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you suffer from liver or kidney problems.
• If you drink large amounts of alcohol.

How to take paracetamol

• Take paracetamol exactly as directed by your doctor.
• Never take more than the prescribed dose. Taking too much paracetamol can cause liver damage. If you suspect that you or someone else has taken an overdose of paracetamol go to the accident and emergency department of your local hospital at once. Always take the container with you, if possible, even if it is empty.

Getting the most from your treatment

• If your symptoms do not begin to improve after taking paracetamol, speak with your pharmacist or doctor.
• Do not take more than 4 doses of paracetamol in any 24 hour period.
• Do not take with any other paracetamol products. Paracetamol is contained in many over-the-counter preparations including cold and flu remedies. Before taking any 'over the counter' medicines check whether they contain paracetamol and do not take with other products that contain paracetamol
• Before taking any 'over-the-counter' medicines check with your pharmacist if it is safe for you to take with your prescribed medication.

Can paracetamol cause problems

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine.
Paracetamol rarely causes side effects, but if you experience any symptoms, which you think may be due to this medicine, discuss them with your pharmacist or doctor.

How to store paracetamol

• Keep all medicines out of the reach of children.
• Store in a cool, dry place, away from direct heat and light.

Paracetamol, codeine and buclizine

Dihydrocodeine is used to treat moderate to severe pain. Drowsiness, nausea and constipation are the most common side effects. Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert or feel dizzy.

About dihydrocodeine

Type of medicine	Analgesic
Used for	Moderate to severe pain
Also called	DF 118, DHC Continus
Available as	Tablets, oral solution and injection

Before taking dihydrocodeine

Before taking dihydrocodeine make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you suffer from liver, kidney, respiratory (breathing), prostate or thyroid problems
• If you suffer from epilepsy or hypotension (low blood pressure)
• If you have recently suffered a serious head injury
• If you have been constipated for more than a week, with or without tummy pain and bloatedness
• If you have ever had a problem with drug or alcohol addiction

How to take dihydrocodeine

• Take dihydrocodeine exactly as directed by your doctor.
• If you have been supplied the modified release tablets, they should be swallowed whole (not crushed or chewed) with a glass of water.
• Dihydrocodeine should be taken with or after food. If however you are taking the modified release form of dihydrocodeine this can be taken without food.

Getting the most from your treatment

• Because dihydrocodeine is a controlled drug, if you are planning a trip abroad, check with the government department HM Revenue and Customs to see if you need any documentation for your medicine. HM Revenue and Customs (HMRC) has a list of medicines that contain controlled drugs and can tell you the amount that you are allowed to take abroad. If you need to pack more of your medicine than you are allowed you will need to apply in writing for a licence from the Home Office before you travel.

Can dihydrocodeine cause problems

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

Common side-effects	What can I do if I experience this
Feeling or being sick	Drink plenty of liquid. Stick to simple foods such as dry toast. If vomiting continues to be a problem speak to your doctor.
Constipation	Try to eat a well balanced diet containing plenty of fibre and drink 6-8 glasses of water each day. If constipation continues to be a problem speak to your pharmacist or doctor.
Drowsiness, dizziness	Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert or feel dizzy. Avoid alcohol; it will increase any feelings of drowsiness
Dry mouth	Try chewing sugar-free gum, sucking pieces of ice or sugar-free sweets. If this becomes troublesome speak to your pharmacist or doctor.
Sweating	Use a cold wet flannel to cool yourself down, if this continues to be problem and prevents you from taking your medicine, speak with your doctor.
Difficulty urinating (passing water), flushing (redness of the face), a fast or fluttering heartbeat, seeing or hearing things that aren't real, mood changes, sexual problems or skin rashes	Speak with your doctor.

How to store dihydrocodeine

• Keep all medicines out of the reach of children.
• Store in a cool, dry place, away from direct heat and light.

Pethidine is used to treat pain particularly after an operation or during child birth. Nausea, vomiting or constipation may occur with this medicine. Your doctor may be able to prescribe medicines to take with pethidine to help with these side effects. Pethidine can cause drowsiness. Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert.

About pethidine

Type of medicine	Analgesic
Used for	Pain particularly after an operation or during child birth
Also called	Pamergan
Available as	Tablets and injection

Pethidine is used to treat severe pain it works on the nerves and brain to reduce the pain you feel. It is particularly useful for treating pain associated with labour and can also be used to ease pain before, during and after an operation.

Before taking pethidine

Before taking pethidine make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you suffer from liver, kidney, respiratory (breathing), prostate or thyroid problems
• If you suffer from epilepsy or hypotension (low blood pressure)
• If you have recently suffered a serious head injury
• If you have been constipated for more than a week, with or without tummy pain and bloatedness
• If you currently or have ever suffered from drug or alcohol dependence

How to take pethidine

• Take exactly as directed by your doctor.

Getting the most from your treatment

• Alcohol will increase any feelings of drowsiness. Avoid alcoholic drinks
• Pethidine can cause constipation. Constipation can often be eased by eating plenty of fibre, such as wholegrain cereals, fruit, green leafy vegetables and drinking 6-8 glasses of water each day.
• You may feel sick or be sick while taking pethidine, especially during the first few days, your doctor may be able to prescribe a medicine to help stop this side effect.
• Because pethidine is a controlled drug, if you are planning a trip abroad, check with the government department HM Revenue and Customs to see if you need any documentation for your medicine. HM Revenue and Customs (HMRC) has a list of medicines that contain controlled drugs and can tell you the amount that you are allowed to take abroad. If you need to pack more of your medicine than you are allowed you will need to apply in writing for a licence from the Home Office before you travel.

Can pethidine cause problems?

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

Common side-effects	What can I do if I experience this
Nausea and vomiting	It usually passes after a few days; as you adjust to the medicine. Your doctor may be able to prescribe a medicine to ease nausea.
Drowsiness	Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert.
Constipation	Try to eat a well balanced diet containing fibre and drink 6-8 glasses of water each day. Your doctor may be able to prescribe a laxative.
Dry mouth	If you experience this, try chewing sugar-free gum, sucking sugar-free sweets or pieces of ice.
Sweating	Use a cold/wet flannel or sponge placed on the forehead.
Difficulty urinating (passing water), flushing (redness of the face), a fast or fluttering heartbeat, seeing or hearing things that aren't real, mood changes, sexual problems or skin rashes	If this occurs speak with your doctor.

How to store pethidine

• Keep all medicines out of the reach of children.
• Store in a cool, dry place, away from direct heat and light.

Consult your doctor or pharmacist before taking if you are allergic to menthol, peanuts or soya. Important: If there are new symptoms, worsening of the condition or failure to improve over two weeks of treatment, consult your doctor if you have not already done so.

About peppermint oil

Type of medicine	Antispasmodic
Used for	Relief of cramps or spasms of the stomach or intestines
Also called	Colpermin Mintec
Available as	Capsules

Peppermint oil works by acting on the smooth muscle in the gut to cause it to relax. This reduces painful cramps and muscle spasms. It is particularly useful in treating these symptoms in irritable bowel syndrome (IBS) and similar conditions.

Before taking peppermint oil

Before taking peppermint oil make sure your doctor or pharmacist knows:

• If you are allergic to menthol.
• If you suffer from paralytic ileus (a condition where the intestine is paralysed).
• If you are allergic to peanuts or soya (Colpermin contains peanut oil).
• If this is the first time you have experienced these symptoms (for confirmation of IBS).
• If you are aged 40 years or over and it is some time since the last attack or your symptoms have changed.
• If blood has been passed from the bowel.
• If you have a feeling of sickness, vomiting, loss of appetite or loss of weight.
• If you have been feeling tired, have severe constipation or a fever.
• If you have recently travelled abroad.
• If you have had abnormal vaginal bleeding or discharge.
• If you have experienced difficulty or pain in passing urine.
• If you are pregnant, trying for a baby or breast-feeding.

Important: If there are new symptoms, worsening of the condition or failure to improve after two weeks of treatment, consult your doctor if you have not already done so.

How to take peppermint oil

• Take peppermint oil exactly as directed by your doctor.
• Try to take peppermint oil at the same times each day to avoid missing any doses.
• Swallow each peppermint oil capsule whole, not crushed or chewed, with water.
• Take peppermint oil capsules half to one hour before each meal.
• If you miss a dose of peppermint oil, take it as soon as possible. If it is almost time for your next dose, then skip the missed dose and continue taking at the usual times. Never take two doses at the same time to compensate.

Getting the most from your treatment

• Do not take indigestion remedies at the same time of day as peppermint oil. Take these at least two hours before or two hours after a dose of peppermint oil.
• Keep your regular appointments with your doctor so your progress can be monitored.

Can peppermint oil cause problems?

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

Common side-effects - these affect less than 1 in 10 people who take this medicine	What can I do if I experience this
Heartburn	Speak to your doctor or pharmacist if this continues or becomes troublesome
Itching around the anus	Speak to your doctor or pharmacist if this continues or becomes troublesome

Very occasionally people can have an allergic reaction to peppermint oil. Signs of an allergic reaction are rash, headache, shaking, unsteadiness and a slow heart rate. If you experience these or any other worrying symptoms, which you think may be due to this medicine, discuss them with your doctor or pharmacist.

How to store peppermint oil

• Keep all medicines out of the reach of children.
• Store in a cool, dry place, away from direct heat and light.

Gabapentin may cause drowsiness. Make sure your reactions are normal before driving. Do not take antacid preparations at the same time as gabapentin. Do not stop taking gabapentin without speaking to your doctor first. Stopping suddenly can cause problems.

About gabapentin

Type of medicine	Antiepileptic
Used for	Epilepsy Neuropathic pain (pain resulting from damage to nerves)
Also called	Neurontin®
Available as	Tablets and capsules

Gabapentin is used either alone or alongside other drugs to prevent the convulsions (fits) suffered by epileptics. It works by reducing the activity of the central nervous system.

Gabapentin is also used in treating certain types of nerve pain associated with diabetes (diabetic neuropathy) or shingles (postherpetic neuralgia).

Before taking gabapentin

Before taking gabapentin make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you suffer from kidney problems.
• If you suffer from diabetes.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or any other medicine.

How to take gabapentin

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Take your medication exactly as your doctor has told you.
• Take gabapentin with a drink of water. It can be taken before, during or after meals.
• Try to take gabapentin at the same times each day to avoid missing any doses.
• If you do forget to take a dose, take one as soon as you remember unless it is nearly time for your next dose. Do not take two doses at the same time to make up.
• Do not take any antacid preparations at the same time as gabapentin as they interfere with gabapentin. If you do need to take an antacid for indigestion, leave at least two hours after taking your gabapentin before you take the antacid.

Getting the most from your treatment

• If you are taking gabapentin for epilepsy, when you first start a new treatment there may be a change in the number or type of convulsions you experience. Your doctor can advise you about this.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
• Keep your regular doctor's appointment so your progress can be monitored.
• Do not stop taking this medicine without speaking to your doctor first. Your doctor will want to reduce your dose over at least a week, as stopping suddenly can cause problems.
• If you are elderly, you may experience drowsiness, weakness, and swollen feet and ankles. Let your doctor know if this happens.
• While you are taking gabapentin, there is a small risk that you may develop mood changes, distressing thoughts and feelings about suicide. If this happens, tell your doctor straight away.
• If you buy any medicines, check with a pharmacist that they are safe to take with gabapentin.

Can gabapentin cause problems?

Along with their useful effects all medicines can cause unwanted side effects which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

Common side-effects	What can I do if I experience this
Drowsiness and dizziness (particularly when first taking gabapentin or after increasing a dose), double-vision or other problems with eye-sight	Make sure your reactions are normal before driving, operating machinery, or doing any other jobs which could be dangerous if you were not fully alert or able to see clearly
Headache	Ask your pharmacist to recommend a suitable pain-killer. If the headache continues, tell your doctor
Feeling or being sick, indigestion, abdominal discomfort	Eat little and often. Stick to simple foods
Diarrhoea	Drink plenty of water to replace the lost fluids
Constipation	Try to eat a well balanced diet containing plenty of fibre and drink 6-8 glasses of water each day
Dry mouth	Try chewing sugar-free gum or sweets
Infections, fever, tiredness, unsteadiness, increased appetite, flushing, hypertension, weight changes, changes in emotions or mood, fits, movement difficulties, shakiness, difficulty sleeping, 'pins and needles', vertigo, breathing difficulties, cough, gum changes, bruises, muscle or joint pains, impotence, swollen feet or ankles, and weakness	If any of these become troublesome, speak with your doctor

Important: If you experience persistent stomach pain with sickness, speak with your doctor or go to your local accident and emergency department without delay.

Important: If you experience jaundice (yellowing of the skin and whites of the eyes), fever, loss of appetite, and dark urine, speak with your doctor or go to your local accident and emergency department without delay.

Important: If you experience a blistering red rash and peeling skin, speak with your doctor or go to your local accident and emergency department without delay.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store gabapentin

• Keep all medicines out of the reach of children.
• Store in a cool, dry place, away from direct heat and light

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Tramadol

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Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty. This medicine is for you. Never give it to other people even if their condition appears to be the same as yours. Never keep out of date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you. If you have any questions about this medicine ask your pharmacist.