Overview
Tilidin 20x 50/4mg is a potent analgesic medication designed to manage moderate to severe pain. Manufactured by Hexal AG, a renowned pharmaceutical company, this product combines tilidine hydrochloride and naloxone hydrochloride to provide effective pain relief while minimizing the risk of opioid misuse.
Active Ingredients
- Tilidine Hydrochloride (50 mg per tablet)
- Mechanism of Action: Tilidine is a synthetic opioid analgesic. It works by binding to opioid receptors in the brain and spinal cord, altering the perception and response to pain.
- Purpose: Effective pain management for various conditions such as chronic pain, postoperative pain, and severe injury-related pain.
- Naloxone Hydrochloride (4 mg per tablet)
- Mechanism of Action: Naloxone is an opioid antagonist. It blocks the effects of opioids on the brain and is included to counteract the potential misuse and abuse of tilidine.
- Purpose: Prevents euphoria associated with opioid abuse, ensuring the medication is used solely for pain relief.
Indications
Tilidin 20x 50/4mg is indicated for the management of:
- Chronic pain conditions
- Acute pain episodes
- Postoperative pain
- Severe injuries requiring opioid-level pain relief
Dosage and Administration
- Standard Dosage: The recommended dosage is one tablet taken orally every 4 to 6 hours as needed for pain relief. The exact dosage and frequency should be determined by a healthcare provider based on the severity of the pain and the patient’s medical history.
- Administration: Tablets should be swallowed whole with a sufficient amount of water. Do not crush, chew, or dissolve the tablets to avoid tampering with the controlled-release mechanism.
Pharmacokinetics
- Absorption: Tilidine is rapidly absorbed from the gastrointestinal tract. It undergoes extensive first-pass metabolism in the liver to its active metabolite, nortilidine.
- Distribution: Tilidine and its metabolites are widely distributed throughout the body, including crossing the blood-brain barrier.
- Metabolism: Primarily metabolized in the liver to its active form, nortilidine.
- Excretion: Excreted mainly via the kidneys, with a half-life of approximately 3 to 5 hours for tilidine and its active metabolites.
Contraindications
- Hypersensitivity to tilidine, naloxone, or any of the excipients in the formulation.
- Patients with severe respiratory depression or obstructive airway disease.
- Acute intoxication with alcohol, hypnotics, analgesics, opioids, or psychotropic drugs.
- Patients with severe hepatic or renal impairment.
Warnings and Precautions
- Addiction and Abuse: While naloxone reduces the risk of abuse, tilidine remains an opioid and can be addictive. Use with caution in patients with a history of substance abuse.
- Respiratory Depression: High doses or concurrent use with other central nervous system depressants can cause significant respiratory depression.
- Head Injury and Increased Intracranial Pressure: Use with caution in patients with head injuries or conditions that may increase intracranial pressure.
- Liver and Kidney Function: Monitor liver and kidney function in patients with pre-existing conditions or those on long-term therapy.
Side Effects
Common side effects may include:
- Nausea and vomiting
- Dizziness and light-headedness
- Constipation
- Sweating
- Dry mouth
Serious side effects, which require immediate medical attention, include:
- Respiratory depression
- Severe hypotension
- Allergic reactions (rash, itching, swelling, severe dizziness, trouble breathing)
Drug Interactions
- CNS Depressants: Concomitant use with other central nervous system depressants (e.g., benzodiazepines, alcohol) can enhance sedative effects and increase the risk of respiratory depression.
- MAO Inhibitors: Avoid use with MAO inhibitors or within 14 days of stopping such treatment due to the risk of serotonin syndrome.
- Anticholinergic Drugs: Concomitant use may increase the risk of urinary retention and severe constipation.
Storage
- Store at room temperature (15-30°C / 59-86°F).
- Keep out of reach of children.
- Protect from moisture and direct sunlight.
Packaging
Tilidin 20x 50/4mg is available in blister packs containing 20 tablets, ensuring easy and secure dispensing.
Manufacturer Information
Hexal AG
A reputable manufacturer in the pharmaceutical industry, Hexal AG is committed to providing high-quality medications designed to meet the needs of patients and healthcare providers. Their extensive research and rigorous quality control standards ensure the efficacy and safety of their products.
For more information or to report adverse effects, please contact Hexal AG’s customer service or refer to the included patient information leaflet.










Camille Prescott –
Tilidin 50mg/4mg has been an excellent addition to my physician-directed pain management plan. Following a muscle injury, I needed reliable relief that would help me stay active while recovering. This medication delivered exactly that, allowing me to return to my normal routine much sooner than I expected. The effectiveness has remained consistent with every prescription, and the product quality has been outstanding. I’m very satisfied with the results and would gladly give it a five-star rating.
Derek Holloway –
I’ve been taking Tilidin 50mg/4mg exactly as prescribed for ongoing back pain, and the results have exceeded my expectations. Instead of constantly planning my day around pain, I can now stay focused on my job and enjoy my favorite hobbies again. The relief has been steady and dependable, making each day much more manageable. The quality has remained consistently excellent, and I couldn’t be happier with my experience.
Fiona Kingsley –
My experience with Tilidin 50mg/4mg has been outstanding. I was prescribed it after a minor orthopedic procedure, and it kept my pain under excellent control during the healing process. It made physical therapy sessions much more comfortable and helped me regain my mobility sooner than I expected. The tablets have always been dependable and well-packaged, giving me confidence in the product every time. I would absolutely rate this medication five stars.
Julian Ashcroft –
After struggling with chronic pain caused by arthritis, my physician recommended Tilidin 50mg/4mg. The improvement was noticeable within the first few days of treatment. I can now take longer walks, complete household chores, and spend more quality time with my grandchildren without being limited by pain. The medication has been consistently effective, and I’ve never noticed any variation in quality between prescriptions. It has truly improved my daily life.
Rebecca Sinclair –
Tilidin 50mg/4mg has been a tremendous help during my recovery from a wrist fracture. My doctor prescribed it to control the pain while the injury healed, and it allowed me to continue working from home without constant discomfort. The pain relief was consistent throughout the day, and I was finally able to get a full night’s sleep again. Every refill has been reliable, and the tablets have always been of excellent quality. I’m extremely grateful for how much easier this medication made my recovery.