If you have been prescribed STILPANE tablets, you are likely looking for clear, practical information you can trust. This medicine is used for short-term relief of mild to moderate pain when that pain is linked with anxiety or tension. It is a combination medicine, which means it contains more than one active ingredient working together.
STILPANE is an S5 scheduled medicine in South Africa.
What it is and what it is used for
STILPANE is a tablet medicine made up of four active ingredients:
- Meprobamate 150 mg
- Codeine phosphate 8 mg
- Paracetamol 320 mg
- Caffeine anhydrous 32 mg
This combination is indicated for the short-term treatment of mild to moderate pain associated with anxiety or tension.
That means it is not simply used for pain on its own. According to the source, it is specifically intended where pain is linked with anxiety or tension, and it is only meant to be used for a limited period.
How it works
STILPANE works through the combined effect of its active ingredients.
- Paracetamol helps to relieve pain.
- Codeine phosphate is a pain-relieving medicine that acts on the brain and nervous system.
- Meprobamate is linked to calming effects, which may help where anxiety or tension forms part of the problem.
- Caffeine anhydrous is also included in the combination.
In everyday terms, this medicine is designed to help when you are dealing with pain together with tension or anxiety, rather than treating only one part of the problem.
Who should NOT use this medicine
Do not use STILPANE if you:
- are allergic or hypersensitive to any of the ingredients in STILPANE
- are pregnant
- are breastfeeding
- have porphyria (a disorder related to blood pigment)
- have severe liver problems
- have severe kidney problems
- have severe lung problems
- have asthma, bronchitis, or breathing problems
- are having an asthma attack
- have just had an operation on your bile tract
- are an alcoholic
- have had a recent head injury
- have a condition where the pressure in your skull is increased
- have heart failure caused by chronic lung disease
- are taking monoamine oxidase inhibitors (MAOIs), usually used for depression
- stopped taking MAOIs within the last 14 days
Important age restriction
Do not use STILPANE in:
- children under 12 years of age
Warnings and precautions (Read before use)
There are several important safety points to understand before taking STILPANE.
Risk of dependency and addiction
Warning: If you take more tablets than recommended, or use STILPANE for longer than recommended, it may lead to dependency and addiction.
The source also states that prolonged use of high doses of codeine has caused addiction similar to morphine addiction. There is also a serious addiction risk associated with meprobamate, with a typical withdrawal syndrome.
STILPANE should not be used:
- for longer than 5 days
- for the stress of daily living
Risk of morphine intoxication
Even when taken at normal doses, STILPANE may cause increased morphine levels in the body because codeine is converted to morphine. This can lead to clinical signs of morphine intoxication.
Liver and kidney risks
Taking higher doses of paracetamol than recommended can cause severe liver damage.
Using STILPANE for longer than recommended may cause irreversible kidney damage.
If you have liver or kidney disease, you should take STILPANE under medical supervision.
If your pain is not improving
If you do not get relief from the recommended dose, consult your doctor. Do not simply keep increasing the number of tablets yourself.
If you take other medicines that affect the liver
STILPANE should be used with care if you are taking other medicines that affect the liver, such as barbiturates used to treat epilepsy.
Extra caution with codeine
Codeine should be used carefully if you have:
- an underactive thyroid gland
- adrenocortical insufficiency (when the adrenal glands do not make enough steroid hormone)
- asthma
- impaired liver function
- an enlarged prostate gland
- low blood pressure
- shock
- inflammatory bowel disorders
- obstructive bowel disorders
- diseases or conditions that cause weakness of muscles around the eyes, mouth, and throat
Extra caution in older or frail patients
STILPANE should be avoided in elderly and debilitated patients. “Debilitated” means very weak, frail, or very unwell.
Labour and newborn breathing problems
The source states that STILPANE given during labour may cause breathing problems in the newborn baby.
Effects on the brain and alertness
Codeine may reduce brain function and activity, and this effect can become stronger when combined with medicines that slow down brain activity, such as:
- alcohol
- anaesthetics
- calming tablets
- sleeping tablets
- phenothiazines
Caffeine-related concerns
Extremely high doses and increased sensitivity to STILPANE may lead to serious problems such as:
- agitation
- increased urine output
- repeated vomiting with extreme thirst
- confusion
- hallucinations
- very high body temperature of 41 °C or above
- abnormal heartbeat, including a fast heartbeat
- electrolyte disturbances
- convulsions
- death
Use with caution if you have:
- peptic ulcer
- an overactive thyroid gland
- high blood pressure
- epilepsy
- an abnormal heartbeat
- other heart or blood vessel diseases
- alcohol dependence
- acute fever
The source also says caution is needed in:
- newborn babies
- the elderly
Meprobamate-related concerns
STILPANE should be avoided in:
- elderly and debilitated patients
- patients with mental depression
It may also cause convulsions in people with a history of epilepsy.
Use with caution if you have:
- reduced liver function
- reduced kidney function
- reduced lung function
Driving and using machinery
Warning: Do not drive or operate machinery while taking STILPANE.
The source says this medicine may cause:
- drowsiness
- impaired concentration
These effects may become worse if you also take alcohol or anti-depressants.
Alcohol
Using alcohol with STILPANE may lead to:
- reduced judgement
- reduced coordination
It may also worsen drowsiness and the slowing effects on the brain.
Pregnancy, planning pregnancy, and breastfeeding
Do not use STILPANE if you are:
- pregnant
- breastfeeding
The source states that safety has not been established during pregnancy or breastfeeding.
If you are pregnant or breastfeeding, the advice given is to consult your doctor, pharmacist, or other healthcare provider before taking STILPANE.
For planning pregnancy, this is not specified in the source. Speak to your doctor or pharmacist before use.
Interactions
Always tell your healthcare provider about all medicines you are taking. This includes:
- prescription medicines
- over-the-counter medicines
- complementary medicines
- traditional medicines
The source specifically mentions the following medicines and substances.
Medicines and substances that may interact with STILPANE
Tell your doctor if you are taking:
- alcohol
- mexiletine
- antibiotics such as:
- ciprofloxacin
- enoxacin
- pipemidic acid
- isoniazid
- anti-depressants such as:
- fluvoxamine
- monoamine oxidase inhibitors
- tricyclic anti-depressants
- anti-epileptics such as:
- phenytoin
- carbamazepine
- phenobarbital
- primidone
- lamotrigine
- gastrointestinal medicines such as:
- cimetidine
- lithium
- methoxsalen
- oral contraceptives
- sympathomimetics such as:
- phenylpropanolamine
- metoclopramide
- probenecid
- cholestyramine
- anti-coagulants such as:
- warfarin
- anti-virals such as:
- interferon alfa
- zidovudine
- phenothiazines
- anti-histamines such as:
- hydroxyzine
Practical advice
- Do not start STILPANE without making sure your doctor or pharmacist knows about your other medicines.
- Avoid alcohol while taking it.
- If you are unsure whether one of your medicines may interact, check first rather than guessing.
Food interactions
Food interactions are not specified in the source.
Laboratory test interactions
Effects on medical tests are not specified in the source.
How to take (Step-by-step)
Take STILPANE exactly as your doctor has instructed you.
General instructions
- Take the tablets by mouth.
- Use it for short-term treatment only.
- Do not use STILPANE for longer than 5 days.
- Do not use it in children under 12 years.
- Do not share your tablets with anyone else, even if their symptoms seem similar.
Usual dose
The usual dose given in the source is:
- Take two tablets orally three or four times a day as required.
Maximum use period
- Do not use for longer than 5 days.
Important dose warning
Do not exceed the recommended dose.
If the effect feels too strong or too weak
If you feel STILPANE is:
- too strong, or
- too weak,
speak to your doctor or pharmacist.
Missed dose
A missed dose instruction is not specifically described in the source.
Because the source says the medicine is taken three or four times a day as required, you should follow your doctor’s directions. If you are unsure what to do after missing a dose, ask your doctor or pharmacist.
If you take too much (overdose)
Warning: In the event of overdosage, consult a doctor or pharmacist immediately. If neither is available, get help at the nearest hospital or poison centre. The source says prompt treatment is essential.
Early symptoms in the first 24 hours may include:
- pallor
- nausea
- vomiting
- anorexia
- possibly abdominal pain
Delayed problems
Evidence of liver damage may only appear 12 to 48 hours after ingestion. This is important because a person may feel better or not feel the full effect straight away, even while serious harm is developing.
Other overdose effects mentioned in the source
- abnormal heartbeat
- severe and/or fatal low blood pressure
- respiratory depression (dangerously slowed breathing)
- shock
- heart failure
- death
Simple adherence tips based on the source
- Keep to the recommended dose only.
- Do not use it for more than 5 days.
- If your symptoms are not improving, contact your doctor instead of extending treatment yourself.
- Keep the medicine in its original packaging until needed.
Dosing table
| Age group | Dose | Frequency | Maximum daily dose |
|---|---|---|---|
| Adults and children 12 years and older | 2 tablets | 3 or 4 times a day as required | Not specified in the source. Do not exceed the recommended dose. |
| Children under 12 years | Do not use | Not applicable | Not applicable |
Possible side effects
Like all medicines, STILPANE can cause side effects, although not everyone gets them.
If your general health gets worse while taking it, or you notice any effects not listed in the source, speak to your doctor, pharmacist, or other healthcare provider.
Common side effects
The following side effects were frequently reported:
- drowsiness
- insomnia
- headache
- anxiety
- restlessness
- unsteady or shaky movements
- constipation
- nausea
- vomiting
- abdominal pain
What these may feel like
You may notice that you feel sleepy during the day, or on the other hand, that you struggle to sleep. Some people may feel unsettled, tense, or shaky. Stomach-related symptoms such as constipation, nausea, vomiting, or tummy pain can also happen.
Less common side effects
The source says the following were reported less frequently:
- difficulty urinating
- muscle rigidity
- sensitivity reactions such as:
- red skin rash
- itchy rash
- sweating
- light-headedness when standing up
- facial flushing
- confusion
- mood changes
- contracted pupils
- sleepiness
- dizziness
- faintness
- excitement
- cheerfulness
- weakness
- headache
- dry mouth
- gastrointestinal bleeding
- diarrhoea
- disturbance of vision
What to do
If these side effects worry you, become severe, or do not settle, speak to your doctor or pharmacist.
Serious—seek urgent help
Stop taking STILPANE and get urgent medical help immediately if you have signs of a serious allergic reaction, including:
- medicine fever
- abscesses or ulcers
- allergic skin condition
- itching of the nose
- bleeding skin rash
- swelling of the lips
- swelling of the eyes
- swelling of the tongue
These may mean you are having a serious allergic reaction and could need urgent treatment or hospital care.
Other serious side effects needing urgent medical attention
Go to the nearest casualty department or seek immediate medical help if you notice:
- hallucinations
- convulsions
- deepening coma
- raised skull pressure
- decreased heartbeat
- increased heartbeat
- decreased white blood cells
- decreased red blood cells
- decreased blood platelets
- blood cell production disorder
Side effects with unknown frequency
The source reports the following, but does not say how often they happen:
- low blood pressure
- balance disorder
- reduced body temperature
- tremor
- pins and needles sensation
Important note about breathing and sedation
The source warns that STILPANE can cause drowsiness, reduced alertness, and in overdose can cause respiratory depression. Seek urgent help if someone becomes unusually sleepy, difficult to wake, or has slowed breathing.
Storage and disposal
Store STILPANE:
- at or below 25 °C
- in a well-closed container
- protected from light
- in the original packaging until required for use
Do not store it:
- in the bathroom
Always:
- keep all medicines out of reach of children
- check the expiry date on the label before use
Do not use STILPANE after the expiry date.
Disposal
- Return all unused medicine to your pharmacist.
- Do not throw unused medicine into drains or sewerage systems, including toilets.
What the medicine contains
Each STILPANE tablet contains:
- Meprobamate 150 mg
- Codeine phosphate 8 mg
- Paracetamol 320 mg
- Caffeine anhydrous 32 mg
Other ingredients
The source lists the following excipients:
- dye lake green (C.I. Nos: 47005, 42090, 15985)
- magnesium stearate
- nipastat
- povidone K25
- sodium starch glycollate
- starch
- talc
Preservative
- Nipastat 0.02% m/m
Sugar content
- Sugar free
Other important excipients
Further important excipients beyond those listed above are not specified in the source.
Pack information and appearance
What the tablet looks like
STILPANE is described as a:
- green
- biconvex
- tablet
- debossed “C26” on one side
- bisected on the other side
Pack sizes
The following pack sizes are listed:
- 100 tablets in aluminium/PVC blister strips, packed into a carton
- 500 tablets in a white polypropylene securitainer with a foam insert and sealed with a white polyethylene cap
- 1 000 tablets in amber PVC jars with a foam insert and sealed with a screwcap
Note: Not all packs and pack sizes are necessarily marketed.
South African registration and holder information
- Scheduling status: S5
- Registration number: M/2.9/2
Holder of certificate of registration:
Pharmacare Limited
Healthcare Park
Woodlands Drive
Woodmead, 2191
South Africa
Hotline: 0800 122 912 (South Africa)
Tel: +27 11 239 6200 (Other)
Practical FAQs (based ONLY on the source)
Can I take STILPANE for more than 5 days if my pain is still there?
No. The source says it is for short-term use only and should not be used for longer than 5 days. If you are not getting enough relief, speak to your doctor.
Can I drive while taking it?
No. The source clearly says do not drive or operate machinery because STILPANE may cause drowsiness and impaired concentration.
Can I drink alcohol while taking STILPANE?
The source warns against alcohol. Alcohol can increase drowsiness and may lead to reduced judgement and coordination.
Can my child use this medicine?
Not if your child is under 12 years old. The source states that STILPANE should not be used in children younger than 12 years.
What should I do if I accidentally take too much?
Get medical help immediately. Contact a doctor or pharmacist at once, or go to the nearest hospital or poison centre. Prompt treatment is essential.
Can I use it if I am pregnant or breastfeeding?
No. The source says do not use STILPANE during pregnancy or breastfeeding.
What if I have liver or kidney problems?
You should not use it if you have severe liver or kidney problems. If you have liver or kidney disease more generally, the source says STILPANE should be taken under medical supervision.
Can I share my tablets with someone else who has similar pain?
No. The source says this medicine has been prescribed for you personally and should not be shared with anyone else.
Is this medicine sugar free?
Yes. The source states that STILPANE is sugar free.
What if I notice a rash or swelling?
Stop taking STILPANE and get urgent medical help. A rash, swelling of the lips, eyes, or tongue, or other sensitivity reactions may be signs of a serious allergic reaction.
Plain-language summary
STILPANE is a short-term medicine used for mild to moderate pain associated with anxiety or tension. It contains meprobamate, codeine phosphate, paracetamol, and caffeine anhydrous. If you are taking it, use it exactly as directed, do not exceed the dose, and do not use it for more than 5 days. It is not suitable for children under 12 years, and you should not take it if you are pregnant, breastfeeding, or have certain serious medical conditions listed above.
This medicine can cause drowsiness, and it can be habit-forming if misused. Do not drive, do not drink alcohol while taking it, and get urgent help if you have signs of overdose, breathing problems, severe allergic reactions, hallucinations, or convulsions. If your pain is not improving, or if you are unsure whether STILPANE is safe with your other medicines or health conditions, speak to your doctor or pharmacist before continuing.
