Tramadol (painkillers)

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UnXmas

UnXmas

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Oct 18, 2012
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I asked my doctor if I could increase the dose of the amitriptyline I take and if there's anything I can take in addition to codeine because I'm already taking the maximum recommended dose of that and an old back injury is giving me pain problems (the codeine helps the pain during the daytime, the amitriptyline knocks me out enough to sleep through it at night). She's sending me for x-rays of my spine and she gave me a prescription for Tramadol, a painkiller to take alongside the codeine which should potentiate the sedative effect of amitriptyline. I know everyone experiences medications differently, but would be interested in hearing how others have found Tramadol, particularly in combination with other painkillers and sedatives, and also regarding its potential for tolerance and addiction (which are other reasons why codeine isn't really enough for me anymore).

Also, I make no secret of my codeine addiction with my doctors. Is her readiness to give me more addictive medications unusual?
 
I found codeine and tramadol did not help me much at all , so my doctor prescribed me palexia ( tapentadol) which I find really take the worst of the pain away and don't leave you feeling fuzzy in the head like tramadol does , at the moment I take 150 mg a day .
 
Be careful with Tramadol. It can be addictive and you can build up a tolerance to it. Just take it as recommended.
 
I tried the Tramadol today. No "high" or other effect on my emotional state, which should mean psychological addiction won't be an issue, though physical dependence, withdrawal, tolerance, etc. still could be. I did what my doctor said and took it while taking codeine as well. My back pain was fine, pretty much as it is if I just take codeine. So I'll keep trying; the idea is that when my pain increases the Tramadol will stop me feeling the increase, as I can't increase my codeine dose anymore to help with it. I'm also hoping it may help me reduce the codeine. The only effects I noticed from the Tramadol were slight nausea and sleepiness.

Now I'll see whether it potentiates the amitriptyline tonight.
 
Grace take it. I give her the lowest amount she'll need. No issues for her exept the doc let know it can cause constipation and to not use it much.....but Grace is 6.:smile:
 
My daughter takes it too, for Ankylosing Spondylitis. It makes her sleepy and she finds it hard to focus on homework. It does help her joint pain. She has been on the same dose for over a year and it is still working, though not quite as well as it did in the beginning. She's 18 and we don't want to increase the dose.

She takes it at night with Gabapentin and both together make her quite sleepy and help her sleep through the night. It does cause constipation but it's easily managed with Miralax.

In terms of physical dependence her pain management doctor recently said he would wean her off it very slowly. She was able to wean herself off it last year briefly (until Humira stopped working and she had to go back on it) with no side effects.
 
Thanks everyone for sharing your experiences. I have an ileostomy so constipation won't be an issue for me. I did sleep well last night. Soon I might try reducing my codeine dose a bit so I'll hopefully be able to tell how much Tramadol is helping with the pain.
 
I've been on Tramadol for nearly 2 years for pain related to a road traffic accident I was in. Whilst the Tramadol doesn't take away all of my pain, it does take the edge off. I would say though that I really have to keep taking the Tramadol to keep on top of the pain. If I miss a dose and the pain gets out of control it can take a while to get a handle on it again. I don't have any side effects from taking Tramadol.
 
The Tramadol is giving me blurry vision, making reading a little bit difficult! Besides that no side effects, if the sleepiness was a side effect, it's stopped now. It's helping a little, I think. I tried taking no codeine this morning to see if the Tramadol made a noticeable difference on its own. I think it did, and helped a little with the codeine withdrawal, but not all that much.
 
Tramadol is a fairly "weak" painkiller according to our pain management doctor. In fact, he's amazed that my daughter has managed on the same dose for quite a while!

There's a drug called Nucynta (Tapentadol) in the US that is similar to Tramadol but slightly stronger I believe. It may be more addictive too, not quite sure. My older daughter tried it and did well on it for a while (a couple weeks), Humira and MTX kicked in and she no longer needs pain meds. The only side effect she had was nausea.

Another option is Extended Release Tramadol, not sure if that might help in your situation.
 
It's so weird that most of you get sleepiness as a side effect. Both my son and I get jittery, restless from it along with a head buzz feeling. I managed 4 doses before I gave up on it for an injury and my son, taking it for back pain for JSpA lasted maybe a few days. Isn't it amazing how meds affect each person differently?

I hope the med works for you unxmas.
 
Clash said:
It's so weird that most of you get sleepiness as a side effect. Both my son and I get jittery, restless from it along with a head buzz feeling. I managed 4 doses before I gave up on it for an injury and my son, taking it for back pain for JSpA lasted maybe a few days. Isn't it amazing how meds affect each person differently?

I hope the med works for you unxmas.
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My GP still finds it hard to believe that codeine gives me energy, as it's a sedative. Codeine does sedate me emotionally, it calms me, but physically it makes it easier for me to want to get up and do things. Did you or your son find something else for pain?
 
Codeine affect my son with the same restless, unable to sleep, jittery feeling. Those were px'ed after the tramadol. He said it was like this restless energy. But none of them really touched his back pain when his JSpA was flaring there. Now it is his wrist that is flaring and we upped his methotrexate hoping it will help with the flare.
 
That's so interesting Clash, generally Tramadol makes people sleepy. When M first started taking it she would fall asleep every afternoon! I agree that it doesn't do much for really bad pain -- she does also have stronger painkillers for those days, we just try to avoid them if possible.
 
UnXmas said:
Did you try a lot of other painkillers before Tramadol, SarahD?
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I tried Codeine and paracetamol before Tramadol. The Codeine resulted in me developing a blockage and I spent 5 days in hospital on IV steroids, antibiotics and EN to try to get things moving again. That's when I was swtiched to Tramadol, as it's supposed to be less constipating.

I find that on their own neither paracetamol or Tramadol work that well. However, I found out that when taken together, paracetamol seems to boost the effect of the Tramadol. It's like a multiplicative effect rather than additive.
 
I'm not sure I'm going to continue with Tramadol because the blurred vision is so annoying. Reading anything is straining my eyes. I know sometimes side effects wear off, but I don't know how long I need to give it before deciding it's not going to go away.
 
I used Tramadol for almost a year while dealing with impingement and bone spurs with my rotator cuff. Took it pre and post surgery. No addiction at all. Not the most potent of pain killers but it did take away my dull pain and throbbing.
 
I'm giving it another try at stopping codeine withdrawal. So no codeine today, just Tramadol. I took a bigger dose this time (still well within safe limits; when I looked it up online I saw my doctor had started me on a low dose). If it can get me through days without codeine without withdrawal symptoms, it will be very useful even though it's not done all that much for my pain. I might have to plan things that don't involve too much reading for those days. My vision is fine reading on my laptop, with the laptop on my desk and me on a chair in front of it. It's just closeup reading on my Kindle that's hard.
 
It doesn't seem to be helping. :( Perhaps I'm just fated to be a codeine addict. My doctors certainly think so, they encourage it even.

Amitriptyline and the other meds I love are different - amitriptyline can cause a physical withdrawal if stopped, but there's no need to keep increasing the dose as there is with codeine, and the same with my other meds; I'd be scared of stopping them because it would mean a return to symptoms, but there's no tolerance, no need to increase. The only other meds that have helped me with pain are oxycodone and diazepam - both have been given to me on a short-term basis while in hospital, the oxycodone for pain after surgery, the diazepam when I had ileus - because opioids slow the bowel, I couldn't have them when I had ileus, and the diazepam relaxed me mentally and physically relaxed my muscles so I could keep still for an x-ray. I've also had morphine after surgeries but haven't noticed such a big difference with that.

Both oxycodone and diazepam involve addiction, tolerance and withdrawal. If I started either of them, I'd be stuck on them. At what point do you decide current painkillers aren't cutting it and you need to start major pain relief? Perhaps this question needs a new thread. Pain - of any kind - hasn't been a big long term problem for me until fairly recently. My digestive system pain always comes in acute episodes, so I'll be in pain a few days, but I know it will end soon, so it is bearable. I'm trying to find painkillers more along the lines of amitriptyline, I've found a couple of other antidepressants that can help with pain, so I'll see what my doctor thinks of them.
 
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My daughter has also tried oxycodone and been given it for breakthrough pain. Since she's so young she tries to limit her use as much as possible. The thing with opioids is that tolerance seems to happen quite quickly for some people and then there's no way to go but increase the dose (you could try a different opioid but oxycodone has been most effective with the fewest side effects for my daughter).

There are other meds for pain that you could try but I'm not sure how they interact with amitriptyline. My older daughter tried Cymbalta. There's also Lyrica, Savella and Gabapentin.

If your GP is prescribing your meds, it might be worth trying to get to a pain management doctor. They know the most about these meds and might even be able to help you get off codeine (if you want to). They also have other solutions for pain: a TENS unit, biofeedback, trigger point injections, nerve blocks etc. And they can help you decide whether you want to be on opioids for the long-term.
 
Maya142 said:
My daughter has also tried oxycodone and been given it for breakthrough pain. Since she's so young she tries to limit her use as much as possible. The thing with opioids is that tolerance seems to happen quite quickly for some people and then there's no way to go but increase the dose (you could try a different opioid but oxycodone has been most effective with the fewest side effects for my daughter).

There are other meds for pain that you could try but I'm not sure how they interact with amitriptyline. My older daughter tried Cymbalta. There's also Lyrica, Savella and Gabapentin.

If your GP is prescribing your meds, it might be worth trying to get to a pain management doctor. They know the most about these meds and might even be able to help you get off codeine (if you want to). They also have other solutions for pain: a TENS unit, biofeedback, trigger point injections, nerve blocks etc. And they can help you decide whether you want to be on opioids for the long-term.
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Thanks for your reply. I've tried gabapentin which didn't help. I think I might ask about seeing a pain specialist. My GP is very helpful, I'm sure she'll send me to one if I ask.
 
I just saw you asked this about back pain! I didn't make that connection earlier :lol:. Both my girls have dealt with a lot of back pain due to AS. A TENS unit has been the most helpful thing so far (besides pain meds obviously). Also, steroid injections (into the SI joints for them) and trigger point injections (for muscular pain). I'm not sure if they would do steroid injections for an injury but it's worth asking about.

To be completely honest, we haven't had a whole lot of success with antidepressants/anticonvulsants (like Cymbalta, Gabapentin, Lyrica). But they're worth a try in case you can avoid opioids.

Good luck!
 
Yes, it's back pain that's the main problem, though if something helps my occasional stomach pain too I'd be extra pleased! I'm going to have an x-ray as I have osteoporosis, to check for fractures. I think if they can determine the cause it may be easier to treat. I had an injury a while ago, but the pain is now increasing. It's always come back if something triggers it, this last time I slipped over on concrete, and it's been worse and not just gone away on its own after a few days like it always has before.
 
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It struck me that despite codeine working so well for my back pain, it doesn't help my stomach pains (i.e. my normal Crohn's pains, which for me is moderate cramping in the centre and/or lower right side of my abdomen). Do Crohn's pains generally respond to codeine or other opioids? I know opioids are not used all that often for Crohn's pain. Opioids do help me a lot with post-surgery pain, but maybe the pain they're helping with then has been pain from the incision rather than pain in the bowel itself (does the bowel even sense pain?).

And tramadol is an opioid, so why would I not respond to that when I respond so well to codeine (and oxycodone)? Maybe I've built up so much tolerance that the normal dose of tramadol I was taking was just far too low for it to affect me.
 
I use Tylenol with codeine for my abdominal pain. It works I've tried ibuprofen and it doesn't work. I've still got some old Darvocet and that works great but can't get that anymore. I think codeine is just all around a better pain killer.
 
Today I found out something that I really should have thought of sooner, and that my doctor should have realised also.

I have a very high tolerance to codeine. I've been taking well over the recommend doses for a long time. (It's all prescribed by my doctor, she knows exactly what I take.)

Codeine is similar to tramadol. So I realised my tolerance to codeine may mean I'm also tolerant to tramadol. So today I took a much higher dose of tramadol - and it worked.

I think this is probably a good thing, it means I'm not tied only to codeine anyway.

I'm just a bit amazed. I haven't taken any codeine today, and not only have no withdrawal symptoms, but the pain is manageable too. I'm almost out of my tramadol prescription though, so I can't test it much more until I see my doctor again in a couple of weeks.
 
Tramadol doesn't make me feel well like codeine does though. I took the higher dose again today, without codeine, and it's helped with the pain, and I've had no codeine withdrawal symptoms. But at this dose the Tramadol seems to make me feel a bit sick, a bit dizzy, and a bit restless whereas codeine causes me no negative side effects and just makes me feel a bit more calm, and just generally physically and emotionally better.

I've finished the Tramadol prescription now, so I'll just have to wait to see what my doctor says.
 
I have a prescription for tremadol. I've had it since the ER visit but I"m too chicken to take it. I have bad feelings when i take pain killers. They like enhance my anxiety it seems. after reading some of the posts here I think I will still not take it. I sure hope I can get my stomach fixed so I don't have to depend on these things. And I hope the same for everyone else.
 
I've been on Ultram for well over a year. I have degenerative disk disease, prior to my Crohn's diagnosis. I have not had an addiction issue with it. It does do a decent job in managing pain along with Tylenol. I have had experience with opiate pain medication as well, and Ultram is much different. I do not get blurry vision, or any other side effects for that matter. I find it a decent pain management drug without the addictive side effects.
 
sidney75 said:
I've been on Ultram for well over a year. I have degenerative disk disease, prior to my Crohn's diagnosis. I have not had an addiction issue with it. It does do a decent job in managing pain along with Tylenol. I have had experience with opiate pain medication as well, and Ultram is much different. I do not get blurry vision, or any other side effects for that matter. I find it a decent pain management drug without the addictive side effects.
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Ultram is a brand name for Tramadol (i.e. Ultram is Tramadol, they're both names for the same thing), which means Ultram is an opioid - what do you find makes Ultram different from other opioids/opiates? I think I may agree with you; although it is an addictive substance, personally I got no "high" or other positive mental side effects from it.
 
mikeymac said:
I have a prescription for tremadol. I've had it since the ER visit but I"m too chicken to take it. I have bad feelings when i take pain killers. They like enhance my anxiety it seems. after reading some of the posts here I think I will still not take it. I sure hope I can get my stomach fixed so I don't have to depend on these things. And I hope the same for everyone else.
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You're right to be wary of addiction. Some people are never comfortable taking a potentially addictive medication, and I think that's a perfectly reasonable way to feel about it.

There are some painkillers with no potential for addiction, if you need pain relief. Unfortunately some - e.g. ibuprofen - are hard on the stomach and not advised for people with Crohn's. Paracetamol (in the US I think you call it acetaminophen) is not addictive, though it's also not very strong.

I would say that you might want to reconsider trying addictive painkillers if you're ever in an acute situation, e.g. if you're in hospital after having had surgery and the doctors give you an opiate for a few days, you shouldn't develop an addiction in that space of time, and once discharged you won't have access to anymore of it so you won't be able to continue with it and risk addiction. When in severe pain, opiate painkillers may well start to seem like a good idea.
 
Hi UnXmas,
It's a synthetic opiate, meaning it's not actually from a plant - it's produced in a lab with a chemical structure similar to opiates. It was designed to be less addictive than opiates. I never got a high or lift from it, but it made me a bit drowsy and nauseous when I first started taking it. If I take it before bed sometimes it will keep me awake. I can go days/weeks without it when I am not in pain, and I do not crave it the same way I did opiates. I weened myself off a bit of an opiate issue over 5 years ago, so I requested Tramadol after a few weeks on Percocet with my back problem. I had no desire to go down opiate dependency road again. Although I don't over use, I have also notice I do not have to increase dose over time to get pain relief. I will increase the dose if my back/Crohn's pain is severe but my pain is generally moderate and I manage in combination with Yoga and regular Tylenol as I can no longer take Advil. Everyone is different though and I hope you find the right pain management med to help with your pain.
 
Thank you for your reply and for sharing your experiences, sidney. You don't happen to know the difference between an opioid and an opiate do you? It's something I've wondered about and keep finding different definitions, and you seem very knowledgeable!
 
I don't think there's much difference as they are both derived from opium, my best guess is if they are compounded with other drugs - meaning heroin is an opiate (not compounded); vicodin an opioid (compounded with aceteminophen into pill form). As I said, that's my best educated guess though.
 
Is kolonopin/colonzapam an opiate? I've read that it is a form of valium. I've been taking that a long time and I want to get off of it. I've been talking the 0.5mg for over 5 years. seems like every-time I try to wean off it, my stomach acts up and I have to take the regular dose. Viscous cycle, I'm caught in. I also take ambien and I've been taking that for a long time also.
 
Wikipedia says "Although the term opiate is often used as a synonym for opioid, the term opiate is properly limited to the natural alkaloids found in the resin of the Papaver somniferum (opium poppy), while opioid refers to both opiates and synthetic substances, as well as to opioid peptides."

mikeymac: Klonopin (clonazepam) is in a group of drugs called benzodiazepines and is used to treat seizure disorders or panic disorder (although it can be prescribed for other reasons). I'm concerned about the side effects you may be having interms of anxiety and suicidal thoughts based on a thread of yours that I replied to. This is what they say about klonopin "You may have thoughts about suicide while taking Klonopin. Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, irritable, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself."

I think it would be a good idea to seek advice about the thoughts and feelings that you are having. It is also habit forming which is probably why you have trouble weaning off it and you would need a plan of how to successfully wean off it.
 
mikeymac - I would second 24601's suggestion of seeing a doctor. If you're not comfortable talking about your suicidal feelings (or if they're not a problem at the moment), it's still a good idea to have a doctor oversee you coming off medications, due to the habit-forming component that 24601 mentions. Some medications are not addictive is psychological terms, but can result in people's bodies becoming physically dependent on them, causing physical withdrawal symptoms if the medication is stopped too quickly. The two medications you mention cause this kind of physical response. Opiates/opioids cause both a physical dependence and a psychological addiction; I'm not certain whether or not the meds you're on can cause a psychological addiction as well.

A doctor should be able to help you plan a gradual taper off them, if you do want to stop them. A doctor may also be able to prescribe things to help minimise withdrawal symptoms such as diarrhoea.
 
mikeymac,
kolonopin is a very, very strong benzodiazepine - much stronger than valium (same family though). It is often prescribed for severe anxiety and nervous system disorders. You will likely definitely notice mental/thought changes when going off of it, so definitely talk to your doctor about it. You may need to go down to a less potent type of benzodiazepine (valium, xanax) to ween off successfully. Please talk to your doctor. I lost a dear friend who was on Kolonopin for many years to suicide - not that it was the only cause, but he definitely did not understand why his thoughts were so disorganized and dark at times. Please keep us posted.
 
I thought maybe the suicide thoughts were coming from the endless chest pains. But as I've said in another thread. I do know I've been taking it too long and ambien also. But when I'm asleep I don't feel any pain. I didn't know that kolonopin was stronger the real valium I always thought real valium was stronger. Question: Why would doctors allow you to take them so long if they caused all these ills? I mean I do follow the instructions on it. But I've been doing it for over 5 years now. I also found out that my Aunt has been taking adivan for 40 years. From my understanding that is another form of valium also.
 
Hi Mikey,
All benzodiazepenes are both physically and psychologically addictive. They have side effects, but they can also be taken safely for long periods of time with medical supervision, and people normally have to be weened off them to manage side effects when coming off of them. There should be a label on your pill bottle that says do not stop taking without consulting your physician. Often when coming off people will have rebound anxiety attacks which may be what is causing chest pains. If you talk to your doctor and discuss both your physical and emotional side effects you are experiencing along with your concerns, he can help you with a treatment plan. Also, you can google more about the medicine to get more information.
 
Well, I know for a fact that my chest pain was caused by the 5 gastric polyps that were removed -1 on Thursday. Reason, I take kolonpin at the same time every night like clockwork. However, I would wake up to the chest pains that lasted all day long and all night. It got to the point recently where the kolonpin wasn't even helping. But however since the GI removed or biopsied those polyps. My chest has been about 85% better. Or what ever he did helped my chest pains big time. I still have them but they aren't as strong and my appetite is coming back also when I had no appetite for two weeks. My appetites did come back a little after taking the kolonpin at night but not much at all. There may be some relation with that but I know my body.Still I do need to get off them with the doctors help. also since those polyps were removed. My depression has gotten less. I'm not defending the drug at all. I just know what ever the GI did took a lot of pain away with or without the kolonopin being involved. at least the way I see it.
 
Really glad to hear you are doing better mikeymac! It's great that the pain has lessened and I think it often makes sense that less pain means less depression (and conversely when we feel depressed that can oftentimes intensify any feeling of pain).

I don't really have an answer about doctors allowing people to be on meds for extended periods of time without seemingly reviewing or discussing it - at least no good answer. But this does seem to happen. My grandmother has been on pain meds for years and years (and may show some signs of addiction) and yet her doctor writes repeat prescriptions without any thought of why she is still on them, while other people struggle to get the same pain meds prescribed even short term and I believe that the med she is on is classified in such a way that it needs to be reviewed periodically so that it can continue to be prescribed yet somehow her doctor does not follow this protocol. It's a little strange that these things can get overlooked for so long.

Anyway very pleased that you are feeling better than you were! Getting your appetite back is a really good sign too!
 
My doctor prescribes me codeine even though we both know I'm addicted. I feel that my long term health is a lost cause, so I tend to aim for immediate improvements in my quality of life, with less concern for long term risks than I'd have if I were healthy, and my doctor understands this. Codeine is a very safe medication anyway, so my doctor feels that in my case the benefits of me taking it long term are worth the cost of addiction. Maybe this is the case with your doctor, mikeymac? Addiction is certainly always a problem, but sometimes it's the best option available. The best painkillers, and maybe the best sedatives and anxiolytics, are addictive.

One other reason doctors will prescribe an addictive med long term is that they'd rather the patient take the meds they prescribe than have the patient start self-medicating.

I do hope you'll be able to get off your meds, mikeymac, it sounds like that's really what you want now. You'll need a good doctor to help you, so if possible, try and find a doctor who understands your issues, physical and psychological.
 

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