My PCP's "take" on Tramadol

Discussion in 'Fibromyalgia Main Forum' started by Musica, Dec 21, 2005.

  1. Musica

    Musica New Member

    I saw my PCP today. I asked him about taking tramadol because some people try not to give into pain meds unless desperate, yet it seems lower pain would help blood pressure stay lower.

    He says that tramadol is NOT addictive; in fact, he has patients who have been on it for quite a long time and they have not needed increased doses. He also says tramadol seems to work better over time. If you have pain and take tramadol, it works okay, but the second and third doses build on the first and second, and help even more. Plus, tramadol only stays in your body around 4 hours max, so it not only makes sense but he recommends taking it on a regular basis for chronic pain. The max is 8 per day, but he would try 6, either 1 or 2 at a time, every 4 hours. Pain can have so many negative effects on our body. He even wrote out a new prescription for 180 in a month, as with the old prescription taking 6 a day would make me need to refill it earlier than insurance would want!!!

    I'm not a big fan of pain pills, but I'll admit, I probably do wimp out earlier than many of you. I just have never had to deal with pain or illness hardly at ALL until 2 years ago, so I guess I am still adjusting to having pain. Also, probably by summer I'll hardly need any except prn, but when I do feel worse, I do take 4-6 per day. And this winter is being worse than last year, so I don't think I'll be looking forward to winters to come.

    Anyway, I know some docs take a real hard stance against using pain meds. I don't think my PCP is a real druggie type! LOL The way he has explained tramadol to me more than once, though, is just very matter-of-fact, especially as it relates to chronic pain. It's not addicting, it works better as you keep taking it, but it only lasts 4 hours so tramadol does need to be taken regularly.

    Have you heard this, as well? It sounds so much more liberal than what I've heard about some docs, but it's good to know I don't have to shy away from tramadol or save it for the worst times just so it will continue working. It WILL continue working.

    I hope this helps some of you who get phony excuses as to why you shouldn't be taking it.
  2. Sue50

    Sue50 New Member

    my dr. will only prescribe 1 a day for me
  3. Kacjac

    Kacjac New Member

    Maybe thats why it won't work all the time for me, I'm not consitent with it, and it leaves your body rather quickly, plus I don't think I've ever taken more than one, although, I knew you can take two. I'm gonna try two tonight! :)
  4. PVLady

    PVLady New Member

    My doctor is a pain specialist with many fibro patients. He does believe in opiates when needed however I cannot tolerate taking them. I was on MS Contin a year ago which totally eliminated pain but I was sick the entire time.

    I take Ultram (Tramadol) and it seems a step up from Tylenol. It makes me tired so I like to take it a bedtime. Also, if I take a whole pill it gives me a slight headache.

    I wonder if anyone else has this reaction? I also take Extra Strength Tylenol and the combo seems to work well.

    Tramadol is very light weight as far as pain relief but better than nothing.
  5. smiffy79

    smiffy79 New Member

    hi musica
    i can have 6 a day at two at breakfast two when ever i need it and if im going out in the evening another two then.
    i was on 50mg of morphine a day and climbing the walls in pain and feeling drugged and stuffed up because the morphine was overloading me.

    as well as the tramadol i take twomg of tizanidine as it stops the spasms and cramping and 50mg of amitriptyline to knock me out at night and make sure the pain doesnt wake me up.

    what your dr said to you is fine.mine wanted to give me the 8 a day but i asked for the 6 after a months trial and as i said above its not every day i need them all.
  6. bpmwriter

    bpmwriter New Member


    i've got another post running about my experience with tramodol. personally, my results were mixed. make sure you take some kind of fiber supplement with the tramodol as my bowel movements came about every 72 hours and they were difficult when they came. for me, even the fiber wasn't effective in solving this side effect. i've also had a couple migraine episodes since taking the tramodol, if you're prone to headaches, this may be another undesirable side effect. and of course, like most meds, tramodol is rather hard on the liver. i don't mean to be a party pooper. i hope it works well for you as many seem to get great relief from it.

    eddie
  7. dononagin

    dononagin New Member

    I take it as needed for pain.. It is a light weight pain reliever but doesn't have as many side effects as the opiates. My fiance is getting ready to have shoulder surgery and they have him on Tramadal as he had addiction history and the doc said that these have a very, very low rate of addiction. He said basically the same as your doc. Joe can take 6 a day. It's not enough for the pain he is in but takes the edge off.
  8. TXFMmom

    TXFMmom New Member

    Tramadol should be a non-starter in controversy.

    It is non-addictive and doesn't produce euphoria and has a very unlikely potential for abuse.

    I take it when I am really bad, try to use tylenol and ostreochondroitin the rest of the time.

    It is not addictive. They took a narcotic molecule and removed the portion which would produce euphoria and the part which would result in addiction or dependence and removed it, leaving a molecule which fits into the pain fiber sites which conduct the types of pain from which many of us suffer.

    Every person is different, however, and some things help some people and not others, with the same conditions and then there are varying degrees of symptoms from person to person with the same disorders.

    I feel confident in using it. ANY DRUG CAN BE USED INAPPROPRIATELY AND CAUSE PROBLEMS.

    Just read for possible interactions, don't piggyback a whole bunch of drugs which are metabolized the same way, and which could cause problems with the liver or kidneys, and ONE CAN AVOID PROBLEMS.

    My daughte-in-law has migraines and Ultram makes her feel "spacey" when she takes it, but migraines do that anyway. One can experience a little dizziness with it and I have a few times, but when I need it, I take it.

    Most of us let other people or put guilt trips on ourselves about taking so many meds, and we shouldn't take anything we don't really need, but don't DEPRIVE YOURSELVES AN SUFFER.
  9. bell9383

    bell9383 New Member

    i have one question tramadol is a narcotic and should only ever be taken for a maximum of three days i was told. So bearing that in mind i went on to paracetamol not knowing its a narcotic to. I found my self being told by a nurologist that all the heads aches i have been experiencing are rebound headaches caused by paracetamol poisoning. I have been taking them quite reguarly since may, not every day but the majority of the time. I now have to go cold turkey for three weeks and never put one near my mouth again. What a lovely christmas i will have but i will have to think positive in the hope the headaches dont get worse before they go all together. Apparently narcotics can bring on alot of the pain that we all suffer just by taking them. tiredness, mussle spasms, mussle tightness, ibs. So all my doctor will give me after i start my weening is nurofen sparinly. plus an extra 10mg of nortripoline. As you can tell i am a little down hearted and not looking forward to christmas at the moment.

    in the mean time hope every one else has a pain free holiday

    nicola
  10. Musica

    Musica New Member

    to know how close it is to tramadol. If it is true that tramadol has had the addictive, euphoric molecules taken out, perhaps it is different than paracetamol?? It might certainly be worth checking into, in case you can take tramadol even if you can't take paracetamol. It is certainly NOT true that you can only take it for 3 days. Like I said in my original post, my PCP says he has patients who have been on it for a long time (months, if not years). Tramadol seems to be the safest non-narcotic narcotic (???) out there. And it seems to work more universally for FM than other drugs, although I don't know why.

    It was well stated above - don't take it if you don't need it, but don't deprive yourself and suffer. Some docs make it sound like a crime to use them at all, and with a relatively safe drug like tramadol, especially if you don't get the migraines, there is no excuse for that attitude. You shouldn't have to beg for pain relief. I have read - and believe - that most people with real and chronic pain are conscious about their use of pain meds and try to be responsible about it.
  11. Mikie

    Mikie Moderator

    I tried it but it made me sick. I took my Morphine for really bad pain and it worked but did leave me feeling groggy. I only usually took it at night. I took ibuprophin during the day.

    I only had to take these things for about the first year off and on when I was on the Guai. Once the Guai had started to relieve my pain most of the time, I no longer needed pain meds.

    Guai is safe and reverses the symptoms of FMS. It has been a God send for me. If anyone is interested, go to guaidoc.com and read about it. The Guai is sold here.

    Love, Mikie
  12. smiffy79

    smiffy79 New Member

    tramadol is a synthetic opioid.
  13. bpmwriter

    bpmwriter New Member


    there seems to be a lot of misinformation floating around on this drug. even the official info on the web varies as to whether tramadol should be taken consistently or as needed. my understanding is that it is a synthetic opiod as smiffy has mentioned. it works on gaba (chronic pain is often associated with gaba deficiencies), but it also causes mild reuptake of norepinephrine and serotonin, just like an snri such as effexor (this information is from the crazy meds site). opiate-based drugs slow everything in the body way down, which is why they're notorious for causing constipation. do you want pain relief only to wake up 5 years later with colon cancer from backed-up pipes?? these are personal, individual decisions we all make everyday and no one should ever be made to feel guilty for seeking relief. it's all about education. it's a shame, but even the doctors are often misinformed. when i told my doc the other day that tramadol increased my migraine activity, he tried to tell me that tramadol is used to treat migraines. after excusing himself for a moment, he came back to tell me, migraines are actually a side effect!

    happy holidays everyone,
    eddie
  14. Tigger57

    Tigger57 New Member

    My doctor pretty much said the same thing. My only problem is that it didn't do anything for the pain.

    Tigger
  15. Mikie

    Mikie Moderator

    Nor is it an SSRI or an SNRI. In fact, it should not be taken with antidepressants due to risk of seizures. The makers of Ultram (Tramadol) market this drug to docs as being like opiods but not really opiods and I think that's where the confusion lies.

    According to "Worst Pills, Best Pills," Tramadol has effects similar to the narcotic pain relievers morphine and codeine including the potential to cause addiction but was not classified as a controlled substance at the time of its approval.

    This is one of the drugs which the book has in its "Do Not Use" category. According to the book, the FDA has received reports of adverse events such as seizures, drug abuse, dependence, withdrawal, and intentional overdose. Of course, many drugs can cause these side effects.

    When I asked my Rheumy how the drug worked, he became angry because he didn't know. All he knew was that the drug rep said it was as good as a narcotic without being one. I researched it and tried one pill which made me violently ill. Often, the only info docs do get is from the reps and I think that's why it is important that we do our own research.

    This drug may help some and if so, I'm glad. We are all different and what makes me sick may be a God send to another.

    Love, Mikie
    [This Message was Edited on 12/23/2005]
  16. Mikie

    Mikie Moderator

    I got this info from RxList online. The list of side effects was in a matrix format but didn't transfer that way. If you read the percentages of those affected, they are Up To 7 Days, Up To 30 Days, and Up To 90 Days, respectively. Seems the cumulative effects may take time in some individuals and more are affected the longer the drug is taken. "CNS Stimlation" refers to seizure activity in the brain. The footnote explains the symptoms associated with this seizure activity. Hope this info is helpful. I wish docs would go to the trouble of researching meds so they are more fully informed when prescribing. They can't depend on the reps to know this info and we can't depend on the docs. We have to do it ourselves.

    Love, Mikie

    SIDE EFFECTS
    ULTRAM was administered to 550 patients during the double-blind or open-label extension periods in U.S. studies of chronic nonmalignant pain. Of these patients,375 were 65 years old or older. Table 2 reports the cumulative incidence rate of adverse reactions by 7, 30 and 90 days for the most frequent reactions (5% or more by 7 days).The most frequently reported events were in the central nervous system and gastrointestinal system. Although the reactions listed in the table are felt to be probably related to ULTRAM administration, the reported rates also include some events that may have been due to underlying disease or concomitant medication. The overall incidence rates of adverse experiences in these trials were similar for ULTRAM and the active control groups, TYLENOL® with Codeine #3 (acetaminophen 300 mg with codeine phosphate 30 mg),and aspirin 325 mg with codeine phosphate 30 mg, however, the rates of withdrawals due to adverse events appeared to be higher in the ULTRAM groups.

    Table 2:Cumulative Incidence of Adverse Reactions for ULTRAM in Chronic Trials of Nonmalignant Pain (N = 427)


    Up to 7 Days
    Up to 30 Days
    Up to 90 Days

    Dizziness/Vertigo
    26%
    31%
    33%

    Nausea
    24%
    34%
    40%

    Constipation
    24%
    38%
    46%

    Headache
    18%
    26%
    32%

    Somnolence
    16%
    23%
    25%

    Vomiting
    9%
    13%
    17%

    Pruritus
    8%
    10%
    11%

    "CNS Stimulation"1
    7%
    11%
    14%

    Asthenia
    6%
    11%
    12%

    Sweating
    6%
    7%
    9%

    Dyspepsia
    5%
    9%
    13%

    Dry Mouth
    5%
    9%
    10%

    Diarrhea
    5%
    6%
    10%

    1 "CNS Stimulation" is a composite of nervousness, anxiety, agitation, tremor, spasticity, euphoria, emotional lability and hallucinations.

  17. crazydaisy0578

    crazydaisy0578 New Member

    I have been on Ultracet over a year and it does work better with doses. It's been a godsend and gave me back my quality of life. I can function and live now. I generally take between 4 and 6 a day.
  18. bpmwriter

    bpmwriter New Member

    "Nor is it an SSRI or an SNRI. In fact, it should not be taken with antidepressants due to risk of seizures."

    it's true tramadol is not technically an SSRI or SNRI but it does behave like one in the brain. if you look up tramadol on wikipedia, you will find that it is GABA-ergic and does cause mild inhibition of serotonin and norepinephrine reuptake, which is the same action as an SNRI. this is exactly the reason it's contraindicated for use with anti-depressants: the dreaded serotonin syndrome. search further and you will find articles on the potential for morphine-like physical dependence on tramadol. this is not a drug to be taken lightly.

    eddie
    [This Message was Edited on 12/23/2005]
  19. Mikie

    Mikie Moderator

    We definitely need to do our research on anything we try. My info posted here was not to say that no one should take this drug. It didn't work for me but it has worked for others. What is important is making an informed decision.

    Eddie, when I researched this drug, I found nothing on its effects on GABA, serotonin, or any other brain chemicals. I would love to see anything you have on this. If this is true, and I believe you, it is important info which I failed to turn up anywhere and which should be supplied to docs and patients. Anything which alters brain chemistry is a heavy-hitting medication not to be taken lightly and, especailly, not to be prescribed lightly.

    Docs lately have been expressing concern over meds which are taken long term and which alter chemicals in the brain. I take Klonopin which increases GABA and I am concerned with the long-term effects. Without it, however, I cannot sleep nor function when there is considerable seizure activity in my brain. It's the lesser of two evils--I hope. Only decades of use of these meds will tell.

    Love, Mikie
  20. bpmwriter

    bpmwriter New Member


    i just edited my previous post to include the source of the info - wikipedia, which states that tramadol has an effect on all three of the neurotransmitters discussed.

    eddie