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02-27-2015, 06:46 AM   #1
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Tramadol (painkillers)

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?
02-27-2015, 09:27 AM   #2
Tony H
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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 .
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02-28-2015, 11:33 PM   #3
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Be careful with Tramadol. It can be addictive and you can build up a tolerance to it. Just take it as recommended.
03-01-2015, 03:44 PM   #4
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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.
03-01-2015, 05:11 PM   #5
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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.
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03-01-2015, 07:58 PM   #6
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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.
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03-02-2015, 04:09 AM   #7
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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.
03-02-2015, 04:20 AM   #8
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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.
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03-04-2015, 09:28 AM   #9
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Did you try a lot of other painkillers before Tramadol, SarahD?
03-04-2015, 09:33 AM   #10
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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.
03-04-2015, 10:29 AM   #11
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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.
03-04-2015, 12:50 PM   #12
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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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03-04-2015, 01:09 PM   #13
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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.
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?
03-04-2015, 01:51 PM   #14
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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.
03-04-2015, 05:42 PM   #15
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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.
03-05-2015, 03:32 AM   #16
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Did you try a lot of other painkillers before Tramadol, SarahD?
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.
03-05-2015, 06:19 AM   #17
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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.
03-06-2015, 05:26 PM   #18
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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.
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03-07-2015, 06:34 AM   #19
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I haven't taken it the past couple of days. I'm giving it one more try today to see.
03-07-2015, 06:48 AM   #20
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Well the blurred vision has kicked in already
03-07-2015, 08:29 AM   #21
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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.
03-07-2015, 11:07 AM   #22
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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.

Last edited by UnXmas; 03-07-2015 at 11:23 AM.
03-07-2015, 11:44 AM   #23
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Have you tried Marijuana?
03-07-2015, 01:09 PM   #24
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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.
03-07-2015, 03:15 PM   #25
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Have you tried Marijuana?
Not legal where I am.
03-07-2015, 03:18 PM   #26
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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.
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.
03-07-2015, 03:24 PM   #27
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I just saw you asked this about back pain! I didn't make that connection earlier . 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!
03-07-2015, 03:28 PM   #28
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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.

Last edited by UnXmas; 03-07-2015 at 03:54 PM.
03-08-2015, 09:12 AM   #29
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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.
03-08-2015, 10:17 AM   #30
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Second the tens unit
No pain meds for my kiddo
But one other extra we recently tried was a homedics massage mat
http://www.homedics.com/body-charger...FUMV7Aod5F8ACQ

Doesn't take everything away ( stomach or back )
But helps a lot
Second the pain management doc -lots of really good options GP don't use
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