tobecontnt
05-23-2007, 10:41 AM
Hello there -- I am currently taking Percocet and Neurontin for chronic back pain. My doctor is concerned that my dosage of percocet has been increasing as my body has gotten used to the current dosage of 2 1/2 pills a day. I have been on them since mid-2004. He was recommending switching over to Ultram because then I could get the time-released version and take only one a day. Can I just stop the percocet and switch over or do I have to wean myself of Percocet first - which scares me to death? Thanks alot.
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zach016
05-23-2007, 11:27 AM
Hi tobe,
You may want to look up information about Ultram (Tramadol) and see what this medication is all about. There are alot of things that you should speak to your Dr. about before going on this medication. At the drugs.
com/
ultram
you can see what I mean.
I'm sure that there will be others along shortly that have 'hands on' information.
Good luck
Zach
You may want to look up information about Ultram (Tramadol) and see what this medication is all about. There are alot of things that you should speak to your Dr. about before going on this medication. At the drugs.
com/
ultram
you can see what I mean.
I'm sure that there will be others along shortly that have 'hands on' information.
Good luck
Zach
conductor
05-23-2007, 04:21 PM
Dear tobe,
Jumping from Percocet to Ultram seems strange to me. For most people, Percocet (oxycodone/acetaminophen) is "stronger" (more effective, more potent) than Ultram (tramadol). Percocet is a Schedule II medication (having a higher abuse potential and usually meaning that it's more powerful when it comes to pain medicine), while Ultram (tramadol) is a Schedule IV medication (having a lower potential for abuse and most often meaning that it's "weaker" when it comes to pain medicine). When it comes to taking a time-released version, oxycodone is available in a time-released fashion...recognized by most folks as OxyContin. If the amount of pills per day is your doctor's concern, OxyContin is available. Please know that the difference in relief between oxycodone and Ultram is significant. Another Schedule II/Schedule IV comparison would be morphine/Darvocet.
I'm not saying I'm right, but going from Percocet to Ultram appears to be a downward spiral--a regression. The doctor, I'm sure, would much rather have his records show that you went from a strong pain reliever to a much weaker one. IN THIS INSTANCE...I really don't think that the "time-release" part of the argument is of that much consequence. Sometimes, the whole "time-release" concept is very important. It just seems like your doctor doesn't like the idea that you've crept up to a whopping 2 1/2 pills a day (sarcasm intended). What I really mean is that 2 1/2 Percocets a day--an amount you've worked up to since mid-2004 (3 years)--is not something treacherous. Of course...I may be missing something here.
By the way, don't take the seizure possibility of Ultram lightly--even though the Neurontin you take is an anti-convulsant. When I was placed on Ultram many, many years ago--while on Tegretol (an anti-convulsant)--I had a seizure before a full 24 hours was completed. Naturally, this doesn't happen to most people, but you should be aware of the risk.
Make sure you do your research like Zach suggested!
I may be way off (which wouldn't be unusual), but I still have the feeling your doctor would prefer Rx'ing--going from a Schedule II to a Schedule IV. This looks better to prescribing authorities like the DEA.
Sincerely,
Jon (Conductor)
Jumping from Percocet to Ultram seems strange to me. For most people, Percocet (oxycodone/acetaminophen) is "stronger" (more effective, more potent) than Ultram (tramadol). Percocet is a Schedule II medication (having a higher abuse potential and usually meaning that it's more powerful when it comes to pain medicine), while Ultram (tramadol) is a Schedule IV medication (having a lower potential for abuse and most often meaning that it's "weaker" when it comes to pain medicine). When it comes to taking a time-released version, oxycodone is available in a time-released fashion...recognized by most folks as OxyContin. If the amount of pills per day is your doctor's concern, OxyContin is available. Please know that the difference in relief between oxycodone and Ultram is significant. Another Schedule II/Schedule IV comparison would be morphine/Darvocet.
I'm not saying I'm right, but going from Percocet to Ultram appears to be a downward spiral--a regression. The doctor, I'm sure, would much rather have his records show that you went from a strong pain reliever to a much weaker one. IN THIS INSTANCE...I really don't think that the "time-release" part of the argument is of that much consequence. Sometimes, the whole "time-release" concept is very important. It just seems like your doctor doesn't like the idea that you've crept up to a whopping 2 1/2 pills a day (sarcasm intended). What I really mean is that 2 1/2 Percocets a day--an amount you've worked up to since mid-2004 (3 years)--is not something treacherous. Of course...I may be missing something here.
By the way, don't take the seizure possibility of Ultram lightly--even though the Neurontin you take is an anti-convulsant. When I was placed on Ultram many, many years ago--while on Tegretol (an anti-convulsant)--I had a seizure before a full 24 hours was completed. Naturally, this doesn't happen to most people, but you should be aware of the risk.
Make sure you do your research like Zach suggested!
I may be way off (which wouldn't be unusual), but I still have the feeling your doctor would prefer Rx'ing--going from a Schedule II to a Schedule IV. This looks better to prescribing authorities like the DEA.
Sincerely,
Jon (Conductor)
tobecontnt
05-23-2007, 05:07 PM
Thank you - I hate going in for my 6 month check up because he has a tendency to make me feel like I'm a criminal or something. Considering changing doctors because he doesn't really seem to know alot about pain meds or people w/chronic pain - going to switch to a pain management doctor at my spine clinic and go from there. I had actually asked him about Ultram and he gave me a prescription for 10 pills to try. With all the things I have read about seizures etc. I am scared to death of a reaction. I had a very bad one with Cymbalta - ended up in emergency room - so I am scared to death of that ever happening again. I will probably stick w/Percocet for now and tell him the Ultram didn't work. I was going to just give one of them a try but wasn't sure if it was safe (example: take percocet today and then try an ultram tomorrow) maybe not a good idea? Thanks again for listening.
madhatter
05-27-2007, 12:38 AM
Conductor is right! Also,I wouldn't be suprised if you went through some withdrawls from the switch.2 1\2 pills a day since 2004 is not that much!
Maybe though since its only that,ultram may work,like conductor said,thats a weird switch?
Maybe though since its only that,ultram may work,like conductor said,thats a weird switch?
ember919
05-29-2007, 04:38 PM
Was interested to catch this message as I'm actually going through a similar situation. I've been taking Neurontin and hydrocodone for about four years. I have joint problems in my neck that cause pain down into my right shoulder, arm and hand. At my worst, I was probably taking about ten 10/325 pills a day. I had surgery last year and things did improve, but I've kind of peaked at a point where I still need anti-inflammatories every day and pain meds most days. I always follow a process - try to distract myself so I don't need to take anything, then ibuprofen, and then if that doesn't work to the pain meds. Sometimes if the pain is really bad I will go right to both together.
So, anyway, I had pretty much accepted that this was my life. And I was lucky because I've never been someone who is affected by that kind of stuff. Neither the Neurontin or the hydrocodone made me goofy or sleepy or happy or whatever. A couple of times the high doses of hydro made me a little disoriented, but that was literally only a couple of times.
So a few months ago I started having some problems. Found some info on the internet and discovered that it was my liver. Went to my PCP, ran some tests, and found that the acetaminophen in the hydrocodone, after all these years, was finally trashing my liver. Luckily, when I stopped the hydro, the liver problems went away. (and to be sure, he had me start taking it again and the problems came right back, stopped again and they went away)
I had no problem stopping the hydro, other than then I had no pain meds.
So called my surgeon's office and told them that I could no longer take the hydro. They switched me to Tramadol, which I think is Ultram without the acetaminophen? Anyway, the Tramadol does not work. It helps my actual neck pain, but does not address the peripheral pain in my shoulder, arm and hand. I went in to see the 'rehabilitation specialist' at my surgeon's office and he told me that the Tramadol should be working. He then said that maybe I had been reacting to the 'buzz' from the hydro all these years, rather than any pain killing properties, that the hydro just made me feel good so the pain didn't bother me so much.
Huh? Well, yeah, I DO feel better when the pain isn't bothering me so much. Duh! Is that not why I am taking a pain medication?
So he ups my Neurontin dosage and tells me to see if that helps. I have to mail that in and wait for it, and in the meantime my pain is still not being adequately addressed. I called the office again last Friday and left a message basically saying, "Look, guys, the Tramadol is just not doing it. I told you this before. What other options do I have?"
A different doc in the office called back and offered me Darvocet. Well, I can't take Darvocet because it makes me throw up. I told him that and he told me I was running out of options for pain meds. I can't believe that is true! Someone had mentioned a prodcut that is the pain stuff in hydrocodone mixed with ibuprofen instead of acetaminophen and I asked about that. He told me I should not be taking ibuprofen, which was the first I'd heard of that.
He then asked me about the hydro, wanting to know if I took it to "take the edge off". I said, "What do you mean? Take the edge off the pain? It makes the difference between the pain being in the background or the pain having a constant impact on my daily life. But I don't think I use to to 'take the edge off' the way you're saying it." He then asked if I felt happier when I took the hydro. I got really irritated and said, "Yes, I feel happier because I'm not in pain!" In the end, he told me to "hang in there" and wait for an EMG that I've got scheduled in two weeks.
So, here I am, frustrated and angry because all of the sudden my doctor's office is treating me like I'm some sort of junkie. I honestly do not understand why they suddenly got all freaky just because I told them the Tramadol doesn't work! Why is that so weird? I know that everyone reacts differently to different medications. And I can't believe that hydrocodone, Darvocet and Tramadol are my only options!
I, too, am thinking of switching to a pain management doc. I want to manage my pain without harming myself physically or turning myself into a mindless idiot. And I'd love to get some PT pointers again and maybe even try something like biofeedback.
I know everything has side effects, so you've got to figure out what works for you. I just wish the doctors would understand that concept, too.
So, anyway, I had pretty much accepted that this was my life. And I was lucky because I've never been someone who is affected by that kind of stuff. Neither the Neurontin or the hydrocodone made me goofy or sleepy or happy or whatever. A couple of times the high doses of hydro made me a little disoriented, but that was literally only a couple of times.
So a few months ago I started having some problems. Found some info on the internet and discovered that it was my liver. Went to my PCP, ran some tests, and found that the acetaminophen in the hydrocodone, after all these years, was finally trashing my liver. Luckily, when I stopped the hydro, the liver problems went away. (and to be sure, he had me start taking it again and the problems came right back, stopped again and they went away)
I had no problem stopping the hydro, other than then I had no pain meds.
So called my surgeon's office and told them that I could no longer take the hydro. They switched me to Tramadol, which I think is Ultram without the acetaminophen? Anyway, the Tramadol does not work. It helps my actual neck pain, but does not address the peripheral pain in my shoulder, arm and hand. I went in to see the 'rehabilitation specialist' at my surgeon's office and he told me that the Tramadol should be working. He then said that maybe I had been reacting to the 'buzz' from the hydro all these years, rather than any pain killing properties, that the hydro just made me feel good so the pain didn't bother me so much.
Huh? Well, yeah, I DO feel better when the pain isn't bothering me so much. Duh! Is that not why I am taking a pain medication?
So he ups my Neurontin dosage and tells me to see if that helps. I have to mail that in and wait for it, and in the meantime my pain is still not being adequately addressed. I called the office again last Friday and left a message basically saying, "Look, guys, the Tramadol is just not doing it. I told you this before. What other options do I have?"
A different doc in the office called back and offered me Darvocet. Well, I can't take Darvocet because it makes me throw up. I told him that and he told me I was running out of options for pain meds. I can't believe that is true! Someone had mentioned a prodcut that is the pain stuff in hydrocodone mixed with ibuprofen instead of acetaminophen and I asked about that. He told me I should not be taking ibuprofen, which was the first I'd heard of that.
He then asked me about the hydro, wanting to know if I took it to "take the edge off". I said, "What do you mean? Take the edge off the pain? It makes the difference between the pain being in the background or the pain having a constant impact on my daily life. But I don't think I use to to 'take the edge off' the way you're saying it." He then asked if I felt happier when I took the hydro. I got really irritated and said, "Yes, I feel happier because I'm not in pain!" In the end, he told me to "hang in there" and wait for an EMG that I've got scheduled in two weeks.
So, here I am, frustrated and angry because all of the sudden my doctor's office is treating me like I'm some sort of junkie. I honestly do not understand why they suddenly got all freaky just because I told them the Tramadol doesn't work! Why is that so weird? I know that everyone reacts differently to different medications. And I can't believe that hydrocodone, Darvocet and Tramadol are my only options!
I, too, am thinking of switching to a pain management doc. I want to manage my pain without harming myself physically or turning myself into a mindless idiot. And I'd love to get some PT pointers again and maybe even try something like biofeedback.
I know everything has side effects, so you've got to figure out what works for you. I just wish the doctors would understand that concept, too.
curiousforever
05-29-2007, 06:41 PM
I'd be more concerned with the tylenol. Although I'm still taking percs (:)
I'd ask about ADDING ultram - I take both and it works better than the fentynal patches and the stronger crap I've been on.
There *is* oxycodone - which is perc just without the tylenol.
I'm going to ask about it at my next refill cause everything else I take is bad on livers as well.
I'd ask about ADDING ultram - I take both and it works better than the fentynal patches and the stronger crap I've been on.
There *is* oxycodone - which is perc just without the tylenol.
I'm going to ask about it at my next refill cause everything else I take is bad on livers as well.
madhatter
05-30-2007, 10:52 PM
With all the people I've talked to over the yrs,pain management is shots,tests,shots,tests,shots,shots! I wish the shots worked for me! I really do,then I would never have to worry about meds ever again. about if the doc. is going to move,we have to deal with all the stuff besides the pain!
Sorry,just venting a little.
Sorry,just venting a little.
trowftd3
05-31-2007, 02:37 AM
With all the people I've talked to over the yrs,pain management is shots,tests,shots,tests,shots,shots! I wish the shots worked for me! I really do,then I would never have to worry about meds ever again. about if the doc. is going to move,we have to deal with all the stuff besides the pain!
Sorry,just venting a little.
That and a diagnosis! I would kill for one of those!!!~Mush
Sorry,just venting a little.
That and a diagnosis! I would kill for one of those!!!~Mush
Fabrashamx
05-31-2007, 02:49 AM
Hi,
I have been/am on both meds. The tramadol (ultram) I have taken as my base med for over a decade, I have hydrocodone for breakthrough, But I am given oxycodone when my pain gets really really bad, about 4 times a year.
I think going from the oxy to the tramadol is not going to make you a very happy camper, it is much weaker, and not close enough to the same thing to prevent withdrawal.
I agree with the other poster, It would be a better idea to ADD tramadol, in an effort to lower the amount of needed percocet, than to switch from one to the other.
Tramadol is a good base pain med, at least for me, but without the other, It would not be enough. I dont take the hydro just for breakthrough, I take it 3 times a day, and the combination of the two meds (plus baclofen) works very well for me and has for quite a few years.
Maybe your doctor will let you add the tramadol, then try to cut back on the oxy until you reach a point where you cant cut back anymore.
Good luck to you, and please let us know what happens!
Your Friend,
Fabby :wave:
I have been/am on both meds. The tramadol (ultram) I have taken as my base med for over a decade, I have hydrocodone for breakthrough, But I am given oxycodone when my pain gets really really bad, about 4 times a year.
I think going from the oxy to the tramadol is not going to make you a very happy camper, it is much weaker, and not close enough to the same thing to prevent withdrawal.
I agree with the other poster, It would be a better idea to ADD tramadol, in an effort to lower the amount of needed percocet, than to switch from one to the other.
Tramadol is a good base pain med, at least for me, but without the other, It would not be enough. I dont take the hydro just for breakthrough, I take it 3 times a day, and the combination of the two meds (plus baclofen) works very well for me and has for quite a few years.
Maybe your doctor will let you add the tramadol, then try to cut back on the oxy until you reach a point where you cant cut back anymore.
Good luck to you, and please let us know what happens!
Your Friend,
Fabby :wave:
ember919
05-31-2007, 04:03 PM
I do not know how long it will be before I can safely take anything with acetaminophen again. But perhaps the idea of daily tramadol with something stronger for bad-pain days might work.
I am still utterly bewildered by the stance the surgeons have suddenly taken. I mean, I take hydro for years and no one says a word. Then I notice a health problem, get it checked out, make the decision to stop taking the hydro -- and that's when they decide I've only been taking it for 'feel good' reasons? Huh? And I still don't understand the logic of if I'm taking tramadol for pain and it is not working, then the hydro must not have been working either and I was just too 'happy' to notice.
As I told the doc the other day, "You dumb*ss! If I was happy, it was because I was not in pain!"
OK, I didn't really call him a dumb*ss, but I wanted to!
I read a little about the patches and those sound pretty bad. So do the morphine-release pills. Docs were suggesting the patches at one time, but I don't think I want to go there. I still don't quite understand the difference between the oxy pain meds and the hydro, but no one has mentioned oxy-anything so I guess that is not a consideration. I have no idea why doc won't just prescribe the hydro/ibuprofen combo or give hte OK for the hydro-only compound.
I thought about going to my PCP, explaing the situation (he already knows some) and asking for a short term script for something to help, but I hate to involve him and I would also hate to further my newfound 'junkie' reputation. EMG is in a week and I guess I will just have to deal with it until at least then. Though, in truth, after all this, I am expecting a lecture about how I need to just "get through the pain" on bad days. Aargh.
Anyway, today is a bad day and pain level is keeping me from doing things I need to be doing. I am so frustrated I could scream. I am still hoping I will be able to work something out that makes everyone happy - docs don't think I'm getting high (dammit, that still makes me so mad!) and I do not walk around contorted up like Igor.
Gee, pain management is fun! (soooooo sarcastic!)
I am still utterly bewildered by the stance the surgeons have suddenly taken. I mean, I take hydro for years and no one says a word. Then I notice a health problem, get it checked out, make the decision to stop taking the hydro -- and that's when they decide I've only been taking it for 'feel good' reasons? Huh? And I still don't understand the logic of if I'm taking tramadol for pain and it is not working, then the hydro must not have been working either and I was just too 'happy' to notice.
As I told the doc the other day, "You dumb*ss! If I was happy, it was because I was not in pain!"
OK, I didn't really call him a dumb*ss, but I wanted to!
I read a little about the patches and those sound pretty bad. So do the morphine-release pills. Docs were suggesting the patches at one time, but I don't think I want to go there. I still don't quite understand the difference between the oxy pain meds and the hydro, but no one has mentioned oxy-anything so I guess that is not a consideration. I have no idea why doc won't just prescribe the hydro/ibuprofen combo or give hte OK for the hydro-only compound.
I thought about going to my PCP, explaing the situation (he already knows some) and asking for a short term script for something to help, but I hate to involve him and I would also hate to further my newfound 'junkie' reputation. EMG is in a week and I guess I will just have to deal with it until at least then. Though, in truth, after all this, I am expecting a lecture about how I need to just "get through the pain" on bad days. Aargh.
Anyway, today is a bad day and pain level is keeping me from doing things I need to be doing. I am so frustrated I could scream. I am still hoping I will be able to work something out that makes everyone happy - docs don't think I'm getting high (dammit, that still makes me so mad!) and I do not walk around contorted up like Igor.
Gee, pain management is fun! (soooooo sarcastic!)
IZZY'SMOM
05-31-2007, 07:40 PM
you csan get compounded hydo at a compounding pharmacy...I live in a tiny burg and we have one a few hours away...my doc has to write the script though b/c when you compound the hydro with nothing else in it, it becomes a sched II just like demerol ect...
I get 15 mg capsules made up for me and its STRICTLY hydro, and cheaper too...I get 12o a month...
You can make them as strong/weak as you like...the doc writes for what strength...mine are also hydro LA [long acting] there are so many things out there, your doc is an *ss for not offering you anything...he knows full well what could help you...
Get into your yellow pages and look up pharmacies, or ****** compunding pharmacies...I fed ex my script every month to them, because i dont want it to get lost...they fed ex my meds back in a day!
hope this helps, and if you ask this guy about this and he tells yoou no, id try to find someone else, but I know thats not easy...He wants to give you TRAMADOL which causes seizures? And is HIGHLY addictive? boiut time you have a sizure on a med he tries to shove down your throat when there are other options, id sue him...Im sick of these docs treating pain pts like junkies...
XOXOXOXOOX,
IZZY'SMOM
I get 15 mg capsules made up for me and its STRICTLY hydro, and cheaper too...I get 12o a month...
You can make them as strong/weak as you like...the doc writes for what strength...mine are also hydro LA [long acting] there are so many things out there, your doc is an *ss for not offering you anything...he knows full well what could help you...
Get into your yellow pages and look up pharmacies, or ****** compunding pharmacies...I fed ex my script every month to them, because i dont want it to get lost...they fed ex my meds back in a day!
hope this helps, and if you ask this guy about this and he tells yoou no, id try to find someone else, but I know thats not easy...He wants to give you TRAMADOL which causes seizures? And is HIGHLY addictive? boiut time you have a sizure on a med he tries to shove down your throat when there are other options, id sue him...Im sick of these docs treating pain pts like junkies...
XOXOXOXOOX,
IZZY'SMOM
Wren9
06-01-2007, 02:27 PM
IZZY'SMOM,
I've been wanting to ask you, do you know how the compounding pharmacy creates a long-acting or sustained-release release mechanism for the hydrocodone? Hydrocodone, while not quite as strong as oxycodone, works better for some people. Norco 10/325 used to work very well for me, but I was switched to opioid-only meds (first Oxy IR and then later a sustained-release opioid was added)...when I reached the APAP (tylenol) ceiling.
-Wren
I've been wanting to ask you, do you know how the compounding pharmacy creates a long-acting or sustained-release release mechanism for the hydrocodone? Hydrocodone, while not quite as strong as oxycodone, works better for some people. Norco 10/325 used to work very well for me, but I was switched to opioid-only meds (first Oxy IR and then later a sustained-release opioid was added)...when I reached the APAP (tylenol) ceiling.
-Wren
IZZY'SMOM
06-01-2007, 07:01 PM
Hi Wren,
I asked my pharmacist and she said they use a gelatin sort of powder tat is mixed in...My caps are a light yellow and the outside is clear and you can see the light yellow powder thru it...
Some may do it differently...
My hubby tweeked his back last week and our doc gave him some reg hydro...he used a couple of mine before his script was called in...and after using them both he prefers that LA hydro for better pain coverage...
Hope this helps!
xoxoxoxox,
IZZY'SMOM:wave:
I asked my pharmacist and she said they use a gelatin sort of powder tat is mixed in...My caps are a light yellow and the outside is clear and you can see the light yellow powder thru it...
Some may do it differently...
My hubby tweeked his back last week and our doc gave him some reg hydro...he used a couple of mine before his script was called in...and after using them both he prefers that LA hydro for better pain coverage...
Hope this helps!
xoxoxoxox,
IZZY'SMOM:wave: