Switching Medications - Pain Management Message Board

tobecontnt · 05-23-2007, 07:41 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.

zach016 · 05-23-2007, 08:27 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

conductor · 05-23-2007, 01:21 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)

tobecontnt · 05-23-2007, 02:07 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 · 05-26-2007, 09:38 PM

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?