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-   -   Rotating between an opiates and tramadol (http://www.healthboards.com/boards/pain-management/544222-rotating-between-opiates-tramadol.html)

daniel1000 10-17-2007 10:24 PM

Rotating between an opiates and tramadol
 
Tramadol worked really well for me for 4 months but now the effects have wained. It is likely that I will be put on real opiates. However if I don't take Tramadol for a few weeks its excellent pain killing powers return. So I am hoping to be able to go on a cycle of say three weeks of an opiate and then three weeks of Tramadol and repeat this cycle. I believe it will reduce my chances of serious opiate addiction. Is this idea feasable. Do Drs ever advocate this?

Fabrashamx 10-18-2007 08:32 AM

Re: Rotating between an opiates and tramadol
 
Hi Daniel and welcome to the pain board. I think a doctor may be willing to try what you suggest, but I have to tell you, doctors consider Tramadol an opiate also, and they would see it as no different than if you wanted to for example, switch back and forth between hydrocodone and oxycodone.

The switching does work for some people, to slow tolerence, but I am surprised the Tramadol quit working for you so fast, I have been on it for many years and I still get relief, but I have to take it with hydrocodone, alone it is not enough to make a difference.

I kind of doubt if switching between two meds that are so similar would have much of an effect on tolerence levels, as your tolerence went up with one, I think you would find you also needed more of the other to get the same relief. I think a 'vacation' is more what you are thinking, people can stop taking meds for as few as 3 days and then find they work better. But after you have been on them long term, the withdrawal is very hard on your body and the bad would outweigh any benefits.

I know there are people here much more knowledgeable than I am about this, I'm sure you will get more advice and I will be interested to see what others have to say also.

Good luck and I hope you can find your answer here.
~Fabby:)

forginon 10-18-2007 08:53 AM

Re: Rotating between an opiates and tramadol
 
I fully agree with Fabby. In my opinion, the success you've enjoyed has come from the drug holiday you've inserted into your schedule rather than any kind of switching. Take enough time away and tolerance is reduced. Switch between two opioids without time away and tolerance remains.

Hope this helps - I think this is mostly accurate.

steve

conductor 10-18-2007 05:30 PM

Re: Rotating between an opiates and tramadol
 
Dear Daniel,

Both Fabby and Steve have my votes!

Tramadol is a controlled substance--a Schedule IV substance in most places. If you look around the Internet, it seems like there's always some hesitance in calling Ultram (tramadol) an [U]outright[/U] opiate. The body, apparently, doesn't produce the same type of responses--things like the amount of respiratory depression, the more limited antagonistic response to Narcan (naloxone), histamine response, etc.

When I was given a sample of it (way back in 1997 or so), I had a severe seizure. Furthermore, there was no relief of the pain I was experiencing.

The actual time away from the tramadol (and anything similar) is probably what made the medication seem like it was working better again. When I went through my first month on generic Duragesic (Mylan), I went through withdrawal. The following month...as I crawled to the pharmacy...I got the Sandoz generic version of the patch. It took me several weeks before I felt like I wasn't ingesting too much of the fentanyl! Then, the situation seemed to be back to normal. (Doesn't it bite--in the biggest manner--that severe pain should ever be a 'normal' situation for anyone?)

Your doctor would probably be open to switching between two medications, as long as they are reasonably similar. Please let us know if anything else develops!

Sincerely,
Jon (Conductor)


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