Discussions that mention cyclobenzaprine

Pain Management board


Hey Blaster, Your taking twice the recomended dosage of Ultram, It's not a benign med. It has both opiate and SSRI properties and the withdrawal is a nasty combination of both. If your liver is impaired the normal dose should be reduced.

Combining NSAIDS is another risky thing to do, Your putting yourself at risk for a gastric bleed, a stroke or a heart attack. Anti inflamatories work by drawing fluids out of your body into your circulatory system. This puts added strain on your circulatory system which can cause heart attack or stroke. These are just risks, but should be weighed very heavily. Not everyone that took Bextra had a stroke or heart attack, but the mechanism of action is the same, increasing the load on your cardio vascular system by drawaing excess fluids into your blood stream raising your BP. Thinning your blood make bleeds harder to stop and more likely to occur. You may have decreased your opiate intake but your putting your overall health at a much greater risk than any pure opiate would.
I would see a doc and rethink the entire cocktail.

Published info.
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Seizures have been reported in patients receiving ULTRAM within the recommended dosage range. Spontaneous post-marketing reports indicate that seizure risk is increased with doses of ULTRAM above the recommended range. Concomitant use of ULTRAM increases the seizure risk in patients taking:

•Selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics),

•Tricyclic antidepressants (TCAs), and other tricyclic compounds (e.g., cyclobenzaprine, promethazine, etc.),or

• Other opioids.

Administration of ULTRAM may enhance the seizure risk in patients taking:

•MAO inhibitors

Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections). In ULTRAM overdose, naloxone administration may increase the risk of seizure

DOSAGE AND ADMINISTRATION
Adults (17 years of age and over)

For patients with moderate to moderately severe chronic pain not requiring rapid onset of analgesic effect, the tolerability of ULTRAM can be improved by initiating therapy with the following titration regimen: ULTRAM should be started at 25 mg/day qAM and titrated in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg q.i.d.).Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg q.i.d.).After titration, ULTRAM 50 to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.
For the subset of patients for whom rapid onset of analgesic effect is required and for whom the benefits outweigh the risk of discontinuation due to adverse events associated with higher initial doses, ULTRAM 50 mg to 100 mg can be administered as needed for pain relief every four to six hours, not to exceed 400 mg per day.
• The recommended dose for adult patients with cirrhosis is 50 mg every 12 hours.