I was offered Tramadol by my pain management doctor today. I am currently on Methadone for pain. I take 200 mgs. a day in divided doses. When checking the interaction between the two medications, there was a sentence I didn't understand. I was wondering if anyone could tell me (in laymans terms) what it means. It reads " Tramadol can also reinitiate physical dependence and precipitate withdrawal symptoms" Does that mean Tramadol will put me in withdrawal from my Methadone? I don't want to fill the script for Tramadol (50 mgs.) if that is the case. I have been on that dose of Methadone for about three years. Any help would be appreciated. Thanks so much. Fall Queen
I am taking Methadone - what will happen if I take Tramadol, will Tramadol put me into withdrawal?
Question posted by fall queen on 21 Sep 2010
Last updated on 10 April 2018
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7 Answers
tlswife4life
9 Feb 2012
I'm in Mmt have been for over 3 yrs. We are given papers to put on our lock boxes and it specifically says not to take tramadol because it will cause wd.
kizzykay
27 Oct 2010
Oh that is exactly what it means you take it your body will start withdrawals immediately and to add to your question there are allot of drugs that will do this so make sure the doctor know what you take he can give you a drug that wont have this reaction... I found it out the hard way i had no clue different medicines could do this to you while taking methadone. Just be cautious of any thing you take with methadone... hope i helped...
dmlady
22 Sep 2010
I was just told today by my new pain doc NOT to take tramadol suboxin or talwin because it will put you into withdraws
hope you have a pain free day
dm
htwooh
22 Sep 2010
The experience I had with tramadol was when I started grinding my hip bone down to a nub . I was in alot of pain and had known the effects of 10mg. OxyContin and norco. When the Dr. wanted to add ultram I tried it but did not feel any pain relief at all so only stayed on it for a week - I am thankful that I didn't mess with it now that I see the horror it has caused among people with pain. It was just a simple matter of it not working but I think people with minimal pain would think it was a better drug , than an aspirin perhaps and end up being completely addicted to it which is the fault of the Dr.'s who do not know any better. My Dr. told me it was not a narcotic so look what he knew. I did end up going to another Dr.
because I was not getting my pain meds on time and the Nurse wouldn't phone in the refill and it was just a mess but I would not take that drug again - it's just not worth it for the horror that could ensue - you might as well take 2 aspirin, tylenol and anything else that might help. Hope you aren't in alot of pain Fall Queen. Take some heavy duty pain meds instead of that crap. Good Luck.
christineATU
22 Sep 2010
I agree totally! Remember how we first met? Still makes me smile... at the time it didn't but now I can. Great advice htwooh!
htwooh
22 Sep 2010
Yes, and I learned alot from that hour of hysterical pissed offed-ness. And all in the dedicated desire to help someone!!! I still don't recognize my avatar Chris - I look so much more like 'yours' hahaha!!! Would you really have changed your avatar just so you wouldn't be confused with me? I must have been pretty mad or was it just what I said in that one answer? I'm trying to fill out IRS forms so am still kinda' nutty - think I must just accept the inevitable of being nutty - on or off meds!! Guess I can't blame the meds anymore - that is pretty disheartening to accept the fact that I am just a nutty person and cannot 'blame' any one or thing.
It all goes back to the beginning of what I was suppose to learn in AA and that single exercise in acceptance and not judging people has been a hard one - must be how I ended up shitfaced under the table some days!!! I guess we can have a little visit - huh Fall Queen since you aren't a newby wondering what we are tallking about on your question time... How is everyone? Is evrything still copesthetic with your son?
fall queen
28 Oct 2010
I thought I might comment on what my pm doc told me when I presented him with a printout of methadone and tramadol being a major interaction. He said if I took both my meds Miethadone prescribed 8 in the morn 4 at noon 4 at dinner and 4 before bed. With the Tramadol the instructions say 1-2 tablets every 4 hrs. as needed for pain. I very nicely told him they didn't really help with the pain, and I would prefer not to take them. Just like I said the first time, I don't think he knew s..t about Tramadol, but played it off like he did and that article was not relevant to my case! That is just my way of saying I think he knew he made a boo boo, but didn't want to admit it. When I go to my pm doc all clients must bring their bottles with the remainder (which there is for me because I go every 28 days). After he counted all my pills and went to put the Tramadol back in my bag of bottles, I very politely told him to keep them one of his nurses may have a hangnail one day! Fall Queen
Phantasm333
25 Jan 2013
Actually, your doctor is right. I have confirmed with multiple doctors that Tramadol IS NOT a narcotic or an opiate. It is "narcotic-like." It's not even a scheduled drug. However, despite not being an opiate or a narcotic it's still possible to get a very slight euphoric sensation and get addicted to it. I was prescribed tramadol for 2 years to treat knee pain, and it didn't help my pain at all. Last year I quit taking Tramadol because one day I was stupid and took too much, resulting in a seizure so severe that I dislocated AND broke BOTH of my shoulders. I had surgery to have screws put in both of them, followed by a month of having both arms stuck in slings. After I was able to take off the slings I had 4 months of extremely painful physical therapy. Now even though I'm through with my recovery I am permanently at risk of dislocating again.
If that happens they won't be able to just pop my shoulders back in place, I'd have to have them surgically put back in place. During the time of being stuck in 2 slings I was subjected to much humiliation. My poor wife had to do EVERYTHING for me, which she always did lovingly, she never complained once, despite having to feed me, tie my shoes, hold the phone to my ear, drive me everywhere, cook all my meals, and even had to wipe me every time I used the bathroom. You'd think she'd only need to help me in the bathroom when going number 2, but no, she was even willing to aim it for me when going number 1! Like I said, she NEVER complained once, and even still views me as a sexual person after all this. My point here is that yes, mixing methadone with tramadol can cause withdrawal, because that's what led to my seizure. I didn't even take them simultaneously, the methadone was still in my system from the day before, then when I took tramadol the next day I took too much. It interacted with the methadone, throwing me into withdrawal, leading to my seizure, breaking and dislocating both shoulders. Then I got to see what my marriage was really made of. That woman is a great woman. There is no other that would lovingly do what she did for me, without one complaint. Anyway, the lesson you should all learn here is, DO NOT MIX ANYTHING WITH METHADONE unless approved by a doctor that knows you're on Methadone. Especially Xanax, (or any benzos at all for that matter), Tramadol, alcohol, grapefruit juice, (no joke), and some others.
jk13
22 Sep 2010
Hi, I currently take tramadol and methadone together. Usually, the major concern is with the seizures and CNS and respiratory depression. That risk is only "risky" if you've ever had a seizure before, or have ever had head trauma. If you stay bellow 300mg, the risks are beyond minimal - however, for many, it could very well result in a very very bad situation. It has always been my understanding with the withdrawal bit, that if you at one point in you life took heroin, and got off the stuff, and stayed clean for years. Taking tramadol could reinitiate withdrawals similar to when you where detoxing from heroin, much more severe than another person who would be unaffected by stopping a short term use of the medication. That is my "understanding" so I might be totally wrong, nonetheless, I was on Methadone, and then added Tramadol, and had no problems with the two together what so ever.
It couldn't hurt to ask a pharmacist or doctor as everyone says.
I currently am however detoxing from the stuff, as I also believe it to be more of a strange and dangerous drug than what doctors would have you believe. If taken at a significant dosage for long term, 6 months to a year, depending on the person, it does cause very very bad withdrawals. The problem with the drug is that it is an SNRI that hits on the opioid sensors. It has the strength that is comparable to codeine according to the charts, although it doesn't even feel that strong to me. The SNRI activity hits the Seratonin as well as norepinephrine reuptake inhibitors almost immediately. This sudden action is very unlike all other SNRI's out on the market, where they normally take at least a week to take effect. This sudden action makes stopping a drug like this very difficult due to the SNRI component, and it's sudden action, much like how other SNRI medications are harder to withdraw the shorter and quicker acting the medication is, usually is true with most extended release medications such as Pristiq. The chemicals in Pristiq act for a very very short time, so the only way to market the drug is to have it extended release, as is true with Cymbalta. So, stopping Tramadol would make you deal with withdrawal from two drugs at once. A very difficult to stop SNRI as well as the Opioid component. I think that Tramadol and Methadone both are some of the most unusual opioids out on the market. The only good thing about the SNRI component is that it puts you in a good mood when you first start taking the medication, however, that more or less went away for me with time.
The amount of pain relief that you would get from Tramadol would be very very minimal in comparison to Methadone, and honestly I'm stopping cause for me, it's just one more component to an already large drug cocktail that I'd like to have simplified. I've gone from 300mg, and have gone down 50mg every 5 days, currently at 200mg - tomorrow will be at 150mg. Definitely terrible depression has hit me unexpectedly, and of the very severe sort, with suicidal thoughts popping threw-out my mind. An increase in anxiety and pain is something that I can deal with, but the mental thing just plain out sucks. Lately, if I don't take the medication exactly on time, I'll also get headaches that are so bad that my eyes will tear up and can't think straight. Once a bit of the medication is taken, they go away, and sit in the background, an uncanny feeling of something lurking in the background. Thank god that my wife has actually stepped it up this time and is actually being supportive and helpful in this for the first time - and seems to understand the mental thing as it happens so suddenly, that it's not like me at all, and is so obviously medication related!
As an overall, the risk vs. helping scenario, doesn't make sense to me. It is a very mild drug, with very bad repercussions, but that is just my opinion, and this really is only my personal experience with the medication, as I would imagine that there are many out there who have found it to be a life saver, and It did help a bit, but 8 or 9 medications is just way to many for me, and I'm trying to eliminate all of the "kinda working" ones, and increase the ones that really work. I should be able to ideally get the cocktail down to just 4 or 5, depending on the amount of side effects that are relieved by the decrease in meds.
Anyways, I hope that this is of some sort of help to you, and that whatever you decide to do, I'm sure that it'll be the right choice for what you currently need! Best of luck!
sincerely
Jeff K
christineATU
22 Sep 2010
Hi there Jeff. Great info but scares the hell out of me! Thumbs up on the facts. But I must say I have heard more bad than good on the tramadol.
jk13
22 Sep 2010
your right, there's more bad to write about tramadol than good unfortunately...
Inactive
23 Sep 2010
Jeff, great info, as usual buddy! Fall Queen, I wanted to add that snri's are notorious for making blood pressure rise, and they can make one crave carbs and sugar. Just thought I'd toss that into the mix here.
Good luck,
sweetlemon
Sacosam
3 Oct 2010
Hello there Jeff , How's the ol' Med studies coming along? What you just said will definately impress both the Ladies , and the druggies , but just who in the hell do you think you are??? are you Dr. Zhavago , or Stu, the Shrink , or Nancy the N.P. From what I see, the only thing I can see that you do well, is use big words to impress people... mainly Ladies who have made mistakes in their choices of both doctors & drugs, and copy phrases from Med books"! Are you hoping they'll come to you for help ? You say you're on, or have been on 8 or 9 meds, [I won't even comment on that] but I will say, are you bragging or complaining ? Your Avatar is also impressive? ?
Me, you want to express your opinions about Me , sure , let me give you some ammo. "I'm dumber than a box of rocks"! so I only say what i'm sure of, and I have to answer two personal questions... First; Have I been there? Second, Have I done that? If I can't answer a solid YES!! to those 2 questions, I keep my mouth shut, lest someone put their foot in it... [and there ain't no drug to cure that Jeff] "If it cost a Dollar to go around the world, I couldn't get outta' sight, so I sure can't impress anybody with all my money... "ALL" my money "HaH"! But if I really want to impress the Ladies , it has to be my total grasp of the English Language... See if someone posts me , and includes words of more than 8 letters, they have to include an explanation, cause i'm lost without it have a great day Jeff. Sacosam
jk13
3 Oct 2010
First of all, you yourself have used eight letter words several times yourself. I know that I write in a very mechanical wordy sort of way that could easily perhaps be seen as snobbery, but that is not my intent at all. I have obviously offended you, and for that I'm extremely sorry.
It just happens that I started taking a series of medications for fibromyalgia a couple years ago, and after numerous trials and errors, I ended up with methadone as acting as the primary pain killer me. It however didn't cut the pain out all of the way. Due to the doctors reluctance to increase the dosage, he added on additional pain killers to help out with the primary pain killer. Both of the supplemental medications that I once took, I recently stopped taking (300mg Tramadol and 225mg Lyrica).
I never take medications without having a complete understanding of what I'm ingesting, as a Rheumatologist tried to prescribe an SNRI while already taking a substantial dosage of another SNRI, that was nearly identical in action. The question that was asked I not only have personal experience regarding the combo of the two, but have done extensive research regarding these two meds, and do have a very good understanding as to how they interact, as Tramadol is also an SNRI, and when taking two of the same type medications, they can cause potentially very threatening problems if your not very careful.
I find medicine, and the way it affects the body to be extremely fascinating, and am also interested with the lack of understanding as to how these medications work, especially when you get into the nitty gritty details. It really is a field of science that has barely been scraped into, and thus is why I find it so interesting. I never claim to be a doctor, or anything of the sort. I don't even have a bachelors degree, I only have a high school diploma, and that's it.
I did mention the number of medications that I was on at one time, a period in my life where I nearly needed to be hospitalized as well as almost lost my job. I guess that I'm just proud of my accomplishments of no longer needing and stopping the Abilify, Lyrica, and Tramadol. This is a step one for me in cutting out all the ineffective meds, and wanted to share the good news. It was not my intention to be showing off. I would never have been able to do this without the help from my therapist. This is the only place that I can share my ups as well as my downs in my fight against mental illness.
I've come to this site as a general due to the fact that I have no where else to go when discussing my problems as well as accomplishments, as everyone that I know personally are very uncomfortable with discussing mental disorders of any sort. This site has given me a sense of a community that I can go to when I need words of support, or if there's advise that I need. I'm also always happy to help others out, especially when it's a topic that I'm all too familiar with. I am very very familiar with depression, anxiety (social, general, & panic), sad, c-ptsd, and fibromyalgia. I'm not showing off here, but just listing off the items that I've been diagnosed with, and have been fighting. These are all things that I have first hand knowledge of. I've also have had problems with numerous medications, finding myself taking an obscenely large series of meds. I've also had first hand experience years back with numerous friends that I've lost due to drug abuse, and have seen the beginnings, and the endings as well. You will very very rarely ever find me answering any other questions regarding bipolar illness, mania, as well as schizophrenia, as I don't know much about these conditions. My goal is not "to impress the ladies" (I'm happily married), but just want to share information, and that's it.
I have no reason to dislike you, and hope that you will be able to come to accept me for who I am, as I can understand the irritation and how I might appear to be a know it all, even though I don't intend on coming off that way. If anyone should disagree with my answers, I'm always open to discussions, and if I find that I'm mislead or simply wrong, then I'm more than happy to admit error.
Sorry for offending you, and sorry about the novel length messages that I write in general, and I hope that you can accept me for who I am.
Sincerely,
Jeff K
Inactive
27 Oct 2010
sacosam,
Why pick on JK??? He knows a lot about meds.
Be nice!
Sacosam
21 Sep 2010
Hi fall queen; Hi Sis... I feel I must step in here and try to help out, though I know very little of anything that involves over 7 or 8 letters. Here goes : Tramadol is not an SSRI. Tramadol & ultram are the same, one being a generic of the other. In my honest opinion [from having taken 3 ,180pill doses
@ 50mg. / pill , total = 540 pills , without knowledge beforehand, found them to be about equal in pain relief strength to (25mg. of ultram = 1, 325mg. aspirin, and they are FAR MORE DANGEROUS . Christine is right , reinitiate means to start , start up , start over , etc... and precipitate means to "cause to happen quickly or before you are ready for it or expect it to.There are 2 drugs that I know to be extremely dangerous (There's probably 500,000 of 'em) one is METHOTREXATE, and the other is ULTRAM / TRAMADOL.
Both have been given "Black Box warnings" by "Worst Pills / Best Pills"! News , and yet they are still being prescribed... Would anybody like to take a wild guess as to why ... "who's da vis'a guy inna' da' back row , he say 'cause dey costa' pennys ta make an' dey sel' fo dollahs" aye , shame for you!! Love ya' jesse! Love ya' Christine ... I'm Sacosam I AM I AM.
christineATU
22 Sep 2010
Back at ya brother. Great answer btw!
fall queen
22 Sep 2010
Thankyou both Chris and Saco F.Q. Long Day!!!
Inactive
22 Sep 2010
Hi fall queen, Please please call your pharmacist/chemist on this! I hate to disagree with sacosam, but I believe christine is right about it being an snri...
This could F things up for you, and we don't want that for our fall queen!
Take care of yourself queen, we need you here.
christineATU
22 Sep 2010
I hate when you can't scroll back to comment on a comment. But that's what I heard. What sweetlemon called it. Not an SSRI but the other one she mentioned. I can't verify that FQ, but that's what I heard. On the other hand, Sacosam knows his stuff when it comes to meds and supplements!
jk13
27 Oct 2010
Tramadol was a med that I took for a long time (however not any longer) with Methadone for pain. Tramadol IS an SNRI medication that also hits on the Opioid sensors, making it also an Opioid. This makes long term use tern into dependence, and at times severe difficulty stopping due to the fact that you're now stopping two types of meds vs. just one, and the SNRI in particular in probably the more difficult of the two components. Some have a harder time with this than others, just like benzos.
Tramadol will only reinitiate withdrawal only if you've had Opioid addiction problem in the past (the methadone taken didn't have any affect cause I was on the med. When an Opioid is stopped that you went through withdrawal such as Heroin or Methadone, you need to make sure that your doctor knows about this. Also, Tramadol isn't a scheduled substance making it a choice pain killer for doctors to prescribe. It is often prescribed regardless if it's the best choice or not. Suboxone is another one that is being pushed due to the FDA, although it usually isn't the best choice as a pain killer, and again I emphasize in "most cases".
Good luck, and hope that this is of some help.
For all of those who know me, I've fallen off the face of the earth due to loosing my job, and being the only provider for a family of two very young boys and a wife, while trying to get funding for a book on progress. This has caused my typical depression and anxiety to now get considerably worse than ever, and has put me into my typical response of withdrawing from social contact. I'll be talking to the doc soon. I've also gained a lovely pain in the gut in addition to the fibro pain and anxiety, along with new spontaneous manic episodes.
Regardless of the situation, I've been able to manage everything that needs to be done (applications, online portfolios, unemployment, etc.), but has taken a toll on me mentally as I feel responsible for the overall situation, in addition to an understanding that it is very likely that I'll have to move far from family to get a job (we live in the midwest, and 95% of my industry is in NYNY, LA, and S.F.), while they in the mean time try to sell the house...
sorry if I go missing again,
Good luck to the Tramadol, however it is a med that in my opinion shouldn't be legal due to the benefit vs. harm ratio. It isn't a very strong med, and the downsides usually (outside of nerve pain at times) vastly outweigh other options. This of course is only my opinion, and I'm not a doctor.
Sincerely,
Jeff K
jk13
27 Oct 2010
oh, and this is an old question... sorry about repeating my-self and hitting on the ladies once again with my knowledge of Tramadol,
Inactive
27 Oct 2010
Jeff,
It is obvious you are not "hitting on the ladies"... OMG!
christineATU
21 Sep 2010
Hi fall queen... It means tramadol can cause "dependence again" (reinitiate means begin again, start over) and it may cause wd's when taken with methadone. At least that's how I read it. I know tramadol alone can cause dependence and wd's when you stop taking it suddenly. Not to mention the higher risk of seizures. It's also an ssri (I think) Double check with your pharmacist to be on the safe side. Other then that, hope your healing well and resting as ordered?
Take care and let me know what the pharmacist says.
Your friend,
chris
Rajive Goel
8 June 2010
Ambien, generic drug name zolpidem tablets, is a non-narcotic sedative-type sleep medication. Ambien is used a sleep aid used to treat sleeplessness and other sleeping problems. However it would be better to seek medical advice from the pharmacist/doc., hope this helps?
christineATU
21 Sep 2010
I checked the interaction and it was "Major" Here's the info I copied...
methadone ↔ tramadol
Applies to: methadone, tramadol
GENERALLY AVOID: Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. CNS- and respiratory-depressant effects may also be additive. In patients who have been previously dependent on or chronically using opioids, tramadol can also reinitiate physical dependence or precipitate withdrawal symptoms.
MANAGEMENT: Concomitant use of tramadol and other opioids should be avoided in general. Tramadol should not be used in opioid-dependent patients, and use in patients who are chronically on opioids is also not recommended. Tramadol is contraindicated in patients with acute opioid intoxication. Tramadol dosage should be reduced if it must be used in patients receiving opioids. Patients should be monitored for development of seizures and CNS and respiratory depression.
Read more: https://www.drugs.com/interactions-check.php?drug_list=1578-0,2221-0#ixzz10FCi1C00
Please double check on this. I don't like the sound of it. Please don't make us worry. Call your pharmacist!!
Rajive Goel
22 Sep 2010
Fall Queen, Chris has answered your question, be careful Tramadol is addictive too.
fall queen
22 Sep 2010
Thanks guys, I think I will just forget the tramadol. I can take extra stength Tyleno instead! Fall Queen
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pain, methadone, tramadol, interaction
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