My Dr. recently prescribed me Tramadol (Ultram) 50mg 1 - 2 up to 4x a day to help manage chronic pain as a result of nerve and muscle trauma. I was previously on Co-codamol 30/500 (Codeine/Paracetamol(acetaminophen)) 2x every 4 hours for almost a year, but due to a tolerence build up they were offering little to no pain relief thus the change in pain medication. When I first took 50mg of Tramadol it had no effect, 4 hours later I took another 50mg and I was hit pretty hard, harder than the Co-codamol ever did. The Tramadol carried on being excellent pain relief for a week at no more than 200mg a day. I woke up one morning this week in quite a lot of pain so I took 100mg of Tramadol and tried to get on with my daily tasks. I realised after an hour (When the Tramadol would usually kick in) I was getting no relief. I tried to carry on with my daily tasks in hope that it would eventually start to help but nothing happened. I managed to get a power nap in then woke up just in time to be able to take another dose of Tramadol, but the same result of no pain relief persisted. Since then I have been in agony and my Dr. refuses to prescribe me anything stronger because of the increased risk of addiction. I tried to argue that I had been on Codeine for almost a year and with frequent check ups with the nurse, I presented no addictive traits that showed cause for concern. Being a resident of the UK it is very hard to even get opiate based pain medication in the first place as they are strictly controlled. It was only after months of being prescribed mediocre medications such as diclofenac, that to be frank, were no stronger than the OTC (Over The Counter) medicines, that I was able to start a course of Co-codamol. I imagine after reading this long post many of you have become bored but I applaud and thank those who continue to read through. The reason I'm posting is to gather as much information as I can as to why the Tramadol (Ultram) would suddenly stop having any effect. I mean zero effect what so ever appart from insomnia which is only remedied by pretty strong sedatives or relaxants I have left over from previous prescriptions. I read Tramadol has a pretty long half-life (duration of effect) so despite being in pain I waited as long as possible between doses. When I spoke to my Dr. about the Tramadol no longer working he said if I was intolerant to the Tramadol it wouldn't have had any positive effects only adverse ones such as allergic reactions. It felt like he was suspicious of me or that he was pushing the blame to me as if it was something that I must have done in order for the medication to suddenly stop working which I wasn't very happy about. He insisted Tramadol is a potent painkiller and that I should continue to use it despite my complaint. Since the visit to him a few days ago I have been using Diazepam (Valium) from a previous prescription for its muscle relaxant properties which have helped ease the pain a little but the strong sedative effect it has on me is preventing me from doing even some of the simplest every day tasks. I hope I have been thorough enough with my recent situation in order to get a detailed response to why Tramadol (Ultram) would suddenly stop working. Just to cover any posts that consist of "search google", I have with numerous search terms but they all lead to websites that advise you not to suddenly stop taking Tramadol (Ultram), which isn't my case. I would like to thank all who have taken their time to fully read my post and to further thank those that can offer positive input into my situation.
Tramadol (Ultram) 50mg suddenly stopped having any effect?
- Asked
- 23 Aug 2011 by Unfilled Void
- Updated
- 27 December 2015
- Topics
- paracetamol, ultram, pain, muscle pain, codeine, tramadol, chronic, muscle
5 Answers
You dont say how long it has been that you have been on the Tramadol, but I would suspect a couple of things it could be. It could very well be tolerance to the medicine. Some meds build tolerance very quickly and Tramadol seems to be one of those or it could be a worsening in your condition. Keep on your Dr until you get answers. See if he will allow any additional testing to rule out that you have a worsened condition. I hope people in the US will come to realize that government run healthcare is not what they think it will be and that we will be facing the same difficulties here once the government obtains control over our healthcare. Most people here believe it will be the same as it is now only that the government will be paying for it. They do not realize how at the mercy of the government they will be and how much we will be limited. The only thing you can really do is be a squeaky wheel and hopefully you will get some relief or at least find out why your pain has gotten so resistant to the Tramadol. Good Luck to you. I hope you feel better soon!
Thanks for your reply. To fill in the blanks, I was on Tramadol for no more than 2 weeks before it suddenly stopped having any effect as far as pain relief, although the undesired side effects continued. The undesired effects being those mentioned on the leaflet that came with the medication, to be specific, insomnia depsite the drowsiness, trouble passing water (urinating), not painful, I just had to stand at the toilet for 5 or 10 minutes before anything happened. In the last few days I developed a small sore in the corner of my lip. Tolerance was my first thought also but to me it seemed very unlikely after just 2 weeks of use. As for pushing my Dr more to get something done it comes down to what you mentioned about the UKs healthcare being run by the government. My healthcare is paid for through tax and as the government only dedicates a limited amount of funding from that tax the doctors feel less of a need to please or help the patient because they get paid either way.
They also seem reluctant to refer you to specialists or to order tests because of how our health care system works. It took me 6 months of being on Co-codamol which is considered fairly addictive and amitriptyline which is meant to treat neuropathic pain just to be refered to a specialist. The amitriptyline offers me no pain relief at all, if anything it just helps me sleep better at night. After waiting that 6 months to actually see a specialist I only got a 10 minute consultancy. The specialists only input was to slightly up the dose of Amitriptyline and come back in 6 months time. I recently went back to the specialist and his last and only suggestion was to either inject botox into the affected area or to just deal with the pain. As a young male the thought of having poison injected into my face and dealing with the side effects is far from desirable despite the appeal to middle aged women wanting botox for cosmetic reasons. As far as I'm aware in the USA your healthcare is paid for with health insurance, so your hospitals and doctors want to please you and get tests done because it's how they get paid. In a way I envy that because you at least get things sorted even if you do have to pay for it more directly. If I went to a private clinic to get my problem sorted it would end up costing me thousands which unfortunately isn't a luxery I have. All the same, thanks for your input nd best wishes, I look forward to any further input.
Speak true and loud!!! Many people here do not realize what good healthcare we truly do have here in the US. No, it is not perfect but it is one of the best in the world! We do pay out of pocket more than we would with government run care but at least we have freedom of choice and if a Dr doesnt please us we can go to another who will. So many people here think government run care is the answer but they are envisioning the same care we get now at no cost and it is not going to be like that. I tell people here to remember going to the Dept of Motor Vehicles that that will be what going to the Dr will be like. The DMV is always a custer f-you know what! That is how our government runs things. Now people think they sghould run our healthcare!? It is really preposterous! I'm sorry. I'm getting on a political rant on your question! Even at two weeks, it is possible to be tolerance because you were already tolerant to the one opioid in the codeine.
I just would want to be sure that it isnt an exacerbation of your original pain generator. It could be things getting worse. Like I said, the squeaky wheel gets greased so keep on the Drs. It has to be very frustrating. We are very lucky here to still have some control over our healthcare decisions. Money making is a good motivator! Drs making money are much more motivated to help thats for sure! Hang in there! I hope you feel better soon. It is too bad they wont give you something a bit stronger. Tramadol is strong but it is not the strongest in the arsenal. You would probably do better on a long acting morphine or oxycodone!
I want to add that the urinary hesitancy you describe is very common to opioids especially if you have any enlargement of the prostate and sometimes mixing w/muscle relaxants make it happen more too.
Thanks again for your further input, I must say the urinary problem was worrying at the time, I thought something was really wrong, I never experienced it with the codeine so I guess that exacerbated things. As for the increase in medication strength, believe me, I've tried. As far as I know the next step up would be Hydrocodone, I think you guys call it Vicodin in the US but for some bizzare reason it's not an approved drug in the UK. My Doctor has said there is no chance of getting morphine because of the increased addiction potential and the fact that I have no official diagnosis, they're just calling it chronic pain of a muscular/nerve origin and Oxy's are strictly reserved for cancer patients.
It just angers me so much that the only treatment I've had in the last year is amitriptyline which supposedly treats pain long term, I'm yet to see any benefit after a year of using it, gabapentin which supposedly does the same thing except it made my entire face swell up and it made sores/blisters form inside my mouth, it even some how managed to remove a layer of my tongue which has also had an effect on my taste buds. I wasn't able to eat for 5 days and was barely able to get out of my bed, the doctors recommendation was liquidize my food. I don't claim to have a medical degree but I know there are steroids that would have helped clear up the allergic reaction instead of letting it clear up on it's own over 3 weeks. The biggest joke so far was when I was prescribed the Tramadol 50mg tablets with no additives. I went back after the 2 weeks of using them complaining they no longer worked so he prescribed me tramacet which is 37.5mg tramadol to 325mg of apap. The only attempt to find the route cause of my problem was an x-ray of my jaw to see if there was a fracture. When it came back clean they started to question me as if there was even a problem. I have to say, I'm really going to feel sorry for the American citizens if your government makes a mess of the medical system like they have here. Sorry to turn my post into a rant, it just angers me so much how the health care system is over here. Thanks again for your input, I guess all I can do is be a "Squeaky Wheel" as you suggested and hope I get somewhere.
My question to you is wondering if you are using the government provided health care or do you use a private health care. I can tell you from experiance that here in the USA if you are poor and cannot afford private insurance you are treated like shyte. You are either given a clean bill of health and sent on your way even if you do have something wrong OR you are given the worst possible outcome given all kinds of medications and expected to just stay on with the health care system when there is NOTHING wrong with you. It's happening everywhere not just here or there but everywhere. If you cannot afford your basic needs {Health Care is a basic need} You're pretty much screwed.
In the UK there is virtually no private health care. Excluding private dental care and eye care, such as laser eye surgery. All health care goes through the government funded organization called the NHS (National Health Service). The NHS is funded through the tax each UK resident pays. Even if you are unemployed and are required to pay no tax you still have a right as a UK resident to receive health care from the NHS. If I found a private clinic to get a private consultancy I'd only be refered to a clinic that specialises in my condition that is run by the NHS anyway. The only thing private consultancy does appart from getting you into debt is slightly speeding up the process of being seen by other departments. There are private hospitals available but as far as I know the only benefit you would receive is getting your own room instead of bieng put on a "wing" with other patients and maybe better or quick treatment.
In the UK it makes no sense to opt for private health care unless you are among the super rich. You could pay for half an appartment for price it would cost you to get minor surgery or to stay in a private hospital for a week. As with all systems, there are pros and cons. Our pro happens to be it's available to everyone depsite their situation (among other pros). The cons are extremely long waiting times and sometimes a lack in quality.
I understand what you are going through. I've been on Tamadol for about a year. I had a bad flare up a few months ago. I have a degenerative disc. And my doctor gave me Norco. I had taken all of my Norco then started using Tramadol again. It was like the Tramadol just stopped having any effect. I never took more than 4 a day of the 50mg. It's unfortunate because when you tell your doctor they think just a drug seeker trying to get high. I'm having a hard time to determine what my next approach should be. I feel your pain... literally.
I have been taking 50ml of tramadol 2 to 3 times a day since 1999. I have taken a lot stronger narcotics intermittently for post-op pain but for my continued chronic pain in my hip, shoulder and back I take tramadol and then I apply Pennsaid at night when I have most of my pain. I have found Pennsaid to be a life saver. Speak to your doctor about it, it's a pharmaceutical product which requires a prescription! Good luck!
That's really interesting! I just searched Pennsaid and have found it is a topical Diclofenac solution. I took Diclofenac oral alongside Tramadol and also found it really helpful
You question was quite a while ago, but for others with this problem, this may apply to their situation. This is for people on tramadol that have then been prescribed bupropion, an antidepressant or quit smoking agent. Taking bupropion (Zyban, Wellbutrin) will inactivate Tramadol. I take both and it was a big problem when I started the bupropion. They both attach to the same brain receptor and the bupropion is the stronger, so it neutralizes the pain med. Thought it was a total loss, but have discovered a partial way around it. In the AM I always take tramadol 1st! Wait at least 45 min before taking bupropion. That way, you get the tramadol to working. The next tramadol works poorly, usually take it with Tylenol because it will help boost the tramadol. By the time I need a 3rd dose, the tramadol is back working pretty good. If you start with bupropion, you're screwed for all day. Hope this helps a few.
TO whoever No you never just stop Ultram you well end up with all kinds of withdrawals it is always best with this one to tapper down from what your normal dose is if you need help call your doctor and get some directions. alot of people the withdrawls are worse than the pain.
Further Information
- Paracetamol Drug Information
- Ultram Drug Information
- Codeine Drug Information
- Tramadol Drug Information
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