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Tramadol and Opioid tolerance
Tramadol and Opioid tolerance
I have a Question about Tramadol and opioid tolerance as the title suggests. If you develope a tolerance to say oxycodone and stop taking it for two weeks but use Tramadol in its place will the tolerance for Oxycodone go down are are the two too closely related for this to take effect???
Oxycodone and tramadol used for chronic pain, if anyone is wondering
Tramadol is not nearly as potent as Oxycodone, And taking higher doses of tramadol increases the risk for seizures. SWIM does use tramadol when he runs out of hydrocodone before he can refill. It does not completely relieve all of the withdrawal symptoms but does make it bearable so he can go to work without raising suspision. His hydro habit is not real big (60 mg/ day) but his withdrawal is all too real. two tramadol in the am, two at noon, and two at night is his regimine. I am not recommending this as I am not a doctor. I am just relaying what SWIM does.
Originally Posted by MayhemMKV
Thanks but im not asking about dependency here. Im talking about tolerance, you know as you take the same dose constantly you need more to get the same relief? My Question is, will the tolerance for oxycodone diminish with time while useing tramadol in its place, or are the two too similar to diminish the tolerance to oxycodone?
I have a perscription for both of these pain relievers, This is a serious question, it has nothing to do with addiction.
Tramadol or not...once you build a tolerance there's no going back. You could not take anything for pain...and still just pick up right where you left off. I am talking about someone like you...who is taking the oxy for pain...you can stop the oxy and take the tram for as long as you want...but you will not lesson your tolerance to anything.
Originally Posted by MayhemMKV
Thank you for your advice everyone
Tramadol - Oxy Tolerance
I believe I understand the question clearly - and it's a good one, especially when talking opiod tolerance (an ALL TOO REAL
fear of all chronic pain patients on narcotic pain medication regiments).
Though not CHEMICALLY-RELATED
to the structure of an opiate, Tramadol works almost identically to that of an opiate. Like, OxyContin in this example, Tramadol works by binding to the mU receptors to block and/or alter pain signals sent to the brain.
Tramadol is SO
comparible to its' cousin that, though not incredibly affective against highly-moderate to severe pain, causes identical (if not worse) withdrawal symptoms when a long-term dose is stopped immediately.
As far as tolerance goes (and the question at hand) - if you've been taking Oxy for quite some time and using Tramadol to fill in the gaps before you go back to Oxy, your tolerance for Oxy will become lower. Because the comparison in strength between extended-release Oxycodone and Tramadol Hydrochloride is extremely different, a few weeks off of Oxy will definitely LOWER
your tolerance to it.
Take into consideration, however, that because of the long-term use of Oxy here is present, tolerance will be VERY
quick to return once you begin taking it again...because the brain has already begun replacing natural dopamine production for the chemical need for opiates.
Hope this helps,
Tramadol is an agonist at the mu opiate receptor, but studies have clearly shown that the analgesic (pain-blocking) effects of tramadol are only partially blocked by naloxone. It has fairly weak opiate effects-- the 'affinity at the mu receptor'-- the binding 'tightness'-- is only 1/6000th that of morphine.
The rest of the analgesic effects come from poorly-understood interactions with serotonin and norepinephrine systems in the brain-- systems that modulate pain in normal individuals. It is effective for some patients who are tolerant to opiates; I have used it with success in patients on buprenorphine (Suboxone) or even patients on naltrexone, who are totally blocked from opiates-- and it often helps with their pain.
The main problem with tramadol is seizures-- I have seen a number of patients who have seized from the drug, especially if they have taken over 400 mg per day. It is NOT a drug to abuse. None are, I know-- but this one will make you have a seizure on a highway driving 60 mph-- without warning. Not a good thing.
Last edited by ddcmod; 11-11-2008 at 03:32 PM.
hello I've been recently been prescribed tramadol 50mg For back pain. I've been reading all the threads here, an i don't like what i hear about Seizures and what not. I have to take 8-10 of these a day to even Get a sign of relief. So what I'm getting at is I want to take something that is not only stronger but something i don't have to take 8-10 times a day. so i would like to know what is in the higher range of Tramadol. any help would be very appreciated
I was browsing the net and came across your unanswered question and registered on the off chance you may sign in again to see it.
Originally Posted by MayhemMKV
The short answer to your questions is yes, your tolerance to Oxycodone will go down if you stop taking it and supplement your needs with Tramadol instead, but only because Tramadol is a much weaker pain reliever. They are both doing the same thing in your body as far as how they work, its just tramadol bypasses certain steps around your Dopamine receptors where actual Opiate Narcotics take strong effects. Basically it bypasses the Euphoria that can accompany many Opiates but still enacts pain relief, using one Mu receptor while not using the other.
However, the recommended dose of Tramadol is only 1/30th as effective for pain relief as the recommended dose of Intramuscular Morphine(morphine injected into muscle tissue), or about 1/12th as effective as 30mg of MS Contin (Morphine Sulfate 'Contin' means time release coating), or about 1/10th as effective as 10mg of Oxycontin (oxycodone).
As is the case with any narcotic, if you stop taking it for a while whether its a couple weeks or a couple months, when you first take it again you will not be adjusted to it. The side effects of nausea, itchyness, and sleeplessness that accompany many narcotics will take a few days for the body to fix as it re-adjusts to the new substances. The desired effect from the drug will also be stronger than it was when you were taking it regularly, but after 2 or 3 days your tolerance will return to the way it was before. It would take years of cell division to regain the lost Dopamine receptors in your brain and make it like you were "starting fresh". This is one of the reasons chronic pain sufferers on Opiate Narcotics develop Hyperalgesia. Your brain has to adjust to allow the drugs to work.
The best way to avoid issues from tolerance such as withdrawl or unmanageable pain is to find a doctor who knows how to prescribe a proper pain management regiment and stick to it, or follow the proper weening-off procedures of slowly taking less and less over time if you are coming off of narcotics. A proper pain management regiment consists of a twice daily dose of time-release relief, a 2-4 times daily dose of a weaker pain reliever usually mixed with Tylenol to take throughout the day for pain, and a small quantity (10 or 20) of "Breakthrough" pain relievers that are stronger for days or circumstances where you know youre going to be in extra pain due to exercise, work-related stresses, moving to a new house, you slept bad and hurt more etc......
Always follow your doctor's instructions unless you know EXACTLY what you are doing, and even then think twice.
Its your life. Take care of it.
Originally Posted by dpm311
I am a chronic pain sufferer and have been for quite some time. Tramadol is not a drug I would ever recommend to anyone by itself. If your pain is anything more than mild it does not provide any relief. Not only that but can have severe effects on your health if you are prescribed a large dose. Many people have had seizures on doses of 400mg per day. Because it is an Opioid many people think it is a good pain reliever derived from Opium like most others. This is false. The definition of Opioid simply means any drug that has a similar effect on Epinephrine and Dopamine receptors in the brain causing pain relief. It does not actually mean it is an Opiate, a drug derived from Opium. In Tramadol's case it works on the Mu 2 receptor enacting pain relief while not using the Mu 1 receptor which means there is no Euphoria and less cause for abuse and addiction.
Doctors LOVE this. But it is a horrible pain reliever with horrible risks at the effective dosage. A much better drug for pain relief is Oxycodone or even Morphine Sulfate. However, tramadol IS a great analgesic to use in conjunction with a stronger pain reliever in small consistent doses, as it boosts the effects of pain relief without adding any extra side effects.
Beware of any strong pain reliever that isnt directly derived from opium as they usually have pretty bad side effects which are written off because of those certain drugs being less addictive. Heres a list of Opiates that are often prescribed for moderate to severe pain with much success:
Codeine Phosphate (the most common salt for codeine, ie. regular codeine)
Hydrocodone - Vicodin, Lortab, Paracetamol
Oxycodone - Percocet, Endocet
If you are a chronic pain sufferer you should take the time to find a doctor who knows how to prescribe a proper pain management regiment. An example of this is a powerful twice daily time-release pain reliever mixed with a 2-4 times daily dose of a weaker pain killer, and finally a limited number such as 10 or 20 of a drug for "Breakthrough" pain, days when you know youre going to be hurting more due to extra physical activity for instance.
An example pain management regiment for moderate/heavy pain is a twice daily dose of 20mg Oxycontin, 3 times daily 10mg/325mg Lortab (Hydrocodone with Tylenol) and 20 pills per month of 10mg/500mg percocet (oxycodone with tylenol) for breakthrough pain.
This is my pain regiment.
Why are you posting to an old thread and then posting to yourself...