June 10, 2008 - 9:45am
Last night I took 4 ultram 50mg instead of my Norco 10. This morning when I took my Norco it did absolutely nothing. NOTHING!!! This happens everytime I take ultram. It takes a few days after I take them for the Norco's to work right again. Has anyone else had this happen? Does anyone know why the ???$* that it happens in the first place?
June 11, 2008 - 6:34pm
#2
Oh, I noticed this, too but
Oh, I noticed this, too but didn't know what to make of it. I can take an ultram, which will put off my need for more oxycontin for almost 12 hours, but later I feel like I need more opioid- otherwise I get mild withdrawal symptoms.
June 25, 2008 - 11:19am
#3
Ultram and Norco 10
I would think that a great deal of your "not feeling Norco" is perhaps a sign that you may need to chill on the Norco for a week or so to lower your tolerance. During that period take the Tramadol. Your are without a doubt going to develop a tolerance with any narcotic pain releiver or benzodiazapine. I take Perc 10/650 for on going back pain and clonazapam for anxiety. If I take them everyday for 2 weeks I would have to double my dose just for it to HALFWAY work. The best advice I could give is to use one or the other because they work in similar ways however Ultram is not an opiate so it would be wise to rotate your pain meds a little. Hope this helps. My dad would be proud that I am using the 2 years of Pharmacy School that I didn't complete for something. Best of luck.
June 25, 2008 - 12:40pm
#4
tramadol
Tramadol is an opioid and what's more has quite a long half-life so your mu receptors will not uptake hydrocodone (dihydrocodeinone) to the same extent.
It is a falsehood to say it does 'nothing'. It will of course refill the receptors which have been cleared of your tramadol and extend your analgesia.
"NEVER ingest anything unless you are 100% sure what it is."
June 25, 2008 - 12:45pm
#5
tramadol
I have never heard of tramadol sending any opiate-tolerant patient into WD. It is NOT an antagonist.
Pentazocine is another matter. That WILL precipitate WD, as will any agonist/antagonist. Thre are many places on the net to find out exactly what sort of opioid you are using and its likely interactions.
"NEVER ingest anything unless you are 100% sure what it is."
June 25, 2008 - 3:30pm
#6
Tramadol
Tramadol is an opioid (synthetic, but still an opioid). More importantly the M1 metabolite of Tramadol is a strong opioid with respect to affinity for the Mu receptor (200 times moreso than the parent drug). In this respect, Tramadol is infact also a prodrug for the M1. The M1 metabolite may have a strong enough affinity for the Mu receptor to cause displacement of *some* other full opioids, however Hydrocodone's affinity for the Mu receptor is significant enough that it should compete relatively well for the binding site. This means that tolerance and cross-tolerance possibly combined with placebo effect is probably more to blame than a direct pharmacokinetic action. If Hydrocodone is taken several hours after Tramadol, there should be significant enough clearance of the Mu sites for analgesic activity (that doesn't mean you will experience the same psychotropic effect of feeling the opioid "high," however, as compared to Hydrocodone exclusively). The significant action of Tramadol on Serotonin can also change the way your mind experiences the effects of it all. Lastly, although Tramadol (and M1) are slightly longer acting (mostly due to the fact that a major portion of the analgesia is created by the metabolic products of Tramadol - principally M1) compared to Hydrocodone, Tramadol is still considered a short acting opioid, and has a half life only slightly longer than that of Hydrocodone (Hydrocodone 3-4 hours, Tramadol 5-7 hours).
/Xtrasystole - BS.Bio, MS Anesthesiology, Pharm/M.D.
Always check with a physician/pharmacist licensed where you live before taking medication. My license does not extend past the state of my practice.
June 26, 2008 - 8:00am
#7
Why
methadone clinics tell you NOT to take tramadol because it "makes opiates less potent" that is stated ver batem from a methadone clinic handbook.
June 26, 2008 - 10:58am
#8
That is sort of what
That is sort of what /xtrasystole is saying, but you wouldn't want to put what he wrote in the methadone handbook! I would hope the methadone handbook instructed you not to take any other narcotic anyway! Pharmacology was never my strongest subject, thanks for the technical info. I would have just chalked it up to placebo effect.
June 28, 2008 - 9:15pm
#9
Maybe it's a serotonin
Maybe it's a serotonin effect. I can't take (serotonin-affecting) antidepressants, because the swing in serotonin will trigger migraine. But I do know that tramadol will help a lot at first( reducing the need for breakthrough opiates), then the next day I need more than the usual dose of breakthrough opiates. I found that it doesn't 'save' me any breakthrough meds in the final reckoning, it actually means I take more. So I don't take it anymore. (It was suggested by my MD-who knows my opiate prescription-for menstrual cramps b/c I don't tolerate NSAIDs well.)
this is what i was told and even given a sheet of paper that says it, at my methadone clinic. 'Tramadol is not necessarily an opioid antagonist, but it DOES DECREASE the levels of opiates in the body.' Because we were told at the m'done clinic NOT TO TAKE Ultram because it would send us into withdrawal. They didnt really go into detail about why, but thats just how it is. Hope that helps. DR. Lois might be able to answer that one a little better.