View Full Version : tramadol precipitates withdrawal?
Cherry's Jubilee
10-09-2008, 05:56 PM
I'm trying to taper my methadone dose so I decided to fill one of the numerous ultram scripts I had laying around (ya know with the ones for naproxen and darvocet and all the shit they try to give you before you get real drugs) to "supplement" my daily methadone dose and hopefully be able to take less.
So, to make a long story longer, I picked up the tramadol script and I was just reading the package insert (you know how you do to try to find some reassurance that [insert shitty drug here] does have some narcotic value) and it says all the blah blah blah, similar to narcotic pain medication, may be habit-forming or cause dependence, acts on opioid receptors, do not stop abruptly to avoid withdrawal syptoms, etc. and then it says "Also, if you are taking regular doses of narcotic pain medications for ongoing pain (e.g. cancer pain), starting tramadol may cause a withdrawal reaction. Report any withdrawal symptoms to your doctor immediately."
That is a direct quote from the package insert. And then it lists withdrawal symptoms. I took 4 an hour ago. Am I going to die? (That was a joke, I know I'm not going to die, but am I going to want to? I'm scared now.)
LorTabitha
10-09-2008, 06:03 PM
That's a new one to me. I've been taking opiate/opiods and tramadol together for years. Never had any problems.
Cherry's Jubilee
10-09-2008, 06:08 PM
That's a new one to me. I've been taking opiate/opiods and tramadol together for years. Never had any problems.
^^Thank you. Good. That's what I wanted to hear. I feel ok...I think.
How could they put false info on a medication insert sheet? It's a national chain pharmacy. Wtf??
^^Thank you. Good. That's what I wanted to hear. I feel ok...I think.
How could they put false info on a medication insert sheet? It's a national chain pharmacy. Wtf??
They can do it because it's not false information.Tramadol and 'done is contraindicated and can lead some pretty unpleasant experiences.CAN being the operative word,I've never had a problem with it and I know many folks that use the combination without problems,but it CAN.
SurfRat
10-09-2008, 07:06 PM
That's a new one to me. I've been taking opiate/opiods and tramadol together for years. Never had any problems.
Same here, often times a couple Tramadols will be just the right thing to tip me over into happyville.
ZodiacKiller
10-09-2008, 07:10 PM
Actually, CJ, I would be real careful---I've had precipitated withdrawal symptoms from Tramadol myself. It was last summer and I doing a lot of smack and barely taking my Sub. Well, one day, rather than take Sub for WD, I took Tramadol---mainly because I knew I'd be copping dope later that night or the next morning at the latest and I didn't want the blocking effect of Sub---and I almost immediately got the hot/cold sweats, clamminess, and felt pretty damn shitty. No vomiting or any of that, but it was not fun. It lasted easily two hours, then I began to feel ok again.
So I'd tread carefully. I've never touched Tramadol since....
ZK
clinton
10-09-2008, 08:07 PM
i had no idea,ive recently been using 150mg with my tea to potentiate
Paregoric Kid
10-09-2008, 11:42 PM
in all of my experience and friends, I've never had or heard of anyone getting thrown into withdrawal from mixing with methadone or anything else for that matter. people even claim it boosts bupe, and that may be true, if just because of its SNRI effects. tramadol is so weak that its activity at the mu receptor is classified partial agonist, this is not the same as buprenorphine which is a partial agonist-antagonist. only 1/3 of tramadols analgesic effects are from its effect on the opioid receptors. the metabolite M1, or O-desmethyltramadol is responsible for most of tramadols opioid effects, it is a full agonist. the tramadol metabolite M5 has been classified as a partial agonist but not much of M5 is produced, compared to M1, and it is 30-fold less potent than the M1 metabolite.
so basically, I highly doubt it could cause any antagonist effects. if anything the people who claim to have precipitated wd from tramadol may just not be getting enough tramadol to feel anything.
bored in sofl
10-09-2008, 11:47 PM
all you can do is try cj
ZodiacKiller
10-10-2008, 08:02 AM
so basically, I highly doubt it could cause any antagonist effects. if anything the people who claim to have precipitated wd from tramadol may just not be getting enough tramadol to feel anything.
Sorry to disagree with you here, PK, but in the described experience I posted above, I KNOW what I felt. I took a large enough dose that day in order to hopefully catch a buzz, and I know how I felt just before. This was a re-markedly sudden change in feeling, and it occurred as a direct result of taking the Tram.
I'm also aware of what precipitated WD from Sub inducement feels like, having experienced that as well. I am also very in tune with what substances I put in my body, and how much. So I know for a fact that the shitty feeling I felt was from the Tramadol. Sorry......:o
ZK
pharmboy
10-10-2008, 08:39 AM
I think Ultram is an antagonist opiate, like Talwin. When I had a ultra rapid
detox once the Dr. used a couple of 300mg doses of ultram instead of
Bup. because Bup. hadn't been ok'ed for URD by the DEA at that time.
I had so much Valium on board I didn't notice any bad effects but there
ya are.
OxyContinuously
10-10-2008, 08:41 AM
tramadol can cause precip. wd in some cases, especially if the patient has been taking a pure agonist narcotic for enough time to have had it build up in their bodies; ie. methadone or any other of the "real" opiates...
but methadone is listed as a specific contraindicated med. while your taking tramadol, iow, don't do it, just b/c u may go into wd
enjoy
Consumed.
10-10-2008, 09:39 AM
tramadol can cause precip. wd in some cases, especially if the patient has been taking a pure agonist narcotic for enough time to have had it build up in their bodies; ie. methadone or any other of the "real" opiates...
but methadone is listed as a specific contraindicated med. while your taking tramadol, iow, don't do it, just b/c u may go into wd
enjoy
I dont know if I agree with a lot of things said. I was prescribed tramadol to help with methadone withdrawal once and it worked wonderful. And I havent seen any evidence ever saying that tramadol will put you in precipitated WDs from full agonists.
Im not talking about your quote specifically either oxy I just think there's a lot of misinformation and true information in this thread.
OxyContinuously
10-10-2008, 09:49 AM
I dont know if I agree with a lot of things said. I was prescribed tramadol to help with methadone withdrawal once and it worked wonderful. And I havent seen any evidence ever saying that tramadol will put you in precipitated WDs from full agonists.
Im not talking about your quote specifically either oxy I just think there's a lot of misinformation and true information in this thread.
yeah im with you in the sense that i never experienced anything like that from tramadol,, but when i took them, on the rare occasion, it was b/c i had nothing else and didn't wanna be sick, so i didn't have anything else in my system...
i looked around on the 'net after i typed my response, and the only things i could find were the warnings where it was contraindicated with methadone, specifically, and then it mentioned the precip. wd's.
so i don't know if they meant *only* methadone and tramadol would cause that reaction, or that it would happen with any opiate mixed with tramadol...
and interesting also, it didn't say anywhere that tramadol is an antagonistic...but it only partially affects mu, so could that be one in the same, as far as symptoms are concerned??
not sure on this one,, i guess Cherry can tell us in a few hours what happened to her, then we'll know
Consumed.
10-10-2008, 10:36 AM
Well oxy I really think in no way is tramadol an antagonist. I dont know why there would be that specific contradiction with methadone only for full agonists. Like I said it worked really well for me with WD/s for methadone so I cant understand it. I mean technically its not even considered an opiate hence why it's unscheduled so I think there's a lot of information not out there on tramadol and maybe on purpose by the drug companies since they know (as you said) is does effect opiate receptors.
clinton
10-10-2008, 11:05 AM
really?????
it put you into wds?
i didnt catch the amount you were taking....?
how much??
Saint
10-10-2008, 11:37 AM
I kicked methadone with the help of tramadol and stayed off done for 7 months. Unfortunately tramadol wasn't strong enough to kill my pain so I'm back on a low dose of done again.
I tapered my done from 75 mgs to about 20 mgs and then started taking tramadol. Gradually increasing the tramadoldose while at the same time lowering my done from 20 mgs to 5.
I felt shitty for a long time but that was mostly because tramadol doesn't kill ALL wd symptoms from methadone + I have a painproblem.
I did make it to zero methadone though and stayed there for over 6 months (I have never taken over 350 mgs of tramadol a day btw).
Mixing done and tramadol didn't have any ill effects on me. Tram did make me nausous though but that's a fairly common side-effect.
(This is the thread, I think most of your questions will be answered there: http://forum.opiophile.org/showthread.php?t=14307 )
If it weren't for my CP I'm pretty sure tramadol is a good tool to quit methadone. I got it prescribed by a painclinic by the way, and that doc told me too ALSO take a low dose of done when I started..
Paregoric Kid
10-10-2008, 02:58 PM
I'm not saying you didn't go into wd, I'm just saying I'm not so sure it was caused by the tramadol. I've even met people who get prescribed tramadol and methadone from the same doctor. and why would it not be contraindicated for all mu agonists? methadone and tramadol have some NMDA antagonist effects.
Ludakris
10-10-2008, 03:04 PM
I kicked methadone with the help of tramadol and stayed off done for 7 months. Unfortunately tramadol wasn't strong enough to kill my pain so I'm back on a low dose of done again.
I tapered my done from 75 mgs to about 20 mgs and then started taking tramadol. Gradually increasing the tramadoldose while at the same time lowering my done from 20 mgs to 5.
I felt shitty for a long time but that was mostly because tramadol doesn't kill ALL wd symptoms from methadone + I have a painproblem.
I did make it to zero methadone though and stayed there for over 6 months (I have never taken over 350 mgs of tramadol a day btw).
Mixing done and tramadol didn't have any ill effects on me. Tram did make me nausous though but that's a fairly common side-effect.
(This is the thread, I think most of your questions will be answered there: http://forum.opiophile.org/showthread.php?t=14307 )
If it weren't for my CP I'm pretty sure tramadol is a good tool to quit methadone. I got it prescribed by a painclinic by the way, and that doc told me too ALSO take a low dose of done when I started..
So, I've used Trams both in combination with full agonists and to try and combat WD's. I think that the idea of "precipitated WD's" may come from the fact that Trams do not kill all WD symptoms, but they do help. I took them once when I ran out of Oxy and I started feeling more and more shitty, but I think it was mainly because I was just going into WD's, not so much because it was causing WD's. Anyhow, I took some Kratom and about 30min later I felt a lot better, so I chalked it up to Trams being shitty.
Plus, I get the nausea, and feeling of my throat closing when I take them. Use just have to see how you react to them, they work better on some people than on others, I think a lot of that has to do with your liver function and your liver's ability to convert the M1 metabolite.
jacky
10-10-2008, 04:03 PM
for me tramadol was a completely successful detox aid from oxy's.
I only needed to use 8 grams of tramadol for two people to get off of a 2 gram a week oxy habit.
at this point in time tramadol was relatively new, and doctors were calling it a non narcotic pain killer.
I thought it was a muscle relaxant.
I was expecting some hell withdrawl, the first few days were not fun, but I did make it to work.
the 3rd day I felt fine, and realized that the tramadol was even making me feel good.
after a week or two, the tramadol was getting me high.
a slow ween off of tramadol was easy,
I stayed clean for 2 months...then discovered poppy seeds.
compare tramadol and venlafaxine, one is a painkiller, and the other, also known as "Effexor" is an anti-dep. compound.
the chemicals names and structures of these compounds are so close, a novice might think they were the same compound.
they are so close.
they could possibly also test one positive for PCP I have heard.
anyway, both tramadol and Effexor have opioidergic/serotonergic/dopaminergic activity. in my opinion Effexor is the more addictive compound.
Effexor withdrawl is pretty much the same as standard opiate withdrawl, but with added side effects.
I know, it was hell when I kicked heroin, with Hep B, only to go to jail a few days later and have to kick effexor without knowing that I was in for a full recurrence of opiate withdrawl effects.
at the time Effexor was so new that they didnt have it at the jail.
so I suffered.
in a Biology class I had I found 3 girls that were all addicte to Effexor, and didnt know what to do about it.
then my Mother started taking Effexor against my advice.
she got hooked, and had to kick Effexor as well. she actually called me up and apologised to me, not realizing before quite how hard to kick a substance is.
when I would start taking Effexor, I would get a stimulant high. the Dr prescribed it to me because he said that they were finding that Heroin addicts really seemed to take to the drug well.
at this point in time they did not know of course about any opioidergic effects.
so this Dr prescribed me some frankenstien addictive compound with possible opioid effect.
these chemists and Dr's think that they are so fucking smart.
two chemicals that are almost identicle, and they still dont have a clue that they might have some negative potential.
in 2000 tramadol was easy to get. I could buy it without prescription in powder form. 10 grams for 90$
me and my wife liked to take it on vacations with us.
we found we could walk all day long taking the substance without getting tired.
it does seem to have some effect on the dopamine system.
all in all its one of my favorite tools. I also took tramadol with poppy seeds almost everyday for three years. at this time I also researched mixing codeine and dxm with this combination. some of those blends were extremely easy to control ones dosages. tolerance was not a problem using these 4 substances.
I have been told to watch taking tramadol when coming off of methadone. I have little experience there...for me I can ween off of methadone fairly easily, taking it down to the microgram range for a succesful ween
Cherry's Jubilee
10-10-2008, 05:17 PM
Well yesterday I took 15 mg of methadone and then around 5 or 6 I took 200 mg of tramadol before I read that insert. After I read it I took a little more methadone thinking it had to be stronger than the tramadol and might prevent that from happening, if it could in fact happen.
I didn't experience any withdrawal symptoms at all and trust me, I'm a big baby and freak at the first sniffle plus I was being hypervigilant, so I would have noticed ANYTHING. If anything I felt a little better. I did the same thing today exactly, except without the extra 2.5 mg of done. My usual dose of methadone is down to 20 to 25 mg a day, so I have been able to take a little less but I don't know if that's because of the tramadol or not.
I don't understand at all how tramadol could precipitate withdrawal but I'm a little slow on the uptake when it comes to chemistry. Fortunately I have all you chemistry nerds and a few IRL so I'm covered. My doctor gave me an ultram script every time I got an oxy script which is why I have so many saved up, so apparently he's not aware of that potential. (or maybe he is, he looks kind of evil, sadistic asshole...) No really, I was shocked by that because I thought it was commonly prescribed in conjunction with other opiates. Guess I'll just try to keep it to a minimum and quit if I feel sick.
Cherry's Jubilee
10-10-2008, 07:02 PM
*Someone* we all know (and love?) is making fun of me for posting about "my trammies." :rolleyes:
ZodiacKiller
10-10-2008, 07:06 PM
*Someone* we all know (and love?) is making fun of me for posting about "my trammies." :rolleyes:
Oh? Can you say where?
ZK
*Someone* we all know (and love?) is making fun of me for posting about "my trammies." :rolleyes:
If it's who I think it is,tell him Nick says that he should be thankful that's all you have in common with gor.
ZodiacKiller
10-10-2008, 07:22 PM
If it's who I think it is,tell him Nick says that he should be thankful that's all you have in common with gor.
Oh, shit....nevermind, CJ---I thought you meant the rat-queen was making fun of you. My bad. Say hi from ZK.
ZK
Consumed.
10-11-2008, 10:18 AM
See I the think the concencus is that tramadol helps and cant be and antagonist...
ZodiacKiller
10-11-2008, 10:23 AM
Gosh, then I guess I'm just a freakish idiot who doesn't know my asshole from my elbow. :cool:
ZK
Consumed.
10-11-2008, 10:37 AM
Gosh, then I guess I'm just a freakish idiot who doesn't know my asshole from my elbow. :cool:
ZK
ZK I wasnt doubting or disagreeing with you but I think (and Im not saying I know this because obviously I couldnt) that you still had some suboxone in your system even if was a little bit and that gave you the PW/s. Just my guess wasnt trying to incinuate anything negative about your experience because I damn well know you have as much knoweldge as do if not more. This is just my best guess based on the pharmacology of the drug and the overall experiences people have touched on! Sorry if I offended you!
ZodiacKiller
10-11-2008, 10:42 AM
ZK I wasnt doubting or disagreeing with you but I think (and Im not saying I know this because obviously I couldnt) that you still had some suboxone in your system even if was a little bit and that gave you the PW/s. Just my guess wasnt trying to incinuate anything negative about your experience because I damn well know you have as much knoweldge as do if not more. This is just my best guess based on the pharmacology of the drug and the overall experiences people have touched on! Sorry if I offended you!
No offense taken, Consumed, certainly not by you personally----I just seem to be the odd man out in this thread. But really, I am very in tune with my body and the substances which I put into it. Oh, well, people can believe what they wish and I certainly hope that I am not proven correct, to be honest...:)
ZK
No offense taken, Consumed, certainly not by you personally----I just seem to be the odd man out in this thread. But really, I am very in tune with my body and the substances which I put into it. Oh, well, people can believe what they wish and I certainly hope that I am not proven correct, to be honest...:)
ZK
Jesus bro,sorry I mean,Satan bro......I never doubted you.There's a wealth of annecdotal evidence about this happening with tramadol,which is why they have the insert.
There are about 20 people posting in this thread and even if it is just you that's 5%.Hardly a small%.
As I said at the beginning........it CAN happen.
Saint
10-11-2008, 10:58 AM
No offense taken, Consumed, certainly not by you personally----I just seem to be the odd man out in this thread. But really, I am very in tune with my body and the substances which I put into it. Oh, well, people can believe what they wish and I certainly hope that I am not proven correct, to be honest...:)
ZK
I remember asking the same question here since I've read that methadone AND tramadol should not be mixed and can cause precipitated wd's, it's not not recommended. But my doc prescribed BOTH at the same time.. I didn't have a problem but a friend of mine had the same effects as you had so I guess it's a different scenario for everyone.
You're not the only one that had a problem with mixing them. So you're no idiot.. (freakish, yes ;-)
Xavier
10-11-2008, 11:14 AM
LOOK, I take tramadol with my methadone a few times a month for the added buzz and its never put me in withdrawal although excessive doses, 500 mg, can cause temporary paralysis. Its actually a good cheap buzz combined with methadone and im maintained on methadone btw so there you go.
ZodiacKiller
10-11-2008, 11:25 AM
(freakish, yes ;-)
Freakish and PROUD, my dear.....:p
ZK
Consumed.
10-12-2008, 09:14 AM
Whatever, it's my bad and I shouldnt have assumed anything. Obviously since it seems to be individually dependent I had no right to make a generalization about all people. I usually make sure my info is 110% and Im sorry if I caused any confusion in this thread.
With that said I posted of my personal experience and that of other using tramadol and methadone at the same time or to use tramadol to come off of methadone. I guess I jumped a step ahead and did the wrong thing by saying tramadol is useful in methadone WD/s when in fact people have had trouble with it. So I'm giving my formal apology for any wrong doing if there was anybody who felt offended by my opinion.
CONSUMED.
Cherry's Jubilee
10-12-2008, 10:35 AM
Jesus bro,sorry I mean,Satan bro......I never doubted you.There's a wealth of annecdotal evidence about this happening with tramadol,which is why they have the insert.
There are about 20 people posting in this thread and even if it is just you that's 5%.Hardly a small%.
As I said at the beginning........it CAN happen.
That's why I found it so confusing. Because typically in order for something to be included on the patient information sheet there has to be some evidence-based reason for it--like controlled research studies. It's just weird because if tramadol is not an antagonist in any way, how could it knock something as strong as methadone, a full agonist, off your receptors, which is what it would essentially have to do to cause withdrawal symptoms, correct?
That's why I found it so confusing. Because typically in order for something to be included on the patient information sheet there has to be some evidence-based reason for it--like controlled research studies. It's just weird because if tramadol is not an antagonist in any way, how could it knock something as strong as methadone, a full agonist, off your receptors, which is what it would essentially have to do to cause withdrawal symptoms, correct?
That's a fair assumption Miss Jubilee.I meant that I'm aware of annecdotal evidence,but I've never checked empirical user data.However it must be out there and it would be interesting to know what % of folks have had this problem and what % is judged necessary before a contraindication warning is given.
Paregoric Kid
10-12-2008, 03:09 PM
perhaps there is a small percent of people that produce excess amounts of M5 or some other weird metabolite and that may be the cause but that would be extreme and rare and only off of anecdotal evidence, not one bit of research can prove the theory that it acts as an antagonist.
Paregoric Kid
10-21-2008, 02:29 AM
just the other day another friend of mine that gets methadone for pain and just also got on tramadol with it from the same doc.
Saint
10-22-2008, 03:41 PM
just the other day another friend of mine that gets methadone for pain and just also got on tramadol with it from the same doc.
That's what I said: I got both tramadol AND methadone prescribed for pain. At the same time. No problem (although I decided to quit the done after two weeks on both medications but I didn't have any ill effects from the combination during those 2 weeks).
I'm been taking tramadol with methadone for quite a few time and never noticed precipitated withdrawal, never, even at high doses..
Its a medical myth with just a fucking study to support it and millions of users saying it doesnt.. For god sake some doctors are even prescribing the 2 together..
Heres my 2 bobs worth....
.....Aint even worth takin.....Giv me some real fuckin drugs, fuckin tramadol..:rolleyes:
Fuckin crocka shit....Aint they responsible for seizures or some shit, if ya is fool enuff to take too much?
I'm wiv zk on dis one.....Tramadols sucks ass....
PhoenixRisen
04-26-2009, 07:33 PM
Despite being (IMPO) a relatively crappy painkiller in terms of the more severe kind, Trammies have always KEPT me from withdrawing. I had a pretty ridiculous M habit, not too crazy, never shot it, but still... Despite coming off of it dozens of times, I've only hardcroe WD once, and didn't let myself finish. It's kind of like Super Tylenol... Reuptakes Serotonin, and Norepinephrine... and it keeps me from getting sick.. I'd give it 5 out of 5 if I'd never had a seizure on it. ;)
LOOK, I take tramadol with my methadone a few times a month for the added buzz and its never put me in withdrawal although excessive doses, 500 mg, can cause temporary paralysis. Its actually a good cheap buzz combined with methadone and im maintained on methadone btw so there you go.
What doses of tramadol do you take and what kinda of buzz does it make you feel? and how long have you been at MMT? at what dose?
For me tramadol mixed with methadone (or another full agonist opioid) never caused precipitated wd for me..
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