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Tramadol vs oxycodone

Posted: Fri Nov 29, 2019 7:23 am
by James7
To get off lyrica, my dr switched me to mirapex and tramadol while I taper off lyrica. Tramadol is taken twice....50 mg at 6 and 50 mg right before bed. Mirapex is 25mg at 6, 25mg at 8, 25 mg right before bed. I reduced lyrica to 100 mg already. The problem was I wasn't staying asleep. After 4 hours, I was waking being unable most times to fall back to sleep. This was for about a month. So, 2 days ago, I was switched from tramadol to 5 mg oxycodone instead....with everything else the same. Does oxycodone need to build up in my system? I'm getting even less sleep with it than tramadol. I'm at 3 hours last night and tonight I can't even get to sleep. If anyone has any idea why it is worse, I'd like to hear it. I am on a cpap, btw. Thanks.

Re: Tramadol vs oxycodone

Posted: Fri Nov 29, 2019 11:28 am
by Rustsmith
Oxycodone has a half life of 3.2 hrs where regular Tramadol has a half life of 6 hrs. So the oxy is leaving your system faster than the Tramadol. What you might do is ask your doctor for the long lasting form of one of these products. Oxycontin is the longer acting version of oxycodone and has a half life of 4.5 hrs and Tramadol ER is a once a day pill with a half life of 8.8 hrs.

Re: Tramadol vs oxycodone

Posted: Fri Nov 29, 2019 2:06 pm
by Polar Bear
James, You say your Mirapex is at 25mg x 3 daily. I'm pretty sure that should be .25mg.

A daily dose of Mirapex at .25mg x 3 = .75mg.
Did your doctor start you off at the starting dose of 0.125mg and did you titrate upwards to your present dosage.
Or were your started directly onto your present doses.

Re: Tramadol vs oxycodone

Posted: Sat Nov 30, 2019 12:49 am
by James7
Sorry....yes .25 and titrated up

Re: Tramadol vs oxycodone

Posted: Sun Dec 01, 2019 12:34 am
by QyX
James, can you be a bit more concerte?

You are not getting enough sleep because the Oxycodone is keeping you awake or because the Oxycodone is either

(1) not effective enough?


(2) it works but it doesn't work long enough and the symptoms come back?

Oxycodone does not need to build up in your system. It should be effective right away but when you have chronic severe RLS and already tried other drugs & you are currently in Lyrica withdrawal, 5 mg of Oxycodone is not that much. 5 mg Oxycodone is the lowest possible dose that can be prescribed in Germany.

My starting dose was 5 mg Oxycodone every 12 hours. However my version of Oxycodone was long acting.

You need to be aware that while Oxycodone can be super effective when it comes to treating RLS related pain and the urge to move, opioids unfortunately can have stimulating effects and additionally, Lyrica is a sedating drug. So insomnia from stopping Lyrica is quite common.

Why do you have to stop Lyrica? Did you have a particular problem with it?

A number of different factors are probably the cause for your current sleeping problems. So if you could provide a bit more details, that would be helpful.

Re: Tramadol vs oxycodone

Posted: Sun Dec 01, 2019 1:16 pm
by James7
I was having memory issues with lyrica and I was having to increase the dosage every couple of months for it to stay effective. I was on 300mg. It would work until about 3am and then I would be up. Oxycodone seems to be more stimulating than tramadol, but the tramadol dosage was only effective until about 3am. Oxycodone really isnt helpful at all. I can't get to sleep because I'm restless and when I do, I'm up shortly thereafter. A longer acting tramadol might be more effective, but I dont need to feel groggy the next day. Why would my dr switch to only 5mg of oxycodone knowing it lasted shorter times than tramadol? I'm only 51 and am still trying to have a career. I need sleep. Stimulants are not good to keep me asleep most likely. If I could sleep at least 6 hrs. getting up at 6am, that would be great. I had to start on lyrica at least 3 hours before bed just to get to sleep due to rls symptoms being so bad, but then couldn't stay asleep, similar to with the opiods. I need solutions because it causes huge anxiety when I have to work the next day. Thanks so much.

Re: Tramadol vs oxycodone

Posted: Sun Dec 01, 2019 4:06 pm
by QyX
Seems like your doctor is not aware that opioids can have stimulating properties in RLS patients. And he doesn't fully realize how severe your symptoms are. Normally 5 mg of Oxycodone is a good starting dose but when this is not enough, the dose needs to be increased and if Oxycodone is stimulating, you need to be switched to a different opioid.

For me Morphine is the least stimulating opioid but Hydromorphone was also working good in that area.

Maybe he doesn't want to keep you on opioids long term and things that some short acting Oxycodone in a low dose for the time being is enough.

I guess you have to talk to him and see if you can get a different opioid in a long acting version.

When Tramadol is working for you, there are also long acting versions out there. However the maximum dose is 400 mg daily. So when you need more than this, the doctor would need to switch to a stronger opioid again.