Does anyone here use Tramadol & Hydrocodone?

[Neco]

That would be more popularly known as Ultram and Vicodin (325mg tylenol) respectively.

I'm kind of sitting on the fence right now.. I've been treating my RLS with Hydrocodone since being diagnosed just over a year ago.. Naturally I've had to deal with issues such as increased tolerance and dependance.. I've already come to terms with the fact that right now Hydrocodone is the only drug that provides me complete RLS relief, and that I have made no attempts to deceive anyone about the fact I 'appreciate' the euphoric effects.

But like any responsible patient who doesn't want to have his only link to sanity suspended, I have become increasingly pro-active about trying to control my usage and been doing my best to keep my tolerance as low as possible. I've taken drugs (in no particular order) such as lorazepam, levodopa, and requip.. lorazepam did nothing for me, while levodopa appeared to be a godsend at first, and then it became physically unbearable to keep taking it due to rebound & augmentation.

Lately I've started to experience headaches and mild nausea with Requip. I have taken it on and off, sometimes as long as a week, sometimes only for a few days. The mild nausea I think I could have lived with for at least a while longer, but the headaches seemed to hit at random (but still coincided with the use of Requip) and would progress to the point of moving from my head and into my mouth, simulating dental pain (which I am NO stranger to and no fan of).

So I have done some reading up on Tramadol over time, and discussed it with my doctor. I have seen plenty of examples of people saying Tramadol works great for Hydrocodone holidays, etc.. So I obtain a small prescription to see if the drug will help me at all. I planned to give it a try this coming Sunday evening. But now that I've done even more reading I have seen people complain that Tramadol can actually kill the effectiveness of other narcotics. In one case someone complained it totally ruined their tolerance to Codeine... Being that Codeine and Hydrocodone are somewhat similar, it does slightly concern me.

I guess right now, I just feel a little confused and conflicted? I know that on the So Cal site, they say no cross-tolerance between opoid narcotics and Ultram has been reported to them, but on that same token it has also not been verified clinically.

What I was planning to do was simply take the Tramadol for 2 or 3 days if it worked, then switch back to the Hydrocodone for a few days, and rinse / repeat.. Hoping this would help solve my tolerance problem with the Hydrocodone.

Can anyone verify that I can expect positive results from this regiment? Ideally I'm hoping to hear from someone who has actually tried what I want to do. But if you know something I don't regardless, please do share information. I'd hate to give the Tramadol a go, and then discover that my Hydrocodone suddenly stops working because my tolerance has gone "thru the roof"

[ViewsAskew]

I wish I could say I'd tried it, but I haven't. Seems that there are several people on the larger Yahoo message board that use Tramadol, but I can't recall them saying anything about this.

If Dr B at the So Cal group suggests it, he's probably on the money. He's up to date and it one of the most informed practicing doctors I've ever met. Then again, I can see why you'd want to hear from someone.

It usually only takes a day or so to get approved for the Yahoo board. It might be worth posting it there, too. We don't have too much crossover of members between the two groups.

Also, Corrie might be along later. She is quite informed about the opiates/opioids.

At any rate, I'm glad to have another opioid user here (I take methadone which COMPLETELY controls my RLS). I also have physical dependence, but no euphoria - methadone really doesn't give any kind of a high. I started at 10 mg in April and went to 15 in September. I really didn't need that much, so I have been taking 12.5 mg. In November I started 13.75. I don't know if this if average tolerance, high, or low. I do wish I'd convinced my doctor to try drug holidays, but I didn't. Now I know I am physically dependent. It will take two weeks to get off of it, but it took me 6 months to get off of a very low dose of Klonopin, so I'll stick with this.

Ann

[cornelia]

Sorry, (I am Corrie), Zach, I take Tramadol for daytime use, but have never been on opiates (yet).
I have never ever read somewhere that Tramadol can counteract the benefits of opiates and I have done a lot of reading on the RLS boards.

I agree with Ann that the best thing you can do is ask dr Buchführer. He will answer you probably within 24 hours.

Good luck
Corrie

[Neco]

I think I'll see about getting in touch with him then.. Can I ask what kind of dosage you started at initially, and how effective you found it? I am actually very concerned about another possible side effect (seizures) because I have been on and off anti-depressants for a couple of years now.

I pretty much have to take TCA's because as an IBS-D sufferer SSRI's are said to be linked to worsening the condition or even triggering attacks. Whereas TCA's are actually believed to help change motility for the better. I could use a good mood elevation these days as it is

I did discuss that concern with my doctor, since I also obtained a prescription for Nortryptiline from him.. Though I guess I just won't know until I try it.. All he could say beyond that was if I had a seizure, I'd know it... /sad lol

I figured the best thing to do is break the tramadol into halves or smaller and see how much I can get away with at first. Is it safe to split tramadol pills like that ?

[cornelia]

Hi Zach,

I use Tramadol drops, I don't live in the US, but in The Netherlands, Europe. So I don't know it you have them in the States. It enables me to play around with the dose. I use either 37.5 mg or 62.5 mg. There are lots of people that take more, but I have learned that you should not use more than 100mg/day. The 50mg pills cannot be cut in half, that's what the pharmacy people say over here. They say that Tramadol elevates your mood and I find this to be true. It also gives me some energy, which I need desperately, because the DA's rob me from it.
I have been on Tramadol for several years now. I took a 6 day holiday from it twice, which only caused problems for 2 or 3 days (depression, flu-like symptoms).
Hope this helps.

Corrie

[ViewsAskew]

Zach, all of the tricyclics and most newer SS ADs are known to worsen RLS. That makes it tough if you have to take an AD, and tougher still if you can only take the older tricyclics.

IBS sucks. I am poking my nose into places it doesn't belong, but do you happen to be anemic? My DH has celiac disease, which is commonly misdiagnosed as IBS. You certainly may have it, so pay no mind to my post if you've had all the necessary tests. [soapbox starts here] I just hate to see people with possible symptoms whose doctors have never even tested them for it. Currently is it estimated that 1 in 133 people in the US have celiac, but 80% of those people are not diagnosed! Undiagnosed, the lifespan of a celiac is 40 years, and the chance of getting an intestinal cancer is 1 in 8, instead of 1 in 1500 (or 1800 - I can't remember) for a non-celiac or a treated celiac. [end soapbox]

Glad you found us, even if we don't have many specific answers for you.

Ann

[Neco]

I have been tested for anemia in the past I believe... When I was 15 years old I think. (I'm 23 now). Its definitely been a tough thing for me to deal with.. When I turned 21 and originally saw my doctor I was pretty depressed but had at least stopped smoking because I thought it would make me healthier (lol), but from then up to the present I've been an unemployed (and thus uninsured or even remotely rich) H.S dropout so my medical options as far as tests go are pretty limited.. I see him every 2 weeks roughly, and will probably inquire about being tested for anemia again.

As for dealing with the IBS stuff, yeah. No money for any real tests, but I've also been dealing with it for a year, like with my RLS (I had some bad food, but antibiotics never showed permanent resolution of lactose/ and later high fat intolerance). At this point, I think I really need to find an AD that works for me.. I've tried a few in the past and they worked for me, and helped me to get better and start taking tests for my GED, drivers liscense, etc.. But combined with the Hydrocodone, I can't go to the bathroom, LOL.. The only one where that didn't happen was with Remeron, but that made me gain 20 - 30 pounds

I definitely know about what makes my RLS worse, etc.. I think it frustates me doctor when I tell him something new I learned every time I come in, heh.. I don't even take my Allegra samples anymore unless its a REALLY bad day for me.
Oh well.. That's life, right?

[ViewsAskew]

You don't have to be anemic to have celiac disease. Most gastros don't even think of testing for it until people are literally dieing. The average time to diagnosis is eight years!!! Some people are misdiagnosed for 20-25 years. Very sad. The real problem is that there isn't any symptom that is common to all people with celiac. Some are extrememly sick, some aren't sick at all. Many are anemic, but not all. Some have strange neurologic symptoms.

RLS is extremely common in celiacs because they are not absorbing nutrients, hence they get low in iron, increasing the chances for RLS.

In fact, I stongly believe that EVERY person with RLS, that is also chronically anemic, or has digestion problems espcially with diarrhea, or who has wierd neurologic symptoms, all should get a tTG-IGA (anti-tissue transgluatminase) test. This is only the first step, but the best test for seeing if you have elevated levels that commonly occur when the body is having an immune response to gluten.

Doctor may fight you on this, but darn-it, this is easily treatable, deadly, and highly underdiagnosed. We currently have 1200 members on this board (although not nearly all of those are active). We should have at least 10-12 celiacs out of that population, and maybe higher because RLS is of higher prevalance with the celiac population, yet I've never seen anyone mention it. Of course, not everyone tell every diagnosis they have, but one would think that we would have heard someone posting about it by now.

Oh, I forgot to warn everyone that I was back on my soapbox again!

Ann

[Neco]

Well I guess its good to be proactive about stuff.. But I have to be honest. I do not like to be scared.. Every time I hear that the symptoms of something I have are the symptoms of 10 other more serious problems and are commonly misdiagnosed, and so on and so on, I just feel like screaming..

Not meaning to come down on you, I just... Have so much to worry about right now in my own life. All I can tell you is this... Stress will induce attacks, dairy products without digestive aids will induce attacks, 14g or more of fat will likely induce an attack. Soda will do it to me too. I have altered my meals a lot. I have a pretty low fat diet, and I have lost some weight on account of it, but I see my doctor every 10 - 14 days... He hasn't becommed concerned with my weight yet, so I trust him.

I mean, I still worry enough that maybe I just have some other "thing" crawling around inside me messing with me, that the antibiotics I got couldn't kill, or properly affect.. If I won the lottery the first thing I would do is get every medical test on the planet - but I can neither afford, nor do I have the time to worry anymore.. Its sad, but I just want to push forward and finish fixing my life, so I can afford to fix my health, without having to worry about "it", whatever "it" may be, in the meantime.

Sorry... guess I brought my soapbox too...

[ViewsAskew]

Zach, never meant to worry you. The really great thing about celiac disease as that there are no medications required! And when you follow the diet, you have the same lifespan and chances of cancers as anyone else. I guess I was thinking that it would be a relief to have this over many other things, as it's completely managable just by diet.

Sorry! Got carried away in my zeal Just pretend I didn't post and pay attention to the other "nicer" people here .

Ann

[ksxroads]

Guess I'll comment on the Ultram/Vicodin issue as that is what currently has provided me relief without any adverse side effects. It is what helped me back in August, and my GP has consented to allow me to use this for the time being.

I had concerns back in August about the hydrocodone/apa becoming less effective and emailed Dr. B at Ann's suggestion. I took his email to my GP and he contacted Dr. B.

Dr. B suggested using hydrocodone/apa (vicodin, loratab, etc) 3 days then Ultram/tramadol 3 days ... if the Ultram proved to be as effective.

He also suggested I try Mirapex ... I had problems with Requip but did try the Mirapex for two weeks. While it helped with the rls symptoms it also disrupted my thinking, caused major depression and sleeplessness as my mind would not shut down. So I no longer take Mirapex.

Daily use: Majority of the days I can take 50mg of Ultram once or twice a day to keep RLS symptoms and pain manageable. Occasionally I will have a couple Excellant days where a narcotic is not needed and otc ibprofen for muscular pain will suffice. (When the days have been good, I have tried not taking anything at night, and find once in a blue moon I can manage to sleep without a med). On rough days I will take an additional 50mg of Ultram if the sensations and pain has not subsided in an hours time. So I may take up to 300mg of ultram on a really rough 24 hour period. Not often.

Corneilia, thanks for the information. I will ask my pharmacist and doctor about daily dose limitation relating to the Ultram/tramadol and while I haven't cut a 50mg in half, that is a good thing to know also!

Night use: At night I tried both and found that the hydrocodone worked best for my night time RLS. In particular for me, 7.5mg seems to hold me over allowing me to get a full 8 hours of uninterrupted sleep.

Using the Ultram at 50mg and then at 100mg I would still experience RLS sensations at bed time, though I would manage to get to sleep, I would wake after about four hours of sleep, sometimes less but never more. Same with the hydrocodone 5mg. With 7.5mg hydrocodone I have no rls symptoms at bed time, and sleep generally about 6-8 hours.

A true blessing.

So at the moment I am using the hydrocodone/apa regularly at night. Ultram during day as needed.

Sleep diaries, daily notes jotted down can be so helpful in keeping you focused and your doctor informed.

Ann, my good friend who has celiac disease, with rls, fibro and lupus is an advocate for gluten response testing too... She will be pleased to hear you on your soap box! *Big Grin*

Good luck Zach, you seem to be making some major strides in your life and I will be keeping you in my thoughts and prayers.

Love and healing light to each of you, Hazel

[Neco]

Well last night was my first night with the Ultram, and I slept relatively well. Although I woke up at 3:30 or so of my own accord.. I keep funny hours sometimes. I am hoping tonight goes relatively well also.

I noticed that it also seemed to help when coming down off the hydrocodone, or at least in my case it seems to have.. I felt much sharper and "level" compared to previous experiences, so I am hoping that will continue as well. I'll definitely have to give it a few days though, as my body has a tendancy to fool me with new medications at times.

I was also reccomened to try Mirapex, but that alone is expensive and I think my doctor also said he had other concerns about it.. Not sure what though, I am assuming some kind of side effects.

Thanks for the well wishes. Hopefully things will work out for the better.

[cornelia]

Hazel, thanks to your reply too. We learn so much on this board. I have a question: I try not to play with the dose of Tramadol too much, because I find that every time when I go down, e.g. 25 mg's, I am in problems as to more RLS the nex day. Do you experience that too?

Another thing: do I understand that you take Tramadol and Hydrocodone on the same day? First you said you exchanged them every 3rd day, which sounds OK to me, but then you say that you use one in daytime, the other at night. Is that right? If so, are you sure dr B meant you to do that?

Anyway, just curious and a bit concerned.

Have a nice positive day!
Corrie

[Neco]

Well it was another good night tonight I think. I woke up for a few hours and tinkered on the PC from 1:30 to 4, but went back to bed and fell asleep rather easily. I don't really feel tired or exhausted either, so I hope this does keep up..

I also started my Notriptyline, but I did notice something weird.. It doesn't seem to happen when I am up and doing things, or sitting at the PC, but when laying at rest in bed I seemed to experience little "ticks" or "twitches", but it was different from the usual twitches or motions I go through with RLS.. It was more sudden, brief, and felt more localized ("small") and was almost like a twitch you might get if you were falling alseep and were slightly jerked back awake.. I haven't had any seizures but I hope that's not a warning sign either.. It would suck to have to give up the AD, but I'd do it in a heartbeat if it means I could still take the Tramadol. I think this stuff will really help me curve my hydrocodone usage and keep it under better control, as long as the effects don't diminish too much over time.

[Guest]

Dr B said if the Ultram worked as well as the Loratab to do the three day on and off switch...

So far the Loratab seems to work best for my night time rls symptoms, and the Ultram manages my daytime symptoms, is what I have found.

This time I have only been on the hydrocodone/apa and ultram/tramadol one week since November 29th. And have used the Ultram three day/nights of the seven nights. On the other four days I have used Ultram during the day and loratab at night.

Back in August I used the loratab day/night for three weeks; then lortab day/night four days and Ultram on weekends for one week; then Ultram alone; then darvon for a week...

The doctor and I discussed keeping a diary of my symptoms and med intake. - I printed out the Fibro Pain Scale that one website had rating pain levels 1-10, I believe that 1-6 are pain levels with OTC meds and 6-10 relate to pain levels managed with pain meds... the dr has a copy too. I use it to list the pain level for each time I take some form of medication be it OTC aspirn, ibprofen, or the loratab/ultram.

Hasn't been a marked pain level when I take the night med, what I list in that instance is rls sensations, how well I slept, if I wake with pain or stiffness, or do not get a full nights sleep I list what woke me, ie rls sensations, painful or not.

Hopefully this info I provide will help him understand what variables we are dealing with, and give him something tangible he can refer to should he want to consult others. I know he is contacting Dr B, and wants us to work with the neuro in his clinic to learn more about RLS treatments.

It has only been a week, lord it seems like a life time! hahahahazey