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tramadol and dilaudid work against each other

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pete81241 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pete81241 Quote  Post ReplyReply Direct Link To This Post Topic: tramadol and dilaudid work against each other
    Posted: Jan/26/2011 at 9:11am
my PC physician recently told me tramadol and dilaudid dont work well together. one may cancel out the effects of the other. based on that i stopped dilaudid and just took tramadol. my pain levels were reduced substantially.....pete
7 spine surgeries for neck, leg and back pain caused by stenosis,DDD, facet hypertrophy and ligamentum flavum. spinal cord stimulator. both hips replaced. surgery on pituitary and pancreas tumors. arthritis. ga
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dbarbeau48 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 12:08pm
Great news Pete. I started up on my Tramadol yesterday after my biospy and most of my aches and pains are either gone or greatly reduced. I have to wait another 3 days to go back on the Diclopenac to be sure no bleeding occurs.
 
Dick
Five knee surgeries from 1970 to 2000. Knee replacement in 2000.Spinal stenosis surgery in May of 2002. Diagnosed with Pseudogout in 2005, effecting hands, knees, and shoulders. Emergency surgery in March of 2006 for spinal infection of L 2 and L 3. During surgery, discovered I had Cauda Equina Syndrome. Spine became unstable after surgery and had 360 fusion with 10 pedicle screws, plates and rods in April of 2007. Retired early as a high school principal. Recently, have had trigger finger surgery on both hands as well as surgery for severe bi-lateral Carpal Tunnel disease.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 12:38pm
Pete--

This is fascinating news.  I have just read the full prescribing information on Tramadol: http://www.ultram.com/sites/default/files/ultramer.pdf and can't find anything specific about tramadol and dilaudid( hydromorphone) taken together.  I am going to continue to look as your Dr. obviously knows something that we don't, and I would say that the proof is in the pudding if you are now getting significant relief with tramadol alone.

If anyone finds anything before I get to it, please do put the link in here?  Thanks, Stevie

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Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 12:47pm
I did find this regarding taking Dilaudid and Tramadol together, but it still doesn't answer how the two meds may cancel out the effects of the other.  I am wondering if there has been a recent study done and I am not able to locate the information. http://www.drugs.com/drug-interactions/dilaudid-with-tramadol-2221-0-1294-768.html

OK--I am still interested if anyone can shed some light on the combination of Tramadol with Dilaudid or any other opioid.  Thanks!!!

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The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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tkay View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tkay Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 1:20pm
I do not have any info on the medications. sorry. I'm new to all this.

Pete it is good though you know that the tramadol is working to reduce your pain.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote medic008 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 3:38pm
Stevie  is the first "study" I found. But I don't like the way this reads, going back for more.
http://www.ehealthme.com/drug_interactions_side_effects/Hydromorphone-Hydrochloride-3343845

Well, I couldn't find anything else. I have looked through what google had to offer(after swimming through the 1,000's of tramadol ad's!!!!) I looked through my PDR, my online drug database, asked my Charge RN, and I even  called 3 DR's I personally know. None of them could shed any light on the subject.

Now this is just *my* opinion,

They both attach to the same receptors in the brain(could be a crowding issue), but tramadol(synthetic opiate) attaches to more than a true opiate(dilaudid). Tramadol also has been shown to increase serotonin levels(making you happier)

So maybe you just feel better because you took out the downer(dilaudid) and added something that acts like an anti-depressant? Again just *my* opinion.

I am going to keep researching this, it has really gotten into my brain.

Tyler
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 4:16pm
Thanks TylerClap

You and I have both come up with about the same material, but nothing concrete yet. What I like is the fact that Pete has had a definite increase in pain relief by getting off of the Dilaudid.  Also, Pete--correct me if I am wrong, but you have never liked the way you felt on Dilaudid, have you?  We also have other members who do well with tramadol.

Something else----and I think that you are on to something here----I personally took tramadol alone for about two years on a prn basis and did well with it.  It isn't the strongest pain medication out there, by any stretch of the imagination, but I felt well on it---none of the depressive episodes I have experienced with things like Oxycontin (have never had Dilaudid so can't speak from personal experience about that).  I am wondering if the increase in Serotonin levels gives that added boost to the pain relieving properties of tramadol.  A really good point.

If tramadol and dilaudid attach to the same pain receptors in the brain, what about other narcotics such as Oxycodone or MS or Demerol?  Here is why I ask----I had an awful time a while back with a huge dry socket.  I tried to get by with tramadol, and it wasn't effective at all.  I asked my pharmacist if I could take a Percocet within 30 minutes of taking the tramadol and he said go ahead.  Within 15 minutes of taking the Percocet I was much more comfortable.  So, the tramadol in my case didn't block the Percocet from working.

Honestly, my knowledge of how opioids work via pain receptors in the brain is limited.  So, I thank you for stepping in and shedding light on this subject, as it is an important one.  So many of our members are on ER narcotics with a different class of opioids for BT pain.  This is really a fascinating topic.  Thanks again Tyler :))  Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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pete81241 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pete81241 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 6:25pm
the tramadol seems to make me more energetic and alert. its a good feeling. and i have less pain.
dilaudid would make me depressed after a few days use. 

drugs.com claims taking tramadol with dilaudid can cause seizures and respiratory suppression.
my PM dr who prescribed the tramadol claimed the drug has very few side effects.
i wish i knew more about receptors.....pete
7 spine surgeries for neck, leg and back pain caused by stenosis,DDD, facet hypertrophy and ligamentum flavum. spinal cord stimulator. both hips replaced. surgery on pituitary and pancreas tumors. arthritis. ga
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Post Options Post Options   Thanks (0) Thanks(0)   Quote medic008 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 9:19pm
I spent 25 min typing up a great post on the difference in the opiate receptors. I hit post and it told me access was restricted! $%^&#*@(#($&$^#%@!%*@()#$&$^$#%#&@(@))#*$

I actually did a paper on this in school because it was personal to me. Anyways here is some copy and paste from another website, I will add some info in parentheses.

Opiate receptor: to receive
transmembrane proteins that bind to endogenous opioid neuropeptides and exogenous morphine and similar natural or synthetic compounds. The three major classes of these receptors are designated mu, kappa, and delta. Morphine(or any opiate) preferentially stimulates mu receptors to produce analgesia, euphoria, respiratory depression, constipation, and pinpoint pupils(addiction). Some other drugs (e.g., buprenorphine(suboxone,subutex/BuTrans)) can selectively block mu receptors while stimulating kappa receptors; this provides moderate to high pain relief with low abuse potential. Stimulation of delta receptors can also contribute to analgesia. The receptors are found in high concentrations in the dorsal horn of the spinal cord and in the brain regions involved with pain modulation or pain transmission (e.g., preiqueductal gray matter). Endogenous agonists at these receptors include endorphins, enkephalins, and dynorphins.

You can break down the receptors even further into 7 sub-groups based on their substrates and physiological effects. I can break them down if you want, or if you have questions please feel free to post them and I will answer them when I can.

Tramadol acts mainly on the mu1 and mu2 receptor, this is where tramadol differs from other true opiates. It can basically select which receptors it works on and which ones it can ignore.
Tyler.
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote medic008 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 9:20pm
Sorry double post.
Left shoulder hemiplasty, needing a complete replacement.
Lower back problems still being sorted out.

I am a RN/EMT-P, any and all advice given is my opinion and not to be taken as medical advice. ALWAYS seek the guidance and expertise of your DR!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Edie Quote  Post ReplyReply Direct Link To This Post Posted: Jan/26/2011 at 11:29pm
I think I saw something about this in this same site, a few months back, but darn if know where. I will look aroung and see if I can find it.
Edie
Multilevel degenerative disc disease
C3-4, broad based disc bulge with small bone spurs
C4-5, dehydration of the disc with broad based disc bulge
C5-6 narrowing and dehydration of the disc, with small osteophytes. Mild effacement of the ventral subarachnoid space. Moderately severe bilateral foraminal narrowing due to disc and spur. Probable C6 nerve root impingement bilaterally.
C6-7 narrowing and dehydration of the disc with broad based disc bulge and postereolateral marginal spurs
C7-T1 narrowing and dehydration of the disc. Small posterolateral marginal spurs with fairly severe narrowing of both neural foramina. Probable bilateral C8 nerve root impingement.
T4 to T10: Moderate to advanced DDD with moderate to severe disc space narrowing
All non operable

Pain in both knees
Torn ACL and MCL in car accident, some years ago, no surgery
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Chronic depression, chronic insomnia, and anxiety manifested in constant hyperventilation (the constant need to take a deep breath) especially when I try to rest.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Jan/27/2011 at 12:48am
Sorry Tyler.  I hate it when that happens.  I have learned that if I do a particularly long post to "save it" prior to posting---sometimes if the post is very long we "time out" and lose it.

Thank you for taking the time to do this research.  I just looked at Tramadol in "Principles of Analgesic Use in the Treatment of Acute Pain and Cancer Pain" (American Pain Society).  It seems to "have a unique, dual mechanism of action.  Neither component alone is sufficient to explain its analgesic effect;efficacy appears to to result from synergism between the two effects.  It is a very weak u-opioid agonist that also inhibits the reuptake of norepinephrine and serotonin."  ( Here we have the "making you feel better component")

Tramadol does seem capable of selecting which receptors it works on and which it ignores--- from my limited ability to understand its mechanism of action.  It would seem that it may not be the best medication to use in combination with some other opioids. 

It is very late and so will come back tomorrow and try to make sense of this.  Thanks, Tyler.  Stevie

Please donate to help Chronicpainsite.com continue to help others.


The information and articles provided on our website are designed to support, not replace the relationship between patients and physicians.

Spinal Fusions L5-S1 and L4-L5. Recent changes now with diagnosis of Lumbar Stenosis with neurogenic claudication. To have multi-levl posterior fusion with laminectomy and decompression of L2-3 L3-4 and fusion and revision of L4-5 L5-1 with instrumentation. Cervical DDD, stenosis, spondylosis, spondylolisthesis and facet arthropathy throughout cervical spine from C3-C7. Thoracic Spine: dextroconvex curvature of the thoracic spine, centered at approximately T8.(Scoliosis with 20 degree curve). At T7-8, a disc bulge. Degenerative disc disease T7-T9. Disc dessication from T3-T11.


NATIONAL SUICIDE HELPLINE 1-800-273-TALK (8255)
http://www.crisisclinic.org/
IN THE UK 0845790 90 90
http://www.samaritans.org/
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tkay Quote  Post ReplyReply Direct Link To This Post Posted: Jan/27/2011 at 8:35am
Just here reading, learning. I dont have anything to add as I have no experience with these two drugs.

Pete I hope whatever works for you, you are able to stick with that. I care and hope you have less pain today.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote sara1 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/27/2011 at 1:22pm
Pete-Great to hear the Tramadol is helping!
DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing Neck-reverse Lordosis of c-spine C6-C7 with impingement, numb hand and sore outer elbow. Bursitis to both knees. RN
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pete81241 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/27/2011 at 1:56pm
Edie...i think you may be referring to tyler's comments on this thread


i seem to be doing better with the tramadol. i take 100mg in the am and another 100 about 1pm. i sill take diclofinac and tylenol. one thing i'm doing is staying in a crouch position all day long. there is less pressure on the nerves in that position. unfortunately i just cant do any more physical therapy or standing exercises. i will just have to accept that if i want to stay somewhat comfortable. thanks for good wishes...pal pete
7 spine surgeries for neck, leg and back pain caused by stenosis,DDD, facet hypertrophy and ligamentum flavum. spinal cord stimulator. both hips replaced. surgery on pituitary and pancreas tumors. arthritis. ga
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Post Options Post Options   Thanks (0) Thanks(0)   Quote sara1 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/27/2011 at 3:26pm
Pete-Have you tried all the pain meds like Oxycontin or Fentanyl patches or did you have a reaction to them? Sorry to hear you're in that position all day that is pain not controlled. I hope they approve your pain pump if you've tried all the meds. Sara
DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing Neck-reverse Lordosis of c-spine C6-C7 with impingement, numb hand and sore outer elbow. Bursitis to both knees. RN
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pete81241 Quote  Post ReplyReply Direct Link To This Post Posted: Jan/27/2011 at 3:38pm
yes sara i have tried everything. it would be good to have the pain pump and actually walk again but at least now i am comfortable in the  "catcher" position. before the tramadol i couldnt even stay in the crouch position very long. i have learned to be content with what comfort i have.....pete
7 spine surgeries for neck, leg and back pain caused by stenosis,DDD, facet hypertrophy and ligamentum flavum. spinal cord stimulator. both hips replaced. surgery on pituitary and pancreas tumors. arthritis. ga
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tkay Quote  Post ReplyReply Direct Link To This Post Posted: Jan/27/2011 at 7:00pm
Hugs Pete.

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