Tramadol and Nefopam

[JRAB]

I’m awaiting a PKR and MRI results on the other; I am in agony! Been on Tramadol for 2 years but pain got worse so GP prescribed Nefopam for when especially severe. Has anyone been prescribed Tramadol and Nefopam together? When I requested more a different GP told me I should never have been prescribed the Nefopam, refused my request and shifted me onto morphine but I’m not happy on it at all. Please if anyone can give me advice, I’d be very grateful, I am so desperate 😢

[Happyrosie]

Hello JRAB. In your position I would approach your pharmacist. Pharmacists know much more than doctors about medicines, their side effects and drug inter-reactions. I’m assuming you live in the UK. Advice to patients and doctors about medicines is part of pharmacists’ function here in the UKI’ve been on tramadol and it did nothing for me. For the last few years I’ve been on a morphine substitute called Butec which is presumably what you’ve been offered. This has made a major beneficial difference to my pain. Apart from the first day when I felt nauseous I’ve been fine on it.

Please post again if you need for help on this.

[JRAB in reply to Happyrosie]

Thank you so, so much for your reply. I am in the UK, I spoke to 2 different pharmacists who both contradicted each other. The 2nd one I asked about how to change from tramadol to morphine said he didn’t know and I needed to speak to a pain clinic. I’m so lost and seem to be unfortunate in the people I have spoken to. I was given oral morphine tablets and oramorph to ‘top up with in the day’ but I wasn’t given any other guidance and don’t feel I was properly prepared to take it. Also, I have long standing mental health issues and am at crisis point so morphine is a particularly risky drug to be on and have around. Nefopam and Tramadol worked but this different doctor said I cannot have both which is why I am in this predicament. I am so down from being in constant pain and professionals ignoring what I’m saying to them. Sorry for waffling on 😢

[Happyrosie in reply to JRAB]

I’m so sorry you’re having this trouble, and I do understand what you’re saying. You are NOT waffling! It so happens my gp took an additional degree in pain management so I can absolutely trust what he says. And I was given guidance!The morphine derivative I’m on is a patch - so it would be hard to overdose on it.

It’s possible that a different doctor at your practice might take a different view? I don’t know what to say about the combination of these two drugs, it’s a pharmacist question!

Do you have a person to talk to about your mental issues - they might have a suggestion??? About who to approach???

[JRAB in reply to Happyrosie]

Thank you so much for your message, I really appreciate it. I am under the Community Mental Health team so they advise on that side of things but I do not appear to have a GP of my own, I always get someone different which is so problematic when there’s so much going on.

The morphine patch sounds much safer to me but did you have to have the pills or liquid first to ascertain what dosage you require?

[Happyrosie in reply to JRAB]

I started on the lowest possible dose. After evaluating this for about three months I asked for a higher dose. I stayed on this for a while and am now on the next dose up and I don’t propose to go higher.

When I come off (and I take them because I have to take an anti cancer pill with the side effect of joint and muscle pain, and I shall come off this in four years) I shall get cold turkey. So I will take a reduced dose over a few months till I come off them. The cold turkey won’t be too bad, just depression lasting a few days I hope. 🙄

[JRAB in reply to Happyrosie]

Thank you so much for your reply, I’ve requested an appointment with a different doctor so I will discuss this with them. Much appreciated 🙂