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Duloxetine with low dose of tramadol?

Winter_night profile image
20 Replies

Hi all

I’m hoping to switch from Amitriptyline (which is no longer working for me) to Duloxetine very soon.

I also take cocodamol here and there and it really helps but I have to stop it ideally because of mast cell issues (a whole other story). Tramadol would be a suitable switch but I’ve read it has to be used with caution alongside Duloxetine due to risk of serotonin syndrome.

I know ultimately I will have to discuss with GP or wait for pain management referral but grateful for any experiences shared. Is anyone on Duloxetine and a low dose of Tramadol - or similar - and if so were you warned of risks/limits? Or is this a no go? I can’t take NSAIDs or anti epileptics so not many options left….

TIA for any experience shared.

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Winter_night
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20 Replies
Loobielu profile image
Loobielu

Hiya, I've never taken tramadol so unfortunately I can't help with your post directly but I have taken amitriptyline and currently weaning off duloxetine. As with all these drugs they seem to help initially or take the edge off but not always much more. I'm finding it's down to whether you can tolerate the side effects! What a grim position we find ourselves in hey. But, as with all these things most things are worth a try and Duloxetine does seem to be the current 'in thing' for Fibro type conditions. Looking at your profile you do seem to be cursed with more than your fair share of suffering, so I do hope you find something that helps asap. Keeping everything crossed for you, take care, be kind to yourself x

Winter_night profile image
Winter_night in reply to Loobielu

Thank you for your very kind words Loobielu - yes, I’m a positive person and resilient but the last few months have tested that. I think a good approach for me might be to switch to duloxetine for now and see how I go with that. Nothing to lose really! I’ll update in a few weeks on how I’m getting on with it. Thanks again for taking the time to response X

Yassytina profile image
YassytinaFMA UK Volunteer

Hello, I do take duloxtene with out any side effects it is supposed too help fibro patients I do read a lot here on the forum , I was initially put on it for anxiety due too fibro/cfs conditions and it works 100 percent for me, i only take Codiene occasionally and it does kick in for pain around 2 hours for me , yes differently a good catch up with your doctor, let us know how things work out for you and take care x

Winter_night profile image
Winter_night in reply to Yassytina

That’s really good to know Yassytina - glad you have had a positive experience of it.. it gives me hope that it might be a good option for me. Thanks for your kind words also - I’ll be sure to update in 2-3 weeks once I’m (hopefully) settled on it X

Sarahvit profile image
Sarahvit

Hello Winter,

I have never been on Duloxetine so can’t comment on that but I have been on amitriptyline and tramadol for over 20yrs or when ever tramadol came out (or drug rep came to my doctor). I’m on ….well was on tramadol 50mg 2 twice a day. 50mg didn’t work at all for me but 100mg is sufficient to keep fibromyalgia pain at bay. My GP prescribed tramadol ER 200mg (which is expensive) I have been having pain in my right upper back which the tramadol has not even touched that pain. But my experience the Tramadol has worked for most days of fibromyalgia pain. It hasn’t caused any side effects for me. I have never taken Duloxetine so can’t comment on it.

Winter_night profile image
Winter_night in reply to Sarahvit

Hi Sarahvit - thank you - that’s good to know. I have multiple pain conditions and I definitely would prefer a slow release med that could keep me more comfortable over the course of the day so I will ask for that to be considered 👍🏻

Sarahvit profile image
Sarahvit in reply to Winter_night

The Tramadol ER is way more expensive than the original tramadol. Just wanted to make you aware because I don’t know that until I went to the pharmacy to pick it up.

Flowerc profile image
Flowerc

hi I was put on duloxetine 6 weeks ago and taken of amitriptyline as they can’t be taken together I have found a difference in my anxiety definitely helping for that on the pain front I have noticed a little help but nothing major have a call with the dr next week to check the dose I am hoping they will put it up then will see if it helps with my pain here’s hoping

Winter_night profile image
Winter_night in reply to Flowerc

Thanks for your reply Flowerc - good to know you’re feeling some relief and hopefully there’s more to come. If you have time to, would be great to hear how you’re doing in a few week’s time x

Flowerc profile image
Flowerc in reply to Winter_night

Hi yes I will let you know x

Flowerc profile image
Flowerc in reply to Flowerc

I did ask my doctor if I could start tramadol but she was having none of it and said a lot of people have had good results taking duloxetine that’s what they tend to give to try and help for fibromyalgia will update you in a few weeks time if I forget which I probably will 🙄 remind me if you like x

SueSto profile image
SueSto

Hi, I have fibromyalgia and took tramadol fir a long period of time. I was not warned of any lasting side effects nd had no problems with it. But I was careful how much I took and didn’t take the prescribed dose preferring to manage the pain during the day. During lockdown I lost 3.5 stone and made sure I walked more than 5,000 steps per day. As a result my pains decreased dramatically and I only take the odd tramadol now. I take Amitriptline at night but again I only take a very small amount which doesn’t always work.

Winter_night profile image
Winter_night in reply to SueSto

Hi SueSto , well done on losing the weight - I have gained 2 stone on amitriptyline and it’s proving impossible to shift so it’s another reason I want to come off it. I’m only 5ft 2 and the extra weight is hard on my joints - I have Ehlers Danlos also which means my joints are loose and weak which doesn’t help! The more I hear about tramadol the more I think it could be a good option for me. The cocodamol is aggravating another condition I have and it’s very hard on the stomach. I’m hoping my GP will agree without too much fuss - fingers crossed 🤞🏻 x

Fillingincake profile image
Fillingincake in reply to Winter_night

Tramadol works well for me, but it is hard trying to decrease them, pain or pills?

Badback35 profile image
Badback35

Hi Winter_night. I take Duloxetine 90 mg per day along with Tramadol 300 mg per day. I've been on this regime for 18 months. They have helped greatly with my fibromyalgia pain and I've had no issues with the medications clashing. After many years of pain I have, at last, got some relief from combining these medications. Good luck. 👍

Winter_night profile image
Winter_night

hi Badback35 - thanks for your reply. That’s really good to hear. I’ve started tapering down my dose of Amitriptyline this week and will be slowly adding in Duloxetine once I get to 25mg. I’m really hopeful - my GP agreed it was a good option without any reservations as apparently it helps interstitial cystitis too (which I have). Next time I see her I will propose the switch to Tramadol as I know she - like most GP’s - prefers to deal with one thing at a time 😁 I’ll report back once I’m settled on the Duloxetine… I don’t know where I’d be without the great advice I’ve had on this forum!

Buildashed profile image
Buildashed

hi winter night, I take Duloxetine and it works for me, I still have pain issues and flare ups, but it definitely takes the edge off,

I have tried all the other meds but side effects for me were awful, it is unfortunately trial and error I think.

I really hope you find something that will help you soon.

I have to say this site and all the lovely members have helped me immensely with their tips and positivity.

Sending you lots of gentle hugs 🤗 🤗🤗

Winter_night profile image
Winter_night in reply to Buildashed

Thank you  Buildashed - what a lovely reply. I’m due to start Duloxetine soon, I’m in the process of tapering down a high dose of Amitriptyline for another week or so before I start it. The withdrawal isn’t pleasant but it’s bearable! My GP agreed Duloxetine was a good swap as it helps with urinary issues and I have suspected interstitial cystitis. The swap is down to the good advice I’ve had on this forum which my GP was happy to take on board. I agree it’s a great place to seek help - sending you hugs back in return ☺️ X

Ritatali profile image
Ritatali

Hi, I would do some more research on Duloxetine, look getting off Cymbalta(American patent) as it has been licensed there for a lot longer, and there are many forums about it. I'm just coming off it after 6 months, and the withdrawal is sheer hell. It did help with nerve pain for a few months, but also caused ne to have permanent explosive diarrhea, complete urinary incontinence, a GERD cough, and disgusting sweating all the time. I couldn't leave the house, and when I did, I had several very embarrassing mishaps. I would advise against, but these drugs work differently for different people. Just be aware that doctors won't tell you, but coming off even low dose Duloxetine can take years to do properly. Good luck with your journey

Winter_night profile image
Winter_night in reply to Ritatali

Hi  Ritatali I definitely had a sensitive tummy for the first few weeks but it’s settled down now. I already have stress urinary incontinence and reflux due to having hypermobile EDS and if anything I’d say my urinary symptoms are better - fingers crossed that will continue. My pain is also better but I’m putting that down to the gabapentin I’ve also added it. I think I will stick with the 30mg dose of duloxetine and not go any higher for the time being. I think my internal issues with EDS are so debilitating I’m falling apart either way!! Hope you’re having a good week yourself x

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