I understand that Tramadol has been re- listed and is now a Schedule three pain medication.

For the last three weeks there seems to have been a problem getting these medications and I personally had my script reduced to thirty caps. This caused having to re-apply every 6 days at best.

This problem now seems to have been corrected and I am now back onto my original script. Has anyone had problems regarding this ?. It had also caused problems with some other medications.

Now I understand for Tramadol they are needing a signature on prescribing.

All the best


33 Replies

  • Hi Bob, I questioned my GP last week about how the changes would or may affect me, she said all it means is they can only prescribe a months supply at a time, there are rules as to how the script must be written but as long as you have a competent doctor that shouldn't be a problem :)

  • I have only ever had Tramadol on a monthly basis. To be honest wish I had never taken it as I get side affects if I forget to take one. Not happy going see the specialist on the 3 July going to ask about trying to come of it but dread the side affects, sure it is addictive :(

  • My husband acted very strangely on this drug (even my daughter noticed) & opted for co-codamol instead, which he was fine with. GPs seem very keen to promote Tramadol, it was offered to myself & daughter too.

  • Yep. Tramadol is now classified as a Schedule 3 Controlled Drug.

    Doesnt make a massive amount of difference to the patient to be honest. The only one that may affect anyone is G.P's can now only prescribe a maximum of 28 days supply (although I have never seen a prescription for more then 28 days worth of tramadol anyway to be honest).

    Other changes such as the prescriber having to write the quantity of the drug precribed in words and figures etc would only affect you if they didnt do this as the pharmacy couldnt legally dispense the prescription - if this happens, remember, this is your G.P's fault and not the pharmacy so please dont blame them ;)

    It isnt a legal requirement for Schedule 3 drugs to have a signature on collection but it could be the policy pharmacy you are using.

    As it has now been re-classified, they may not be so easily obtained for new patients but, if they are already on repeat for you then the change isnt likely to affect you.

  • Thank you for the replys. I can understand when your in pain taking it but I think the side effects of taking it over a long period of time should be explained.

    I have been on it twice a day for approx 5 years and when I asked my doctor about I thought I was addicted to it he said no :(

    So going mention coming of it next month at the hospital.

    My advice is don't start it like Fran and her daughter :)

    Ian I don't understand the classes and what this means.

    Have a good day all. Rose

  • I had heard this was a good medication for pain from a friend so I had asked my doctor about it and she told me it wasnt a good medication to take for long term pain, mind you Im sure the Hydromorph Im on isnt good for long term either, I wish I could get off all the medications Im on, Im sick of drs just trying to mask the problems instead of really trying to fix it. Ive been trying a unconventional treatment at the moment and out of the 2 weeks Ive been taking it Ive only had one day where I felt real intense pain, but Im still taking my medications for now hoping to ween myself off of them soon.

  • If it's hydromorphone it sounds as though your doctor's on the ball & checks on interactions with what you take. If you're concerned about the amount of meds you're taking did you know you can ask for a review of them all, just ask at reception & they should be able to help. It could be some may be interacting or cancelling out others. Please be careful using unconventional treatment alongside your meds though. I'd be inclined to ask your doctor about taking them with what you're on. Is it that you're hoping to wean off your traditional meds to replace them with the other treatment?

  • I take trammodal extended release 200 mg it helps me

  • Hi Bob, how does tramadol differ from co-codamol? Are they both schedule 3 pain meds? I have no idea what a schedule 3 is, pardon my ignorance! Anne

  • Restrictions are more strict with Tramadol,

    With Tramadol your script is limited to 100 capsules at any one time. In the past I was given 200 caps. Your medications such as Tramadol will be reassessed more often in the future


  • Hiya Bob. Not strictly correct info & hope you don't mind me pointing it out. As tramadol is available in different strengths & forms the amount of 100 monthly, which I guess is your prescribed monthly dose, isn't necessarily a good guide as depending on they type or even required dose it could be fewer. The new guideline since being upgraded limits prescribing to a month, no specific amount mentioned & non repeatable, which means it should be reviewed by the GP each month, guess they'll soon get fed up of that! No amount is stated. This link explains if you're unsure

    I do hope you don't think I'm being pedantic but knowing first hand how GP's have readily prescribed it before this new classification (Smarties springs to mind!) thought it was best to be straight on this.

  • Hello

    Tramadol doses in my case consists of the 50mg dose, that I take two of when required, My dose now varies daily depending on how bad I am on a specific time period.

    Generally on a day I will take 2x50mg twice daily, although I do vary the dose to 2x50mg four times a day. I take medications like pain medications so that I prevent withdrawal problems. The daily dose sometimes reduces lower that my minimum dose and I sometime will increase the medications to slightly above the recommended dose.

    Tramadol is also prescribed in 100mg dose that is generally only prescribed as slow release medication. i have never used this type of tramadol, my knowledge is restricted.

    My dose generally was prescribed in 200x50mg script. Since the changes my prescriptions reduced to 30x50mg script now returned to 100x50mg script that does now seem to be the largest script that will now be given.

    Thanks for your comments, Generally I have never taken these as smarties and if I did they would generally reduce my sugar supply as far as Tramadol is concerned


  • Hiya Bob. I hope you didn't think I was inferring that you're not in need of this drug, that wasn't the intention of my reply, I completely understood you obviously are genuinely in need of it. I just wished to emphasise that it wasn't necessarily a case of a limit of 100 tablets prescribed per month & understand why you stated as you did having explained now in giving your prescribed dose. This is the case in your instance but I was trying to explain that it can now only be prescribed monthly, whatever the dose or amount of tablet or capsule. Your GP is now having to follow the guidelines & is correct in his prescribing for you in limiting to 100 per month.

    My use of the word Smarties was to emphasise how GP's have in the past too readily prescribed tramadol with little or no consideration as to whether the patient could receive pain management with a less strong & possibly less addictive drug first.

    I hope you haven't taken offence to my reply. ;)

  • Thanks Bob, I am on co-codamol, and although I am prescribed 2 per dose, that makes me feel sick, so I take 1 with 1 paracetamol. Would you say tramadol is a better painkiller?

  • I for one am pleased its classification been upgraded. I've seen the awful side effects taking this drug for just one day, taking 50mg 4 times over the course of the day. I appreciate some have no side effects & it can be of benefit but in my opinion is handed out far too frequently. Dependency can be a big problem & if you just google "tapering off tramadol" the user evidence of those who struggle is there in abundance.

  • I have been taking sustained release tramadol for 2 to 3 years, and I haven' had the side effects mentioned. Nomoreheels have you any statistics to support your opinion that tramadol 'is handed out far too frequently'?

  • Certainly, & can provide evidence if you wish. My opinion is just that, mine, from personal experience but it is an increasingly commonly prescribed painkiller. Pain management clinics rely on it as a first step medication frequently, something one of my GPs isn't happy about. Prescriptions have almost doubled in the past seven years, from 5.9 million in 2006 to 11.1 million in September 2012. This may be due in part to the fact tramadol costs the NHS just 1.99 for 100 in generic form & we all know how much pressure the medical profession is under to reduce costs in prescribed medicines & this can be to the detriment of the patient. My husband, father in law & myself can attest to that as each of us are, of have been, on the receiving end of how that can affect our conditions when being controlled on our meds we're taken off them, for no other reason than cost, replaced with cheaper options which are not as efficient as the ones they've replaced.

  • I personally think that if they paid more attention to getting the underlying diseases under control, then they would be prescribing far less strong pain meds. I personally wouldn't be having to take 8 30/500 cocodamols a day if I could get my inflammation under control - I know, because the short courses of steroids that I take get rid of my pain completely, but I can only get that relief for two weeks of every three months, and the rest of the time its maximum cocodamol.

  • Good point earthwitch. I'm in much the same situation as yourself at the moment. having been pulled off daily etoricoxib & can only take it prn (nothing offered to replace it) & desperately in need of an alternative as I'm relying on 8 30/500 co-codamol prescribed prn & not nearly as effective. Annoyed with myself as should have taken it last night & forgot as I knew I'd have a heavy day today & kicking myself as suffering now & will tomorrow. Similar with steroids, although I'm back on them at the mo until next month when I've little doubt my Rheumy will have me taper off them again.

    I was under control with both my NSAID & steroid (which I appreciate isn't a long term solution) but pulled off both & left with MTX which whilst I wouldn't want to be without simply isn't enough to keep me on an acceptable level.

  • By the way when I said personal experience in regards to tramadol, I was incorrect in inferring I had taken it (apols, genuine mistake). It was my husband's experience which I had to deal with as was I fearful with the side effects he experienced which fell just short of me calling an ambulance as he insisted I shouldn't. I called a helpline who kindly helped me & advised what I should do & if he didn't respond to take him to A&E.

  • My condition is Psoriatic Arthritis so I am treated as a RA patient, Tramadol and NSIDs are given to suppress the pain we suffer Some treatments for this are supplemented with one of several antidepressants that suppress nerve damage. RA is generally controlled with DMARD or Biologic medications they have the effect of controlling the immune system and slowing the RA down.

    The taking of strong Opiate type medications is only a small part of suppressing peoples RA . Many patient will be referred to Pain Clinic to learn how to control their medications with the addition of TENS and relaxation Techniques. Any patient who suffers from severe contraindications will need to discuss this at the GP Surgery. Yes we suffer withdrawal, although done properly these feelings can be suppressed and we can get relief from severe chronic pain.

    All medications demand trade offs and because chronic pain is so much of a problem we all need to understand the pros and cons of taking these medications. Believe me I would prefer not to take any of the aforementioned drugs especially DMARD, We all have to make trade off for a comfortable life. I remember when I first started to suffer from my condition it took an age for me to reach medications that assisted me as a patient.

    I now have had my condition now for about thirty years and I would be horriifed if I needed to go back to that period of time.

    Medications like these are a tool that needs to be used with sensitivity and understanding If you cannot be sensible in treating yourself and have trust in the prescriber as they have to have in you. You will become in for a hiding for nothing. Trust in all sides needs to be taken

    The costs of medication is looked into by NICE, Patients need quality of life. Sometimes over prescribing does happen that is why now our medications are checked every twelve months in GP surgery or chemist attached to Surgery. Generally strong medications are reviewed at that time


  • Hiya Bob. I have replied to the earlier post & it's got crossed with your reply. I completely understand & you do have my sympathy. You have valid & necessary reasons for having the need for this drug & please don't think I haven't taken that into consideration in my reply. I understand the need for it's use as a nerve suppressant as my h was prescribed it as one of his first step drug at the start of treatment at the pain clinic with the intention of adding morphine to help control his pain but unfortunately wasn't able to tolerate it resulting in a most awful experience for both him & me. He can therefore not be prescribed morphine alone as it wouldn't have the same effect. He is still suffering terribly as nothing except steroidal injections can now be offered & he's still waiting for the appointment for those to be done as with it being spinal & needs to be guided a theatre booking has to be made & we all know how long those can take when pain isn't considered an emergency & quality of life, certainly in his case, is something he's still wishing for at present & appears is in the distant future. He's another "victim" of an invisible condition.

    I agree medications should be overviewed every twelve months but that's unfortunately not always possible in understaffed & oversubscribed Surgeries. Ours is a case in point. We have valid need of reviews & have requested two, one for my h & one for my f-i-l & neither have been performed. Both necessary as has been proved with drug contraindications resulting in yet more more expensive meds added to prevent serious & additional health problems namely angina & liver failure. An outside source at ours has to be brought in to do this & there simply aren't the necessary funds budgeted for it within the Practice to provide them on a regular basis to enable a yearly review for all. It's a case of if & when they can be performed & a matter of waiting. Meanwhile meds are being prescribed which aren't necessarily benefiting the patient & therefore money wasted on prescribed drugs by the patient choosing not to take what they are given or indeed conditions worsening by the use of cost effective drugs rather than ones the patient can tolerate & is effective in a particular patient or new conditions arising by taking what is being, as in our case, incorrectly prescribed. If only a complete review would be performed on prescribing as a whole then this wasted budget wouldn't occur & the Practice run well & staff cuts wouldn't need to be implemented. Our Practice Manager now only works 4 days a week & is under increasing pressure of cutting her hours even further & having been in her position I don't see how that can aid the smooth running of a General Practice. I'm sure ours isn't the only Practice in this position.

    I do feel though we are now veering away from the reason for this site, I am anyway & maybe it would be best to draw a line under this particular topic. I appreciate it's good to share & think that's wonderful in helping one another, but I hope we can agree we do each have opinions & our own reasons for expressing them & just have to take one anothers into consideration.

  • I was prescribed this at my last Rheumy appointment but only after an increase in pain it had not been offered before maybe because I was "coping" with other painkillers. I haven't taken it YET but that may change today as I'm in a lot of pain, what are the problems with this drug as I'm wary of taking it now?!

  • hi to everyone, I had tramadol only once, it made me so ill, I could not stop throwing up, and was not eating. Not sure what grade 3 is, but is it an opiate medication? like morphine. I also used to be able to take Zomorph but as I get older, find I can't stomach most of the pain killers, like co-codamol etc., but hey, I'm still standing (even if in pain) Rita

  • SCHEDULE 3 (CLASS 3) DRUGS have a lower potential for abuse than drugs in the first two categories, accepted medical use, and mild to moderate possible addiction. These drugs include steroids, Low-dose Codeine, and Hydrocodone-based opiods.

  • im afraid i don't understand what this is all about. what does it mean 're-listed'. also i had terrible bother even getting pain relief when i started with this disease. in the bad times, like now i take 100gm of tramadol twice a day. before i went on 'bio's' i was on 200gm twice a day.

    there have been periods when i have stopped needing them at all and i have never had any problems with that and i have never had any side effects either.

    i just don't want new comers to be afraid of this wonderful drug when they are suffering. 'one side does not fit all', is all i'm saying. XX

  • Relisted means it's been moved up in the Controlled Drugs lists to a higher one, the highest being Section One & GPs will need to observe tighter restrictions on the prescribing of it to try to cut down on misuse as it now considered a Class C drug.

    I agree with your last comment Jeanabelle, & I am doing all I can not to be alarmist. We have to be careful with what we say about the meds we're using full stop & can only base any replies on experience which is why I am trying hard to be guarded in the content of my reply. I have defended MTX in past posts in a similar instance & aware this is a similar thread but whilst MTX can be problematic & cause distressing symptoms even at low dose, tramadol is a less specific drug & regularly prescribed for many painful symptoms. It's an opioid similar to morphine but thought of as a safer option yet has the same risks of overdose as morphine, here I mean unintentional, ie not knowingly od'ing when taken with other meds which may interact where it's genuinely prescribed for very real pain & not in cases of misuse for recreational reasons. It's twice the strength of codeine & has to be used with particular care if prescribed alongside other meds such as amitriptyline. Opioids like tramadol need close monitoring & it's recommended patients should be seen at least once a month if on them long term. The benefits would appear to be greater in short term use than long term because of concerns of being addictive & must be tapered if coming off it after long term use, although if it's only been used short term this shouldn't be necessary as the body wouldn't have developed a tolerance to it & therefore not developed a dependency.

    Hope this helps. I really don't wish to alarm but it is a little understood & yet regularly prescribed drug.

  • thanks for yor reple. as i said 'one size doesn't fit all. all the best and thanks again. x

  • Tramadol in my experience and according to Wikipedia is an 'opioid analgesic' and according to my Collins dictionary opioid means 'any compound resembling cocaine and morphine in its addictive properties or physiological effects.' I have two friends who were prescribed it - not for RA but for other conditions. They had horrendous experiences the worst being hallucinations and neither were told that it was an opioid nor that it was addictive. My vet even prescribed it for my arthritic dog when I had never heard of Tramadol saying that it was just another pain killer. It was only when my dog started to exhibit very strange behaviour that I happened to mention it to friends and those that had taken Tramadol told me of their experiences which explained everything that I was seeing in my dog.

    I have never taken Tramadol myself so cannot speak from first hand experience. It probably is a very good painkiller but it's always good to be aware of the side effects as neither the doctors nor the vets it seems will tell you.

    Wikipedia has good information on Tramadol with a diagram of the human body showing potential side effects.

    Perhaps it's for the above reasons that it has now been re-listed?

  • Going to read up on Tramadol in Wikipadea hope I haven't put anyone of taking it :( Just speaking about myself the sooner the better I come of it, I take it for my knees and going to need help to get of it. All the best to you all xx

  • Hope you don't mind me mentioning this but in my experience KJay & victoriablue, Wikipedia isn't always the best source to depend on as it's compiled & edited by many contributors & can contradict. I've found that there are better sources of information on sites such as pubmed (an American site) & our own NICE guidelines, where issues of medicine are concerned. Far more reliable.

  • I take 3 or 4 Tramadol a day: it is definitely my pain drug of choice. I am one of the lucky ones where this med actually works and has not had noticeable side effects. I get the liver checked periodically and all is ok. I also take 20 mg of methotrexate a week and 500mg of naproxen twice a day. All that said, it does not touch the pain of a bad flare.

  • I hope not as just been given tramadol by my doc. I've only got 30 to start with so will be needing more soon xx

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