Tramadol and Morphine IR: I had been on... - Pain Concern

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Tramadol and Morphine IR

Nikki43 profile image

I had been on Tramadol, Morphine ExtendedR and MOrphine ImmediateR for 8 years and My doctor just told me that I had to choose between the Tramadol and the Morphine IR as I cant have them both. I choose the Tramadol. But these are very different drugs to me. I take the Tramadol every morning as it brings me up out of pain. I hesitate to take it at night as it keeps me awake and wanting to do more things since I feel so little pain so I take the morphine mostly at night or in extremely painful times. Morphine brings me down, sleepy. Tram brings me up. She said the Tram and the Morph IR were basically the same drug, I dont think that is true at all. Im wondering why the sudden change after all these years. I lost 90 pills and it kinda sucks. I could never live without the Tramadol. She seemed surprised too when I choose the Tramadol, she asked me why I choose it. I said I can live without Morphine, I cant live without the Tramadol. It works wonders for me. My past doctor let me try everything, and I mean everything and I choose the Tramadol over the rest. I get 400mg a day and I dont run out. I did have to withdraw from it ONCE recently because they wouldnt fill my script for two weeks past the refill date because I had to come in for my appointment first, worst experience of my life. I do not feel addicted to them, as I do not get tolerance (I am so lucky) and I do not run out, I do not try to get more and more over time. I been on the same mg of both drugs for 6 years and they affect me the same now as they always have. I am wondering if she is wrong about the interaction. I cant find any evidence online of this being a rule. THanks

16 Replies

You could try swotting up on opiates at BNF and look at the comparison. You could also find this link helpful.

Regards Rib

Kerryjess profile image
Kerryjess in reply to RibvanRey

I was taken off Tramadol as I was on 400mg per day and it wasn't controlling the pain. Also I was having stomach issues and was diagnosed with med- induced IBS. The pain clinic put me on to a Fentanyl pain patches, first 12.5 and then 25 mcg. I wax told to take Tramadol until the patches kicked in. When I fell 2 weeks ago, my GP said I could take Tramadol and paracetamol to deal with the extra pain in was in.

Dud you ask your Dr the reason why you had to choose? Just wondering if it is to do with cost.

Nikki43 profile image
Nikki43 in reply to Kerryjess

She said They cant be taken together. It had nothing to do with cost on my part. I didnt argue about it. She knew I been on them both for 8 years.. It keeps my pain away and has for many years. I hope to never have to take more or heavier stuff. But I know it can happen.

Tramadol is not an opiate as it doesn't come from the Poppy. However it does work on the same part of the brain as opiates. So the Doctor is right in a way but the 2 drugs work in different ways. Asking you to chose one over another seems an odd way for your doctor to work.

When you take strong prescription drugs for a long time - your bodt becomes dependent on them for their positive effects. This is NO an addiction although you will experience difficulty in coming off that drug.

Pat x

They are not the same and they can be taken together! GPs infuriate me! Tramadol is on step 2 of the pain ladder as a mild opiate and morphine is step 3 as it's is stronger. They work on different receptors too. You'll find many people on here on step 2 and step 3 drugs. I'm on tramadol and oromorph. I can't take mst as I get side effects. Speak to your local pain team they will know. My guess is your gp is worried about addiction but we are all addicted it doesn't mean we abuse our meds. He may be twitchy about this new seretonin crisis reaction that NICE harp on about as my gp stopped my fluoxetine until I told him if he didn't give it back I'd name him on my suicide note! I got it back thank goodness as I was a mess x

Nikki43 profile image
Nikki43 in reply to sharelle

I wish I could stick up to my doctor like that. I had taken them that way for over 8 years and I have never asked for more. I dont get tolerance like most people.. She had no reason to suddenly drop me for that reason. Annoying. Thanks for info, i had figured she was full of it.

in reply to Nikki43

Fight your corner. You deserve to live a quality life.

in reply to sharelle

I see you wrote: (but we are all addicted) I'm not thank you very much.

I can't take tramadol because it keeps me awake for over 24 hours with just one pill. I'm allergic to morphine. I take Opana ER and it works wonderfully. It doesn't put me out, but helps my pain in order to get up in the mornings. Hope this helps sweetheart!!! xxx Mitzi

GPs are not god although they like to think so! Do some research of combination analgesia and take it with you when you see her and if that's no good change GPs. Doctors doing training never study chronic pain on their course x

in reply to sharelle

Dr's like to think they are god? This is insane. How can you 'know' that all GP's think they are anything?

Taken off drugs? If these drugs were HELPING you. See another doctor to get them again and state why you need them. If My doctor tried anything like this I would go nuts. I will not live in pain.

Hi look on there is a major warning of using the two together . Not advised. This is the site a lot of GPS use . 

Also I find pharmacists very helpful and knowledgeable about drug interactions. If you are not happy with with what the go is saying ,ask them why after all these years they wish to change it . Or ask to see another go . Good luck 


I suspect it is the fact that you were taking 3 opiate meds at once.Even though Tramadol is not from te poppy it is recignised as an opiate.The risk. Of accidental O.D rises steeply when a person is on more than 2 opiates at once.I know this because i queried why my 3 opiate was removed after 10 years of no problems taking them.I never had any addiction problems either.It wasnt my G.P who stopped my 3 opiate t was my Consultant Anaesthesiologist,and he explaied the reason to me when i queried why a sudden reduction after so many years of successful pain control ( as much as can be achieved).hope this helps.

I was told by my GP not to take Tramadol and morphine as it could cause convulsions, I took his advice and just take the morphine now, it doesn’t have the same effect as Tramadol but it does help

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