Much has been written about Tramdol bit I still get confused!

Just wondering where it comes on the scale of pain relief meds. David has been on Fentanyl patches for years - increasing according as pain worsens. He tops up with cocodamol when needed. Together with a cupboard full of other rugs for relaxing muscles etc.

Can he take Tramadol instead of cocodamol or as i say where do they fir in?

And don't tell me to ask GP or pain consultant!

Pat x

21 Replies

  • Hi Pat, I am no expert but I know tramadol is a synthetic opiate(it has to be specially signed for like fentanyl).It is stronger than cocodamol but weaker than morphime.50mg of tramadol is equal to 10mg of morphine.My pain relief scale went paracetamol and ibuprofen, the on to cocodamol, then up to tramadol, then morphine.To my knowledge it would not be usual to take tramadol and cocodamol together would be one or the other.Mixing Fentanyl and Tramadol could heighten the chances of suppressed breathing or the rare serrotonin syndrome in rare cases.x

  • Sounds a good answer to me! Wonder how you make a synthetic opiate?

    As he will have to reduce patches soon i was just wondering if there was something stronger than cocdamol to add instead. Sems not as he gets on very well with Fentanyl

    OK. Have to try a litle more RLC!

    Pat x

  • I have had two operations on my back for disc problems and nerve damage I still get chronic pain and have Fentanyl patches and tramadol. I have been diagnosed with COPD so I was wondering after reading your post if it is related. But I couldn't cope at without medication

  • I was prescribed tramadol after I broke my sternum and ribs in a car accident . It is supposed to be a very strong pain killer but it didn't do much for me. I was told to take paracetamol in between if needed. I was then prescribed Tramadol again for a long period of time for my chronic bone pain due to osteoporosis, wedge fractures and arthritis. I still don't think it helps me much at all. So, I am on co-codomal higher dosage now and was on morphine patches just for 6 weeks. In other words, we are all unique and some people think Tramadol is marvellous, but I don't. I would suggest you speak to someone about mixing ....I know you said don't mention doctors, but some drugs are OK to take together and some are not. I wish you all the very best. :)

  • I did smiled cos the first thing I always advise people talk to GP and or pain consultant! They do monitor his drugs and pain tolerance very closely - just me looking to see what the options might be.

    Yes we are all different. Opiates for one are useless for others if you have an allergic reaction. Same as TENS.

    Of course now he is learning to walk again there is extra pressure put on those dormant parts. Mo physo offered - you don't now it seems.

    Anyway very helpful thanks

    Pat x

  • I do hope things start easing up! Funnily enough, about 10 years ago I used the TENS machine when I was in agony with my bones (ugh) and it did ease the pain quite a lot. then, this year when I managed to get 3 new wedge fractures in my spine the TENS machine made the excruciating pain I suppose it depends on the kind of pain, where it is, and how you are feeling...ah well, I expect we could all go on and on about this....just wish they could find a "miracle" pill that would help us all....yeah, that'll happen :p :p Lots of good wishes to you. :)

  • Louisiana, Hi,

    I just read your comment regarding a miracle pill that would make us all pain free!

    Now this may sound a bit conspiracy theory, lol. But if the R&D of any pharmaceutical company did bring such a pill out that could infact do as you suggested that a miracle pill could do... well I don't think it would even be made public! Due to all the costs of the research and development, then applying for patents, meeing all safety etcetc.. Well basically every tablet that has been developed so far and has cost millions to develop, well they'd become more or less not worth a bean! No drug company would allow development, and small companies, well if they worked something out, along would come a big corporation with a big budget and basically money would change hands and tthe large pharmaceutical company thats bought the patent etcetc would... yes they'd bury it!. It does indeed seem that money is a good reason for it not to happen.

    I hope you do find something that works for you soon.

    kind regards Lynda

  • Hi, I understand how limiting it can be to go to Gp's etc about combining drugs. It can be amazing how they can miss how drugs should not be used together etc. In fact I think it is horrifying. Maybe, if people can, it is best to Internet search to find out about drugs supplied yourself and see what should/should not be mixed and matched. I have learnt one thing though which does seem not to be advised by the medical profession that.... the body gets use to pain meds. Therefore to keep increasing amounts or strength will ultimately reach a plateau where their effectiveness no longer works. The combined side effects can also be unseen but horrendous. I took high volumes of Ibuprofen and then Co-codomol for severe migrain for years. Result: they didnt work and I discovered I had damage to my liver.... caused by the pain meds. I now take the minimum I need, am glad to feel more alive even though feel some pain which I manage in other ways by stretching exercise, sleep etc. I think there is a real danger that patients so want relief from severe pain that they will blindly do whatever the medical practitioners tell them. I think that kind of trust can be more detrimental than we think. Please research and satisfy yourself if you can. Your local Pharmacist will be able to review your meds and provide advice more so than your Gp. I do hope this has been of some help.

  • I find my pharmacists fantastic for explaining how the different drugs work. On two occasions he spotted drugs that could have caused my lupus to flair. My next advice is form a good relationship with yours and get him/her to check all your scripts.

  • I agree, first talk to your GP then double check with your pharmacist and do provide info on any health products as well as meds.


  • My GP said that Tramadol is the next step up from the co codamol 30 I was taking. I was maxing the co codamol 30 most days but managing my pain better with Tramadol even though I can take one every 4 hours I am finding a I do not need it as much. Still have underlying pain but not feeling so severe.

    My wife swears by the TENS machine but because I have a few heart conditions I have been banned from it.

    Strangely Morphine has less of an affect on me as my Tramadol. I was admitted to hospital with collapsed lungs and was in pain and they gave me loads of morphine but they kept asking how I felt and a consultant bought in students to ask me questions about my problems and then asked them how much morphine do they think I had been given? They all gave a lot lower dose. The consultant stated I should not of been able to hold a conversation if I was normal ?

  • Thanks everyone for your excellent replies.. My reply to Louisana sums it up best.

    David has a lifelong membership pf the pain c;linic and between them. GP amd phar,acy his frugs are ,omitored very carefully. And ,e who gives them to him.

    I was just interested to find out where on the pain relief scale Tramadol fitted. Clearly, with the long time use of morpjine, he has moved well beyond that stage.

    It is hard to find a balamce between having pain relief and some life other than being a zombie.

    Because he is having to learn to walk again after his op - the extra pressure on his broken spine is very painful. Sadly the hospital ony looked at the success of the hip and not the whole picture. Physio would beneit his bits now taking the weight.

    Thanks again.

    Pat x

  • Tramadol now has been upgraded to a cat 3 medication. As such you will have to sign twice when you get a new script. The GP also will need to take further actions before He fills out the script.

    Sometimes, the GP will need to discuss before prescribing, so If this happens do not be suprised.

    Every twelve months you may have a meeting with the chemist to check your medications and also the GP will want to discuss your complete script with you at the same time. Remember Tramadol is a opiate type medication.

    Try using a TENS, that can reduce your doses of strong medications


  • Hello stranger Bob! Nice to hear from you

    How's things?

    Pat x

  • Hello Pat,

    Been hectic now seem to be starting a flare as we have so much going on with our old address.

    Been to a mass of meetings and associated nhs things.

    Physio causing more problems that the treatments worth so I am starting the needle and pins on Monday

    How are you both ???


  • Meessagge sent Bob

    Pat x

  • Hello Pat

    There seems no message

    Regards BOB

  • Wonder who I sent it too!

    Tried again.

    Pat x

  • “Cracked” ISBN: 9781848315563 a book written by James Davies Senior Lecturer Social Anthropology and Psychotherapy at The University of Roehampton (London UK) details some of the misleading and dishonest research results that have been presented in Professional Journals and conferences.

    “Bad Pharma” ISBN 978-0-00-735074-2 a book written by Ben Goldacre in 2012 details how drug companies mislead doctors and harm patients.

    The Drug Safety Research Unit (DSRU) has a take on the issue

    as well as

    which specializes in the adverse effects of drugs

    One has to research how one own body behaves in respect to drugs. This can take a number of years as one needs a great deal of feedback from other people, because it is very difficult if not impossibility to notice what one's own body does in various situations. It also takes time to build up a database of responses to various environmental situations.

    When fit and healthy who needs a database of responses to environmental situations. When a health disability manifests itself the database has to be built from scratch.

    The picture is made more complicated because muscle behaviour has an influence on how much pain can be generated. Hence the reason why chiropractic treatment, Alexander lessons, Reflexology Yoga, T'ai Chi and Martial Art study have a bearing on pain control. Sleep deprivation also has an influence.

    The body has a stress breakdown point. A health disability can reduce the stress at which the stress breakdown point occurs considerably. The behaviour of a painful condition below the stress breakdown point is very different than when the stress experienced is above the stress breakdown point.

    I do not take drugs for pain. I do things like Alexander Technique, Mindfulness, meditation, T'ai Chi. Chiropractic treatment helps with the pain caused by nerve root compression.

    You asked a question that does not have a simple answer.

    Hope what I provided is helpful.

  • Wow that's one very long list of numbers and letters. Thought it was going on for ever!

    My question was fairly si,ple for David's treatment but yes everyone is different and how they want to approach their chronic pain. David had an op on his back 30years ago that by today's knowledge would be considered dangerous. It was done in good faith based on knowledge available and it went so wrong. He thenn had a double whammy of broken back with further nerve damage.

    As i said - you can only make an y decision based on the information available.

    With the drugs he already takes i was asking where did Tramadol fit? Was it higher or lower than cocodamol and fentanyl?

    You have found a drug free life. Good for you bit in the same way as I hate basket weaving it all depends on the individual and is wrong to say yhis is right and that's wrong.

    And don't forget he IS married to ,e!!

    Pat x

  • Hi iam in hospice for rest they have put me on morphine and tramadol It is working but need a lot of movicol. Artpats

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