Strongest between Tramadol 50mg and codeine

[Liz32]

Is one a better painkiller,or does it depend on where the pain is, and what type of pain you have?

[efilwol]

Codeine and tramadol are both 1/10 the strength or morphine (which is the gold standard of opioid pain relievers). Codeine needs to me metabolized into morphine in the liver and about 7-10% of the population are so-called "poor metabolizers" which means they cannot convert codeine into morphine. I am a poor metabolizer, so codeine does not work for me, but tramadol does. Tramadol is also different from most opiod pain relievers in that, as well as being a opiod agonist (the usual method of action in opioid drugs) it is also acts as a SNRI.

I use Tramadol MR (extended realease) 200mg BID and it definitely helps with me, but as juliesS observes, it also depends on what kind of pain you have - neuropathic or nociceptive. I have osteoarthritis among other things and I find tramadol useful whereas I have had no success with drugs sometimes used to treat neuropathic pain (anti-depressants and anti-convulsants like amitriptyline, pregabalin, gabapentin etc)

But everyone is different in how they react to medication, so the only way to see what works for you is try. Theoretically, codeine and tramadol should be the same strength, but depending on a number of factors, they may act very differently on different people and different types of pain. HTH.

[Liz32 in reply to efilwol]

Many thanks for your time and advice, its very helpful and I am pleased that you have your pain under control. Best wishes.

[tkountouris57 in reply to efilwol]

Everyone is different you are correct , I try all is well for pain , as I have AS tramadol 50 works but if I take more effect my balance , best no to take nothing if possible , but how can we , the EMBREL 50 injection I found useful for AS MOST OF THOSE PAIN KILERS ARE MORE ADDICTIVE THAN MANY OTHERS , codeine is no good drug , most of the population is poor metabolisers do not absorbed what they take , so need to try many different things , for me low dose of tramadol works to much and the side effects arrive ,

[teadrinker]

Hi Julie

I also had a lot of trouble getting Paramol earlier in the year. A pharmacist told me that it was something to do with the license-holder changing and therefore they'd stopped making it. I tried several different pharmacies, feeling like a junkie looking for a fix, before resorting to the GP for a co-dydramol prescription. felt like writing to the big pharmaceutical companies & saying, " It's all very well but where does this leave us pain sufferers?!" I liked the fact that you could buy it over the counter without having to trail up to the GPs every month, though they have now put it on repeat prescription for me & it doesn't seem to matter.

From what I remember, the dose was less potent than co-dydramol, but the wobbly, sickly side-effects seemed less with paramol. Seem to manage co-dydramol better if I take it with food.

As for tramadol - have re-named it "Trampled-on" as this is how brain & body felt after taking it!

[Hidden]

I use tramadol 50mg x 8 daily and Ihave taken them now for many years, backed up with TENS and amitrytalene75mg nightly and cox 2 inhibiters. It is generally thought that doctors

prefer to give tramadol instead of morphene. Although some pain clinics prefer to go to morphene far earlier and for a longer period. I feel that its best to have something in reserve

as you can with tramadol get used to it after a short period of time

I hope you can control or tolerate your pain

[Liz32 in reply to Hidden]

Thanks R.Bell, reaching the end of my teather i think it sure is time for action,i just never seem to have the time and when i do i grab it and try to relax, but even thats getting too painful. So i will go back to the Drs and get sorted hopefully