Extended release or regular Tramadol?

[SleeplessinOR]

For those on Tramadol, do you find the ER version of the immediate release version most effective? What dose are you taking? Thank you.

[John_naylor]

I’m on 1800mg Gabapentin and 100mg Tramadol and am getting through. Slept through last night but a few days ago I woke up 3 times and dancing around all evening! Can’t seem to find the trigger…

A few months ago, I felt that I was in Tolerance to my Tramadol after about 15 years and my GP suggested a Tramadol holiday (bless him!). In trying to find a way of titrating down slowly from 100mg I was given extended release but it was ineffective and I couldn’t use it.

[Poe7]

I took Tramadol for 12 years. The immediate release bc the extended didn't take away the RLS symptoms at all for me.

As my Dr or I didn't know about Tramafol augmentation, he kept increasing my dose until I got up to the max allowed which was 400ng daily.

Two years ago I went to a new neurologist and she stopped the tramadol (slowly) and switched me over to methadone add I'm doing pretty good with that.

[SleeplessinOR in reply to Poe7]

Thank you for your reply. My neurologist gives me Tramadol, both ER and IM, and he also gives me oxycodone, but he refuses to give me ER oxycodone nor Methadone so I’m kind of stuck with what he’s giving me. I’m afraid to look for a new doctor as so many won’t give opiates at all and I refuse to take a DA medication. I tried gabapentin and couldn’t tolerate the side effects. The oxycodone works but only for about 2-3 hours at a time. I tend to metabolize medications very quickly. I am currently alternating the Tramadol and Oxycodone every couple of weeks but neither give me long enough relief to get quality sleep. I’ve stopped taking the ER Tramadol as it isn’t working at all anymore. The regular still does work but I’ve reached tolerance so not near as well as it use to. I know about the potential for augmentation, which is why I alternate as I won’t increase my dose even if the doctor would. What a mess.

[TeddiJ in reply to SleeplessinOR]

Hello. I was in a similar mess, as you say, for a number of months. One of the many things I have learned is that there are more doctors who would prescribe Suboxone than other opioids, as they say it is safer overall and less risk for them. Just wanted to point that out to you, as it does work very well and much longer than oxycodone. I also used kratom to get me through many messy months-I wouldn't have made it without kratom, due to various scenarios and waiting for new appts. etc. Hang in and good luck.

[SueJohnson]

You might want to try pregabalin. Although it is basically the same drug as gabapentin except you don't need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other.

[SueJohnson]

Have you had your ferritin checked? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. When you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, fast after midnight and have your test in the morning. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you advice.

[SueJohnson]

Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium, foods that cause inflammation, ice cream, estrogen, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, using a standing desk, listening to music, meditation and yoga.

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.

[ookla]

I found that the extended release version only lasted 18 - 20 hours and it was misery watching the clock, waiting to finally be able to take my next dose. I never could figure out the best time to have the drop off. I'm on the immediate release now and it's so much better.