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Tramadol Caution


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#1 thismoment

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Posted 26 July 2015 - 02:54 PM

Recently I sustained an injury to a muscle and was in a lot of pain. I saw the doctor a couple of days ago and she prescribed Tramadol HCL 50 mg-- up to 3 times per day as needed-- I was given a month's supply. 

 

I got the briefing from the pharmacist and I read the Cautionary Notes from the pharmacy that include these headers: Common uses; How to use this medication; Possible side effects; Additional information; and General information.

 

Tramadol appeared to be a straight-up pain med, similar to an opioid.

 

So I took one.

 

After a couple of hours . . . H E L L O . . . Yes the pain subsided a little, but there was something else-- something broader, heavier, and oddly familiar. I staggered to the computer  . . . Google . . . Tramadol HCL 50mg Wikipedia . . . 

 

SURE ENOUGH!! There it was: The drug includes a special bonus effect-- Tramadol inhibits the reuptake of serotonin and norepinephrine-- it's a bloody SNRI.

 

Tramadol (marketed as Ultram, and as generics) is an opiate pain medication used to treat moderate to moderately severe pain.[1] When taken as an immediate-release oral formulation, the onset of pain relief usually occurs within about an hour.[5] It has two different mechanisms. First, it binds to the μ-opioid receptor. Second, it inhibits the reuptake of serotonin and norepinephrine. wiki

 

I emailed my physician and expressed my disappointment, having struggled for more than 2 years to withdraw from the SNRI Duloxetine. Then I took the remainder of the drug back to the pharmacist for disposal, with the request that they include the SNRI information in their Cautionary Notes.

 

I've said it before: We have to be our own medical advocates!!


#2 TryinginFL

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Posted 26 July 2015 - 03:28 PM

TM,

 

Gosh, I'm sorry to hear that.  Wow - what a surprise! 

 

Good thing that you looked it up - I remember taking it years ago for pain and had no idea! 

 

Hope that you will soon be doing better, even without the pain killer.  All of these experiences thankfully make us all more leery of what we are taking.  


#3 fishinghat

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Posted 26 July 2015 - 04:40 PM

Tramadol is actually considered an NRI and an SRI. That is a norepinephrine reuptake inhibitor and a serotonin reuptake inhibitor. The action is a little different than an ssri or snri. Yes, both block reuptake of serotonin into the post neuron receptors but the mechanism is different. The ssri/snri block the pre neuron receptors and allows the buildup of serotonin/norepinephrine making it more available to the post neuron receptors. NRI and SRI block the proteins that carry serotonin and norepinephrine therefor not allowing the reuptake at either type of receptor. Tramadol is considered on of the weakest NRI/SRI. But just like TM said. You sure don't want to take it with an ssri or anri AND it still is an antidepressant with a bite for a withdrawal.

 

Good catch TM.


#4 lady2882Nancy

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Posted 26 July 2015 - 09:08 PM

OMGosh my Hubbie's doctor (the idiot doctor that I had to deal with for so long) just prescribed Tramadol/Acet for his back pain.

I have been questioning it as my Hubbie does like his rye and water in the evening and the acetaminophen is hard on the liver. Now I am even more concerned.

I don't know what I can do about it though as there is no way that Hubbie will believe me that it is bad for him (he still thinks that this doctor can do no wrong despite what happened to me) especially since it is helping so much with his back. He has arthritis, spinal stenosis and a twist in his spine. 

I guess all I can do is keep an eye on him and be prepared for whatever happens. It does explain the change in his mood in the last week or so as he has been on it for a month now.

Oh how I do hate that we no longer have doctors who educate themselves on the meds they prescribe.

 

Thanks for the heads up.


#5 thismoment

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Posted 27 July 2015 - 12:30 AM

LN

 

"Oh how I do hate that we no longer have doctors who educate themselves on the meds they prescribe." Exactly; I got an email back from the doc who said not to worry because it only affects the u-opioid receptors. 

 

The doc hadn't looked it up, and I didn't argue. I just returned the pills to the pharmacy for disposal. My muscle is sore, but it will heal.

 

Next time around I will research the appropriate meds myself and ask for them by name.


#6 Ramona80

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Posted 30 July 2015 - 06:04 PM

Wow! Good thing you caught it! I completely agree with you that we need to be our own advocates! 


#7 hyg

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Posted 03 August 2015 - 03:50 PM

ThisMoment, I am sorry that happened to you, and so glad that you weren't taking cymbalta when it did. That had me wondering if doctors still write tramadol prescriptions (or fentanyl) for patients taking cymbalta. Very scary thought. Thanks to all of my forum friends, I now take an additional step with all of my patients. I go to Rxlist.com, input all of their medications to check for drug interactions, and give them a copy. If they have questions, I immediately refer them back to their doctors. Thank you to everyone who posted that site. Hyg



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