[DallasGuy]

Hi. I was wondering if my only chooses at night are to either try and cut the pain with Ibuprofen and Acetaminophen aka Tylenol, or take a peice of tramadol. When I do take tramadol I only take 12.5mgs, but I would love it if I had an in-between. I'm always scared to take tramadol as I don't want to become addicted to it, but at the same time, I don't want to be in pain. I'm already on a 300mg pill once daily of gabapentin.

[caroline2]

I've tried Tramadol some yrs ago and it did nothing for me. My two pain meds are ibuprofen and I take 2 before my head hits the pillow.... During the day, some ibuprofen and Pain RX herbal which I've been taking a couple yrs or more. And I use DGL for stomach protection. MY worst pain is from arthritis. The burn from nerve damage is pretty much gone. Now and then I get twitches in that area so don't know if the nerves will ever come back or not.

[Jomar]

Have you ever tried a TENS to block pain sensations or various topicals?

What type of pain is it? muscle, nerve etc.
Where is your pain located?

[razzle51]

never heard of 12.5 of Tramadol ..... I take 100mg of tramadol 3 times aday along with 600 gabapentin in am and in PM . Tramadol is not a narcotic so I think you can go up on dosage with no problem.. tramadol comes in 50 and 100 mg tablets ... are you reading that dosage of 12.5 correctly

[pinkswede17]

Originally Posted by DallasGuy

Hi. I was wondering if my only chooses at night are to either try and cut the pain with Ibuprofen and Acetaminophen aka Tylenol, or take a peice of tramadol. When I do take tramadol I only take 12.5mgs, but I would love it if I had an in-between. I'm always scared to take tramadol as I don't want to become addicted to it, but at the same time, I don't want to be in pain. I'm already on a 300mg pill once daily of gabapentin.

It is now a schedule IV med and technically part of it's mechanism of action is the same as every other opioid, it's classified as an opioid as of 2013.

I'm guessing you have nerve pain since you're on gabapentin? Depending on the cause, there are several different other meds for nerve pain -other NSAIDS - Aleve, prescription ones - Mobic, diclofenac, Celebrex, many others, muscle relaxants, Savella, Lyrica, amitriptyline, capsaicin, nortriptylline, imipramine, Cymbalta, Lidocaine patches, as well as other treatment modalities - TENS units like someone mentioned, spinal cord stimulators. There's a lot of other options out there. Talk to your doctor about other choices. Tramadol is pretty much the weakest opioid there is. Tylenol with codeine is considered about as effective as tramadol, but carries about the same addiction risks. I don't know if you'd be more comfortable with that. If you're only seeing a PCP and it's not effective, ask for a referral to a neurologist or pain management specialist, depending on the cause of your pain.

Good luck.

[mrsD]

I'd like to clarify a few things here for readers:

1) It is unlikely that 12.5mg (1/4 of a 50mg Tramadol tablet ) will work much for pain in an average sized adult.
The starting dose of Tramadol is 50mg as determined by the industry. But there is some evidence as published by Dr. Jay Cohen MD in his book that many doses of drugs are given that are too high for some. Here is a list of all his books:
http://www.amazon.com/Jay-S.-Cohen/e/B001IGOV4G
He believes that many doses of drugs are "arbitrarily" chosen for marketing and that some lower doses actually may work for some people. A study on Crestor for example shows that 5mg once or twice a week is very effective for lowering cholesterol.
But splitting doses does reach a point of below minimum effect, and I think 12.5mg of Tramadol for adults (depending on weight) is below clinical value.

It appears that his website Medication Sense is now closed.
But this one is still available:
http://www.jaycohenmd.com/bio.html
http://www.jaycohenmd.com/safermedication.html

I personally find 25mg of Tramadol effective, but just barely.

2) The Scheduling of drugs in the US into 5 categories, is basically done according to their addictive/abuse potential. Schedule IV only has 2 opioids listed in it:

https://en.wikipedia.org/wiki/List_o...drugs_%28US%29
Only 2 opioid drugs and many tranquilizers and a few muscle relaxants, and sleeping aids, appear in Schedule IV.

I personally believe that Tramadol is much weaker than codeine for pain relief. It does not have much anti-tussive qualities if any, like codeine, and it has seratonergic properties.
Here is a monograph explaining the differences between codeine and Tramadol:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

Because Tramadol is mostly activated to an active metabolite, it is sometimes not effective for patients with certain deficiencies in liver metabolism. It is also the reason why there is a time delay when taking it and experiencing pain relief (up to 3 hrs after swallowing).

I use Tylenol mostly for my PN pain. There is a type of extended relief of it, available, and is labeled Arthritis strength on the label. This is helpful at night especially and gets one thru that 3-4am pain hump.

I also use various topical products, a magnesium lotion, Biofreeze gel, Salonpas patches, and Aspercreme Lidocaine for my feet and knees. I rotate these depending on my flares which seem to coincide with severe changes in barometric pressures. (for these acute flares, I will use 25mg of Tramadol).

I get dizziness from Tramadol sometimes, and nausea, so I keep it for only very bad nights at the 25mg dose. Tramadol is preferred by neurologists for nerve type pain, and fibromyalgia. I've attended medical seminars for these chronic pain conditions, and tramadol was listed for both as better than opiates, and useful for its serotonergic effects.

DallasGuy... you might explore some topical agents. But use them carefully, and not all over the body. They are best for target areas that are moderate to small in size.

I'll throw this out there too... Dextromethorphan... DM.
It has some effects for reducing pain in some people. It is in many antitussive products and singley as Delsym.
20mg of this at night might help. But it does not work for all equally. People using antidepressant drugs should avoid DM however, as there is a potential for serotonin syndrome. I'd also avoid it with Tramadol.

Originally Posted by DallasGuy

Hi. I was wondering if my only chooses at night are to either try and cut the pain with Ibuprofen and Acetaminophen aka Tylenol, or take a peice of tramadol. When I do take tramadol I only take 12.5mgs, but I would love it if I had an in-between. I'm always scared to take tramadol as I don't want to become addicted to it, but at the same time, I don't want to be in pain. I'm already on a 300mg pill once daily of gabapentin.