Dr. wants me to try this and then get oof Tramadol . Anybody with feedback good or bad. So far I have heard good things

It has a long half life in the body, and for some it is hard to titrate to a useful
dosage.

Its main drawback is that it affects the heart. People with any heart rhythm abnormality (some you are born with and are hidden) can lead to Methadone
stopping the heart.

I have an explanation for this in a sticky on the chronic pain forum.
When combined with other drugs that prolong QT it can be very problematic.

For example:
the most recent publicized event was Anna Nicole Smith's son who died of a combination of SSRIs with methadone. (at normal doses).

So it is suggested now that if you are going to try methadone, you have an EKG and have the QT segment evaluated and find there is no prolongation of it.

.......and I wonder why the big switch. Tramadol is a very mild opiate, but methadone is a potent opiate. There are many other meds in the middle with long acting properties that you could try first with the QT prolongation risks.

Methadone is also tricky because the 1/2 life in the body is long, but the
actual pain relieving time (activity at the pain receptor level) is less than the half life. I did a CE on this subject this summer. This makes the drug hard to handle if anyone has liver enzyme problems (inherited or acquired) and also who may have QT issues.

I think doctors are using methadone more for patients without insurance because it is inexpensive, and it has a lower abuse potential since it does not have the euphoria that other opiates have. It is very common now in the chronic pain community.

Razzle what are you taking tramadol for? If it is fibro... heavy opiates are not indicated for fibro (new data) anymore.
Tramadol is the preferred pain reliever for fibro patients.

I take the Tramadol for nerve pain for my Syringomyelia