37.5mg Tramadol X 1/day: Addictive?

[dddave]

#37.5mg Tramadol (Ultracet) seems to be the most effective OTC painkiller for my arthritic knees.

For about a month, I've been taking 1 tablet per day, around noon, before I go out.  It is far more effective than any of the NSAIDs (paracetamol, enteric aspirin, ibuprofin) I've used.

 

Is that low a dose still potentially addictive or capable of causing undesirable side-effects? 

Will the effectiveness of that dose likely diminish over time, requiring a larger dose for the same effect?

Edited June 25, 2022 by dddave

[billd766]

Where did you get the Tramadol from?

 

I got it from the hospital for a backpain problem and it has done my arthritic knees a lot of good as a sort of side effect.

 

I am on 50mg twice a day and I can only get it from the hospital doctor as my pharmacy tells me that it is prescription only.

[clearance]

Try to switch to Ketorolac, it is very effective and non-opioid, but I think in Thailand it is only injections, not tablets.

Also, you can ask for Nimesulide (Nise) in your hospital, it is another non-opioid that is very effective for arthritis related pain. 

 

With Tramadol you will need to increase dosage to get same effect every months or so, it is not suitable for long time.

Edited June 25, 2022 by clearance

[lopburi3]

39 minutes ago, clearance said:

Also, you can ask for Nimesulide (Nise) in your hospital, it is another non-opioid that is very effective for arthritis related pain. 

Banned in USA and much of the world due liver issues - not to be used for more than 15 days where not banned from my reading.  

https://en.wikipedia.org/wiki/Nimesulide

[proton]

1 hour ago, billd766 said:

Where did you get the Tramadol from?

 

I got it from the hospital for a backpain problem and it has done my arthritic knees a lot of good as a sort of side effect.

 

I am on 50mg twice a day and I can only get it from the hospital doctor as my pharmacy tells me that it is prescription only.

Many pharmacy sell Ultracet, even Boots, 145 baht for 10 but has about 350 mil paracetomol in it. Taking 2 does not seem to have much more effect.

Edited June 25, 2022 by proton

[KhunLA]

I'm NOT a DOC ...

 

But with such a low dose, once and early in the your routine, I doubt if you'll have any issues with dependence, or even needing to increase dosage, as long as your pain level doesn't increase.

 

You are way  below what many are prescribed for pain relief:

"Usual Adult Dose for Pain:

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain"

 https://www.drugs.com/tramadol.html

[Lacessit]

https://www.drugs.com/tramadol.html

 

I am seriously thinking we take far too many medications for our own good. I have eliminated five of mine with a combination of diet and exercise.

 

Every medication we take has to be processed by the kidneys and/or liver. Worldwide, 53% of deaths in the elderly are caused by acute kidney failure.

 

I don't have a problem with short-term use of medications to treat acute symptoms. It's when doctors start prescribing them for long-term use, alleviating the symptoms rather than addressing the root cause, that I say whoa.

[Hummin]

Weight loss and building up strenght to fight arthritic with knees with elastic band workout and balance board to finely quit painkillers. 

 

Boring and hard work but with time and patience most could be able to help themselves.

 

For others better start early than later. 

 

Have taken tramadol a few days once and awhile for my back, but I get mood changes when taking them, so not any good for me. And yes highly addictive for some, and toxic as well in the long run.

[RickG16]

16 minutes ago, Lacessit said:

https://www.drugs.com/tramadol.html

 we take far too many medications for our own good

We as in Americans? In my experience, Americans seem very keen to chuck medication down their throat.

 

Although I'm not saying it's exclusively an American problem, of course.

 

Edited June 25, 2022 by RickG16

[Olav Seglem]

2 hours ago, billd766 said:

Where did you get the Tramadol from?

 

I got it from the hospital for a backpain problem and it has done my arthritic knees a lot of good as a sort of side effect.

 

I am on 50mg twice a day and I can only get it from the hospital doctor as my pharmacy tells me that it is prescription only.

I takeone tramadol every evening for my legs pain.

It help.

Get it from my local doctor j  buriram, no problem.

(Also get from my norwegian doctor when in norway)

 

 

[Sheryl]

2 hours ago, billd766 said:

Where did you get the Tramadol from?

 

I got it from the hospital for a backpain problem and it has done my arthritic knees a lot of good as a sort of side effect.

 

I am on 50mg twice a day and I can only get it from the hospital doctor as my pharmacy tells me that it is prescription only.

This is untrue. Tramadol is still category D. It can be sold without prescription. However, a grade 1 pharmacist must be on duty at all times and records must be kept of all sales.

 

Many pharmacies cannot meet this requirement or do not want the hassle, and thus choose not to sell it.

 

Annoyingly, they then tell their customers it can't be sold by pharmacies rather than telling the truth i.e. that their particular pharmacy will not sell it.

 

Although record of sales is all that is required by law, the drug has become a popular "recreational" drug among Thai youth and mNY pharmacies are skittish about selling it for fear that they will be blamed later if there is an issue. Some respond to this by limiting the amount they will sell (my local pharmacy limits it to 20 tablets, for example).  Others will sell ultracet (tramadol plus paracetemol) but not tramadol alone. Still others may ask to see a prescription of some sort (Thailand does nto really have a prescription system - but a medical certificate that lists tramadol as treatment will suffice in that case).

 

Reverting to OP - a single dose of 37.5 mg, once a day, is not very likely to cause dependence if you keep it at that dose and frequency. Whether or not it will keep working at that dose, you will have to see.  The most common adverse effects with Ultracet are:

 

• Dizziness.
• Drowsiness.
• Nausea and vomiting
• Constipation.
• Dizziness
• Drowsiness
• Nervousness or anxiety
• Other mood changes
• Sweating.
• Itching.
• Headache.

 

[marin]

43 minutes ago, RickG16 said:

We as in Americans? In my experience, Americans seem very keen to chuck medication down their throat.

 

Although I'm not saying it's exclusively an American problem, of course.

 

Then what are you saying?

[RickG16]

1 minute ago, marin said:

Then what are you saying?

That many Americans have serious issues with medication and look for any excuse to pop a few pills. 

[Lacessit]

45 minutes ago, RickG16 said:

We as in Americans? In my experience, Americans seem very keen to chuck medication down their throat.

 

Although I'm not saying it's exclusively an American problem, of course.

 

Not at all, it's common to most Western countries.

Having said that, I continue to be gobsmacked by the amount and variety of medications dished out by Thai doctors. It's almost like an Olympiad, and the winner will be crowned by the managing body of pharmaceutical companies here.

[RickG16]

3 minutes ago, Lacessit said:

Not at all, it's common to most Western countries.

Having said that, I continue to be gobsmacked by the amount and variety of medications dished out by Thai doctors. It's almost like an Olympiad, and the winner will be crowned by the managing body of pharmaceutical companies here.

Agree... I think there is a culture of overprescribing, and that some Thais feel they haven't got their money's worth if they don't go home with a bag full of medicine. 

[bkk6060]

I have taken it on and off several times for various issues.  My opinion even at that low dose it can be  addicting and cause sleep disorders.  Combining it with alcohol or other medication is a very bad idea.

Add, unfortunately any of this stuff has side effects mostly with the liver and kidneys.  I took Celebrex for awhile and it worked great until I was told of the potential liver burnout, so I stopped.

Too bad there is not something that will help with inflammation or arthritis that is not a potential problem.   I guess some herbal supps. but those from my experience never really work.

 

[KhunLA]

15 minutes ago, RickG16 said:

That many Americans have serious issues with medication and look for any excuse to pop a few pills. 

Going to have to disagree with that.  Especially since ACA (obama care) came into play.  It's damn expensive to get a script and get filled, with deductibles and overall family plans, before things are covered.  Depending on one's plan of course.

 

Go to GP, cost you, get script, maybe refill once, depending what it is. Costs again, once or twice.  Then back to the GP, additional cost for new script, repeat, for another 1 or 2 week supply. 

 

If no insurance, then off the gov't hosp, more cost, and very short supply of meds, after hours waiting to get seen, depending on where you live.

 

Or you could just see Charles, Bubba or Jesus, down on the corner for some Oxy, cut that in 4, save you time and probably cost the same ... ????

[grain]

12 minutes ago, RickG16 said:

Agree... I think there is a culture of overprescribing, and that some Thais feel they haven't got their money's worth if they don't go home with a bag full of medicine. 

That's exactly the case. When Thais go to see a doctor they expect the doctor to give them a big bag of medicine to make them better, if the doctor doesn't give them any medicine, or only gives them just one type of medicine, then he's a bad doctor, and the word will spread fast. Thais will then avoid going to that doctor.

[billd766]

3 hours ago, proton said:

Many pharmacy sell Ultracet, even Boots, 145 baht for 10 but has about 350 mil paracetomol in it. Taking 2 does not seem to have much more effect.

Thank you for the information. I will ask the pharmacy. He normally tells me if there is a generic or an alternative.

[billd766]

2 hours ago, Sheryl said:

This is untrue. Tramadol is still category D. It can be sold without prescription. However, a grade 1 pharmacist must be on duty at all times and records must be kept of all sales.

 

Many pharmacies cannot meet this requirement or do not want the hassle, and thus choose not to sell it.

 

Annoyingly, they then tell their customers it can't be sold by pharmacies rather than telling the truth i.e. that their particular pharmacy will not sell it.

 

Although record of sales is all that is required by law, the drug has become a popular "recreational" drug among Thai youth and mNY pharmacies are skittish about selling it for fear that they will be blamed later if there is an issue. Some respond to this by limiting the amount they will sell (my local pharmacy limits it to 20 tablets, for example).  Others will sell ultracet (tramadol plus paracetemol) but not tramadol alone. Still others may ask to see a prescription of some sort (Thailand does nto really have a prescription system - but a medical certificate that lists tramadol as treatment will suffice in that case).

 

Reverting to OP - a single dose of 37.5 mg, once a day, is not very likely to cause dependence if you keep it at that dose and frequency. Whether or not it will keep working at that dose, you will have to see.  The most common adverse effects with Ultracet are:

 

• Dizziness.
• Drowsiness.
• Nausea and vomiting
• Constipation.
• Dizziness
• Drowsiness
• Nervousness or anxiety
• Other mood changes
• Sweating.
• Itching.
• Headache.

 

I normally order my BP and diabetes tablets by email once a month.

 

I have been on the BP medicine since 2006 when I had 2 stents fitted.

[Etaoin Shrdlu]

2 hours ago, RickG16 said:

Agree... I think there is a culture of overprescribing, and that some Thais feel they haven't got their money's worth if they don't go home with a bag full of medicine. 

A Thai doctor will never prescribe three meds when eight will do.

[Sheryl]

16 hours ago, billd766 said:

I normally order my BP and diabetes tablets by email once a month.

 

 

You can't get tramadol online or by email order, at least nto anywhere I know of. You need to go in person to a pharmacy that always has a "real" pharmacist on duty. They may ask for ID, since they are supposed to keep a record of purchases.

[Pumpuynarak]

I get Ultracet from my local Siam pharmacy and they always have me sign for them. The pharmacist told me not to take more than 4 tabs per day, no probs as i only use when i really need and the max i take is 2 tabs per day.

I find they are the only tabs that really do the job, forget Nurofen etc and the other tabs available in 7/11, a waste of time for me.

[billd766]

11 minutes ago, Sheryl said:

You can't get tramadol online or by email order, at least nto anywhere I know of. You need to go in person to a pharmacy that always has a "real" pharmacist on duty. They may ask for ID, since they are supposed to keep a record of purchases.

Thank you Sheryl.

 

I did a Google search last night on Tramadol and I am not happy with the doctor.

 

My wife took me to hospital as I was in severe pain for my bad back. I had a couple of X-rays, a blood test and some meds including Tramadol. That fixed my back and knees great. Last night I did a Google search on Tramadol and I am sure that is the cause of my problem. I have attached the Word file with my comments. He gave me 15 days supply of Tramadol 50mgand I have 2 days left which I will dump.

 

I have had trouble sleeping at night for the last week or so but I kept falling asleep in the day. I stopped taking Tramadol on Friday and I reckon it will take me another week to get over the Tramadol.

Tramadol side effects.docx

[Sheryl]

22 minutes ago, billd766 said:

23 minutes ago, billd766 said:

Thank you Sheryl.

 

I did a Google search last night on Tramadol and I am not happy with the doctor.

 

My wife took me to hospital as I was in severe pain for my bad back. I had a couple of X-rays, a blood test and some meds including Tramadol. That fixed my back and knees great. Last night I did a Google search on Tramadol and I am sure that is the cause of my problem. I have attached the Word file with my comments. He gave me 15 days supply of Tramadol 50mgand I have 2 days left which I will dump.

 

 

Unfortunately all pain killers have side effects. Not the doctor's fault. It often boils down to: which is worse, the pain or the side effects of the pain killer?

 

From the sounds of it, you were in severe pain and the tramadol relieved it. But gave you trouble sleeping etc. Not unusual.

 

I don't know how often you were taking it, but it might be wise to taper before stopping altogether. Because aside from possible withdrawal effects of the tramadol (if you were taking it several times a day, very possible) you may again have severe pain.

 

Would be worth addressing the underlying cause of the back problem. Depending on what it is, this might involve physical therapy , exercises and/or surgery. 

 

 

[BritManToo]

23 hours ago, dddave said:

 

Is that low a dose still potentially addictive or capable of causing undesirable side-effects? 

One a day for 30 days will probably be addictive. Not to mention the most common side effect of not being able to finish sex for every day that you take one. 

Edited June 26, 2022 by BritManToo

[proton]

2 hours ago, Sheryl said:

You can't get tramadol online or by email order, at least nto anywhere I know of. You need to go in person to a pharmacy that always has a "real" pharmacist on duty. They may ask for ID, since they are supposed to keep a record of purchases.

Mine does not just hands Ultracet over, Boots used to get you to sign but no ID asked for so you could sign Boris Johnson if you wanted to. Had one today with a few 100 pipers 8 year old blended single malts, recommended for aches and pains.

Edited June 26, 2022 by proton

[deptrai]

After taking Ultracet 3x daily for a week, I experienced a side effect...urinary retention.  I went back to Vicodin.  Fortunately, I later had surgery to correct my problem and have been mostly pain/drug free since.

[TimeMachine]

Stop taking it. It is not worth the risk. From experience, it is dangerous in more than 1 way and in Australia it's hard to find a Doctor that will prescribe it for good reason. Get off it now and find something else non opiod. Best cope with a bit of pain. 

 

Sure you can adopt the attitude that if you can get it freely and want to live happily while you can, but what happens when you can't get it and the sides kick in hard. You will be stuffed more than the pain you were initially in. 

[bkk6060]

I have taken it on and off for several years. It is an opioid and I think 100%  one a day can cause addiction.   Take one a day for a few weeks and try to stop.  This for me, causes withdrawls for 2 to 3 days.  Irritability, some confusion, and desire to take a pill to  "feel normal".

Everyone is probably different with their tolerance and addiction traits.  Even one pill affects me, others may not experience this.

Edited November 8, 2023 by bkk6060