Is Tramadol Still Available Over The Counter?

[Mudcrab]

I buy 500 capsules for Bt450. I’ve been taking 6 (occasionally 8) capsules per day for years. It is only addictive for some people – not me. No effect on my driving. No adverse effect in conjunction with alcohol for me. It only reduces my chronic pain a little but that’s better than nothing.

Hahhahahha keep taking the pills!!!!

[Mudcrab]

Yes, thats how it is for me too, it is rare i eat them, i tend to forget they exist,

i dont like eating any medicine unless i have no choice

Bit of seasoning might liven them up.

I hear grasshoppers with pork seasoning, Tramadol and a nice red go down a treat !!!!!

[Mudcrab]

Tramadol can also safely be combined with paracetamol for increased pain relieving effects

Just ask the hostage

[avidflyer]

The United States' NIH does not mention any addictive properties for Tramadol. The NIH is a seriously conservative organization. No way it could be addictive for anyone without NIH waving BIG RED FLAGS.

[Fgis]

It Tramadol good against back pain ?

[Khonwan]

I buy 500 capsules for Bt450. I’ve been taking 6 (occasionally 8) capsules per day for years. It is only addictive for some people – not me. No effect on my driving. No adverse effect in conjunction with alcohol for me. It only reduces my chronic pain a little but that’s better than nothing.

How can you say it's not addictive while you have been taking 6 to 8 capsules daily for years? Have you tried stopping? "Being addictive" and "making you drowsy/unfocused/high" are two separate issues.

I know because I have indeed stopped taking it for two weeks (cold turkey) last year; I’ve written about this in another tramadol topic not long afterwards. And yes, my knowledge of the English language extends to making a differentiation between those two states you refer to.

[Sheryl]

There is a wealth or scientific literature attesting to the fact that tramadol use can create physical dependence and lead to withdrawal symptoms, although it seems to do this less easily than the opioids.

From Lakartidningen(a Swedish Medical Journal)2003 Feb 27;100(9):712-4. Title: Treatment with tramadol can give rise to dependence and abuse. :"Tramadol is a centrally acting opioid analgesic which is increasingly used in Sweden. Dependence, abuse and withdrawal has been reported in patients treated with tramadol. The incidence of these adverse effects is considered to be low. Patients with a history of substance abuse might be at higher risk than others to develop dependence. The number of forged tramadol prescriptions uncovered in Swedish pharmacies was relatively low in 2001, compared to those of prophoxyphene and codeine, but increasing."

from Drug and Alcohol Dependency 2003 vol 69 Title: Physical dependence on Ultram (tramadol hydrochloride): both opioid-like and atypical withdrawal symptoms occur. "In 1994, the Drug Abuse Advisory Committee (DAAC) of the Food and Drug Administration (FDA) concluded that Ultram (tramadol hydrochloride) could be marketed as an analgesic drug without scheduling under the Controlled Substances Act based upon extensive pre-clinical, clinical and European epidemiological data. However, to guard against unexpectedly high levels of abuse in the United States, the DAAC recommended that an independent steering committee (ISC) be appointed to proactively monitor abuse/dependence. In the event that high rates of abuse were found, this ISC was given the authority to immediately recommend to the FDA that Ultram be scheduled. In the course of the surveillance project, the ISC received reports of withdrawal following abrupt discontinuation of Ultram and in some instances, following dose reductions. In most cases, the withdrawal symptoms consisted of classical opioid withdrawal, but in some cases were accompanied by withdrawal symptoms not normally observed in opiate withdrawal, such as hallucinations, paranoia, extreme anxiety, panic attacks, confusion and unusual sensory experiences such as numbness and tingling in one or more extremities. Withdrawal symptoms of either type were one of the more prevalent adverse events associated with chronic Ultram use, comprising nearly 40% of all adverse events reported with Ultram. Most of these consisted of typical opiate withdrawal symptoms, but 1 in 8 cases presented as atypical. These results indicate that physicians and other healthcare professionals need to be aware of the potential of Ultram to induce withdrawal of the classical opioid type, and that atypical withdrawal may also occur."

Tramadol has since been made a scheduled drug in a number of US states.

In other words, caution is needed.

[JDGRUEN]

Sorry for the slightly off topic question - but it is related... Does anyone know if the pain medication propoxyphene hydrochloride. Darvon / Darvocet is available in Thailand - over the counter?

[poanoi]

It Tramadol good against back pain ?

Yes, i take it for back pain, when i cant stand it any longer

[mommysboy]

I can imagine that it might cause psychologically dependence to those that are already troubled who might misuse it, or who use it as a recreational drug in conjunction with other drugs, eg, alcohol.

The trouble with studies is that they often end up saying what someone wants to prove, and are often countered by an equally volumnous amount of studies proving the opposite. As a mate of mine said, 'figures don't lie but liars can figure'.

It must be used sensibly and being of a generally addictive nature I am quick to put it aside, but I can understand why others can go on and on without any problems.

Not to be toyed with. And the question is not so much is it available, as do you really need it?

[Sojourner17]

Tramadol is still available at various pharmacies and very effective,but it`s also VERY addictive.I`ve used it in some periods when I have Sciatic pains,but I`ll only use it as a last resort when the pains are unbearable.

Good luck .

Actually, tramadol has the lowest abuse potential of any drug in this class. Not to say it has zero addictive potential, but compared to even codeine, it's relatively low risk.

[maturebrit]

I had a high speed bicycle accident 3 days ago involving a song-low going the wrong way on the road shoulder. Head on and I ended up lying in the cargo area of the song-low. The upshot is I have a lot of very painful soft tissue bruising in my neck,shoulder, hip and knee. I have read Tramadol is a helpful pain killer. I have never tried it. The norelgesic I have been taking is of little help. I was told by a pharmacist today Tramadol is no longer available OTC. Have any other members any info on this?

The upside is that the police were very helpful getting things straightened out. The motorcycle was held by the police until the financial end was resolved. The moto driver paid to have my bike repaired. And all parties concerned said I should go get checked out by a doctor. The reason I didn't was I would have been out of pocket for any treatment, even though I was told I would be reimbursed. I felt that was wishful thinking. Also I am sure I have no broken bones.

tramadol are great and quite strong but quite frankly you really should go get a doctor to check you out first..... you might end up doing damage if you dont....

sorry to hear of the incident and hope you recover asap....been there done that

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[Sheryl]

Sorry for the slightly off topic question - but it is related... Does anyone know if the pain medication propoxyphene hydrochloride. Darvon / Darvocet is available in Thailand - over the counter?

Not available in Thailand period, even with prescription. It has never been approved for use here.

Your OTC pain killer choices in Thailand are paracetemol, aspirin, a very wide range of NSAIDs, and tramadol.

[jrtmedic]

Propoxyphene AFAIK withdrawn in the USA an Europe in about 2005-6 due to addiction,fataliities and cardiac problems associated with usage.

Maybe still available to the chronically addicted by special prescription if a doctor can be found who is willing to prescribe !

[Khonwan]

My aim is not to dispute that tramadol can, in some cases, lead to addiction but rather to suggest that a great many people find it a useful, and even the most useful OTC medicine for certain conditions, without becoming addicted or suffering any other major side effect whilst not consuming more than the 400mg total daily dose.

I believe, based on reading many sources over the years, those most at risk of addiction from this opioid are those who tend towards addiction be it with alcohol, tobacco, gambling, etc.

Tramadol’s effectiveness also varies between people. I find it also varies between conditions. It does nothing for me should I occasionally suffer sinusitis or a headache. NSAIDS proved more effective for the pain in the weeks after my surgery, last year, for a broken collarbone that required a plate. Paracetamol are more effective for me for dental pain. I use tramadol for my chronic back pain caused by ankylosing spondylitis (AS; a form of arthritis). I also take NSAIDS for this condition but only to minimize inflammation in my joints since they do not appear to help with the pain, in my case. Tramadol is my OTC drug-of-choice for my AS but even it is of very limited benefit to me, simply taking the edge from my chronic pain (my pain is not acute), which allows me to function a little better in my daily life.

In order to counter my perception of increasingly negative reports on tramadol, I read http://www.ranzcp.or...spx (published April 2009 with imprimatur from The Royal Australasian College of Physicians, Faculty of Pain Medicine ANZCA, The Royal Australian College of General Practitioners, and The Royal Australian & New Zealand College of Psychiatrists) from which the following has been lifted:

4.3 Evidence for risk of dependence

There is currently no Australian data from which to infer the

numbers of people with CNMP who are legally prescribed

opioids for the relief of their pain and who subsequently

develop dependence on opioids. However, general

consensus is that this number is generally small.

Methods for detecting and measuring severity of prescription

opioid dependence are weak. The published randomised trials

have been of too short duration to allow for the development

or detection of atypical drug use, even if appropriate

screening tools for addiction or dependence had been used.

Some studies excluded patients with ‘addiction.’ In others

adequate criteria for diagnosing ‘addiction’ were lacking. For

example, it is hazardous to equate reported ‘drug craving’ or

‘reported symptoms and signs of addiction’ with addiction. In

only a minority of comparative trials have investigators even

attempted to approach this question. Furthermore, none of

the studies were rigorous enough to draw conclusions about

opioid prevalence of addiction or use.

(CNMP: chronic non-malignant pain)

Edited January 21, 2013 by Khonwan

[Sheryl]

Note that the above is not discussing tramadol but rather opiates in general. (Tramadol is an opioid agonist but not an actual opioid).

'

Adfdiction risk from painkillers prescribed by western docs and addiction risk from self purchased meds without medical oversight may also nto be quite the same, the latter likely more of a risk.

[Khonwan]

Ah but, if you read the report again (page 15 of the document), it specifically includes tramadol as an opioid (at least for the purpose of the Colleges’ findings). It makes the distinction between opiates (which tramadol is not) and opioids (including tramadol) therefore the article I posted very much applies to tramadol. I do agree, though, that the unsupervised purchase of tramadol as an OTC drug increases the risk of abuse and addiction compared to that of prescribed tramadol. Personally, I hope it remains OTC in Thailand (I have far greater concerns over OTC antibiotics!).

Opiates and opioids

Opioids are drugs that have actions similar to those of

morphine. Opiates, a term commonly but incorrectly used

synonymously with opioids, are substances that are derived

from opium and strictly speaking include only codeine

and thebaine. For the purposes of this document ‘opiates’

refers to drugs derived from the opium poppy: morphine,

heroin, codeine and thebaine; ‘opioids’ refers to drugs

that have actions similar to those of morphine including

the opiates, but also synthetic and semi-synthetic drugs

including pethidine, hydromorphone, fentanyl, methadone,

buprenorphine, oxycodone, dextropropoxyphene,

dextromoramide, pentazocine, tramadol and others (see

Appendix three), all of which are ‘prescription opioids’ in

Australia and New Zealand.

(tramadol underlined by me)

[jrtmedic]

"Adfdiction risk from painkillers prescribed by western docs and addiction risk from self purchased meds without medical oversight may also nto be quite the same, the latter likely more of a risk"

One must of course exclude the USA which as a result of irresponsible prescribing now has a major problem with "prescription drug" addiction.

[jrtmedic]

Khonwan

Thank you for your interesting post.

AFIK there is very little evidence of "opioid" addiction occuring in patients who are prescibed these medications for sound clinical reason.

As an example I know of a relativly young man who used Fentanyl patchs for chronic, severe , arthritic hip pain for over 3 years. He was delighted to be free of the need to use the patchs once he had undergone a successful arthoplasty !

[The Dude]

The Dude's experience is that Tramadol is indeed addictive and withdrawal symptoms are massively worse than codeine. careful with this med folks. cannot dig it

[candypants]

I buy 500 capsules for Bt450. I’ve been taking 6 (occasionally 8) capsules per day for years. It is only addictive for some people – not me. No effect on my driving. No adverse effect in conjunction with alcohol for me. It only reduces my chronic pain a little but that’s better than nothing.

How can you say it's not addictive while you have been taking 6 to 8 capsules daily for years? Have you tried stopping? "Being addictive" and "making you drowsy/unfocused/high" are two separate issues.

my thoughts exactly, 6 to 8 a day for years? sounds like a habit to me.

[Khonwan]

I buy 500 capsules for Bt450. I’ve been taking 6 (occasionally 8) capsules per day for years. It is only addictive for some people – not me. No effect on my driving. No adverse effect in conjunction with alcohol for me. It only reduces my chronic pain a little but that’s better than nothing.

How can you say it's not addictive while you have been taking 6 to 8 capsules daily for years? Have you tried stopping? "Being addictive" and "making you drowsy/unfocused/high" are two separate issues.

my thoughts exactly, 6 to 8 a day for years? sounds like a habit to me.

And do you have knowledge of the recommended dosage? And do you suffer chronic pain for which there is no treatment? Or do you just like to pass frivolous judgement on people you do not know? Go and educate yourself first, or restrict yourself to the general forum where the bar is set suitably low.

[candypants]

i don't want to argue with you about it, as i am far from an expert.

i suppose if it was a habit you would be pretty defensive about it, though that certainly does not seem to be the case here.

Edited January 22, 2013 by candypants

[Khonwan]

i don't want to argue with you about it, as i am far from an expert.

i suppose if it was a habit you would be pretty defensive about it, though that certainly does not seem to be the case here.

Thank you.

The maximum dosage (as per the label) is 8 capsules (50mg capsules) per day. Funny thing is, as I posted my previous reply to you, I had already forgotten to take my due dose – by around 3 hours; the reason being that I have no craving for the medication. I don’t experience pain when I’m lounging, resting my back (which is what I was doing), which is why I rarely take the last two permitted capsules at night.

I am fortunate (as are the majority of people in the general population) to not suffer from addiction to anything. I’ve never even tried to smoke a cigarette in my life, nor ever tried any illicit drugs despite being a teenage college student in Holland in the ‘70s when access was quasi-legal. I have always enjoyed moderate alcohol, consuming probably 7-10 bottles of beer per week for several decades yet have reduced this to less than 1 bottle per week during the past 2-3 months in order to lose weight (successfully), with no craving for alcohol.

And, as previously stated in my reply to wpcoe above, I have made sure that I’m not addicted to tramadol by purposefully coming off it “cold turkey” last year for 2 weeks without problems.

Opioids get a bad press, but quite unfairly as per the full document I’ve posted, which has impeccable credentials. As with most aspects of life, dissatisfied consumers tend to report their experiences much more than satisfied consumers hence a look at forums such as this may easily lead one to reach the wrong conclusion about tramadol – a drug that is misused by those who do not require it medically and used appropriately by those whose conditions require it to better function in their daily lives.

[wpcoe]

IMHO the degree to which tramadol (or any substance) is addictive can vary from person to person. I believe the people who say they have taken tramadol long-term and can stop it cold turkey with no consequences. I also believe the people who claim to have substantial withdrawal symptoms when they try to quit tramadol.

There should be no tramadol holy wars. But, because some people DO experience addiction it is only prudent that people be advised the possibility of becoming addicted before they choose to start a course of tramadol.

[mommysboy]

IMHO the degree to which tramadol (or any substance) is addictive can vary from person to person. I believe the people who say they have taken tramadol long-term and can stop it cold turkey with no consequences. I also believe the people who claim to have substantial withdrawal symptoms when they try to quit tramadol.

There should be no tramadol holy wars. But, because some people DO experience addiction it is only prudent that people be advised the possibility of becoming addicted before they choose to start a course of tramadol.

And equally I'm sure you'll agree that it is important that people who might derive great benefit not be put off by scaremongers.

As with any drug the benefits have to be set against the drawbacks in a given situation. Thus, for someone in chronic pain the choice to use Tramadol will likely be a no brainer.

[Mossfinn]

On the addiction aspect, I would suggest getting informed clinical advice, suggesting someone is addicted without knowing the persons full history, does seem like a leap of faith, in my opinion of course.

How it has been explained to me in the past, is that the most likely people who get addicted are those that take pain killers for a short term problem, do not come off them when the problem has passed and hence in time become addicted to the particular medicine.

Those that have long term pain management and are given medication to combat the pain generally will not become addicted, it kind of acts as a counter measure.

If you are in pain, take the prescribed medication, when you are no longer in pain, stop, you obviously will not become addicted.

If you are in long term pain, the medicine acts as a counter balance, you will not generally become addicted, although I am not entirely sure of your options in this case, come off the meds and be in agonising pain, I fear not.

And just to clarify, my information, comes from senior clinicians and Professors in pain management, but I am to see them again this week and I will clarify yet again.

[Mossfinn]

Thus, for someone in chronic pain the choice to use Tramadol will likely be a no brainer.

I posted before I saw yours, quite right of course.

[endi11]

First time user.Do you swallow the capsule,or let it melt in mouth.

[monty]

First time user.Do you swallow the capsule,or let it melt in mouth.

just swallow...

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