Is Tramadol Still Available Over The Counter?

[Italian guy]

Update: Tramadol in its pure form seems not to be available OTC anymore. However, it can be purchased in combination with paracetamol (1 pill = 37.5 mg tramadol HCI - 325 mg paracetamol) with the commercial name of ULTRACET. There might be other brand names of the same or similar compound around, not sure about that.

[Sceptict11]

When using aceamenophen (paracetamol) take not of the following !

“Liver warning: This product contains acetaminophen. Severe liver damage may occur if you take • more than 4,000 mg of acetaminophen in 24 hours • with other drugs containing acetaminophen • 3 or more alcoholic drinks every day while using this product.”

ref

http://www.fda.gov/Drugs/DrugSafety/ucm310469.htm

[Sheryl]

Update: Tramadol in its pure form seems not to be available OTC anymore. However, it can be purchased in combination with paracetamol (1 pill = 37.5 mg tramadol HCI - 325 mg paracetamol) with the commercial name of ULTRACET. There might be other brand names of the same or similar compound around, not sure about that.

The pharmacy you went to may not have had it, but tramadol by itself is still OTc in Thailand, as of cousre is tramadol + paracetemol.

Brand names for tramadol alone:

Amanda

Anadol

Analab

Ambron

Madol

Madola

Modesnal

Pacmadol

Paindol

Pharmadol

Ramadol

Sefmal

Tamolan

Tracine

Tradolgesic

Tramada

Tramadil

Tramadol Stada

Tramadol T.P.

Tramadol Utopian

Tramadan

Tramal and Tramal retard (this one is an import; sanofi aventis)

Tramamed

Tramax

And several others.

ultracet is AFAIK the only brand of combine dtramadol + para.

[jmccarty]

It Tramadol good against back pain ?

I have been taking it off and on since May last year when I broke 4 vertebrae and ruptured 7 discs. It does work, but my tolerance to it has increased to where 200mg is needed to get a bit of relief. I do find that I can not sleep well at night if I take Tramadol and have gone for up to 4 months without taking it. When I do take it, still seem to have a high tolerance to it so need ever higher doses.

Codeine works better in my opinion.

[Sceptict11]

Read about Tramadol before taking it !

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

[wpcoe]

I was initially prescribed tramal for a ruptured disc, and was probably on it for ten days or two weeks, and was able to wean myself (actually the doctor gradually reduced the dosage) off of it with no withdrawal issues.

However, in July I reinjured my back and thought I would self medicate. I tried going off the tramal several times but found the pain was still enough that I needed to keep taking it. I was on tramal for over four weeks, though was able to wean myself from 6x (300mg) daily at the onset to 2x daily (100mg) in the fourth week. However, after I stopped totally, the withdrawal was not pleasant. I would take one 50mg tramal every other day just for some relief from the withdrawal.

[Sheryl]

Yes, while tramadol is generally thought to be less addictive than opiates, it is still possible to develop dependency...and to need increasing doses to get the same effect. Caution is needed.

[MrHammer]

Yes, while tramadol is generally thought to be less addictive than opiates, it is still possible to develop dependency...and to need increasing doses to get the same effect. Caution is needed.

You can get withdrawals from chocolate too and not to mention nicotine.

Personally, I think that the risk of opiates are highly overstated because they are by and large not patented and therefore non profitable where as many NSAIDs are sold at significant markups while actually being very dangerous for your heart and brain. NSAIDs like Ibuprofen, Gofen, Celebrex etc have very real cardiovascular risks.

People prone to addictiviness get addicted. When I was some years younger and dumber I did some drug experimentation with the one beginning with 'C', but only 5-10 times total. Never had any kind of cravings at all, while a friend of a friend was completely addicted to a point were it really interfered with his life.

My point is that it is your brain creating the addiction, not the drug.

Paracetemol -> Aspirin -> Opioids/Opiates in that order.

[anon8]

However, after I stopped totally, the withdrawal was not pleasant. I would take one 50mg tramal every other day just for some relief from the withdrawal.

Could you describe the withdrawal symptoms, please!

[Sheryl]

However, after I stopped totally, the withdrawal was not pleasant. I would take one 50mg tramal every other day just for some relief from the withdrawal.

Could you describe the withdrawal symptoms, please!

I'll leave it to wpcoe to give first hand account.

but the known withdrawal symptoms include:

nervousness; panic; sweating; difficulty falling asleep or staying asleep; runny nose, sneezing, or cough; numbness, pain, burning, or tingling in your hands or feet; hair standing on end; chills; nausea; uncontrollable shaking of a part of your body; diarrhea; or rarely, hallucinations (seeing things or hearing voices that do not exist).

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a695011.html

[GaryB7471]

Chronic pain is horrible. I am lucky. A 100 count bottle of Advil last me for a year or more and I tell my Dr how much I take at my physical every year.

[wpcoe]

I will share that my withdrawal was probably related to the SSRI (seratonin) properties of tramal: my mental state and emotional stability were compromised when I stopped taking tramal.

The idea that some people are more prone to addictiveness probably has some merit. However, in the past -- in a waaay distant past -- I could take, or leave, recreational drugs and substantial quantities of alcohol without a hint of addiction. I partied with a lot of heavy drinkers (several of whom are now AA members in recovery) and recreational drug users and kept up with them. I never had a problem *not* drinking/partaking if I chose not to, even for a month or longer. I have also taken tramal in the past with no dependency/withdrawal issues. THIS TIME, however, was unpleasantly different.

So, yes, withdrawal from tramal "can be" problematic. Be thankful if it isn't an issue for you, but please don't discount the experience of others for whom it is.

In fact, I just ran across this recent (29-Aug-2013) DEA document on Tramadol, which states, in part:

"Tolerance, dependence and addiction to tramadol have been demonstrated. Abrupt cessation from tramadol has been associated with two types of withdrawal syndromes. One is typical of opioid drugs with flu-like symptoms, restlessness and drug craving. This type of withdrawal syndrome is encountered in about 90 percent of cases of withdrawal from tramadol. Another withdrawal syndrome (encountered in about 10 percent of cases of tramadol withdrawal) is atypical of opioids and is associated with hallucinations, paranoia, extreme anxiety, panic attacks, confusion, and numbness and tingling in the extremities."

I would say I was in that 10% group. Even though I thought I had intelligently weaned myself off tramal by gradually reducing the dosage, I apparently was in over my head. Although I struggled for about a week, I consider I probably had a relatively mild withdrawal.

[munz]

Hi folks, its Saturday 26th 2013, in Jan.of2001 I had a motorcycle accident and ripped off my left arm at the elbow and my right leg at the hip,among other injury and amputations,I went through 4years of reconstruction, pain theropy, physio,etc morphine addiction was enevitable, I removed the problem myself,getting off morphine my way meant a disclaimer for the doctor. Then they put me on dihydracodiene, which worked for the pain at first but I needed to take a higher and higher doseage, so then I was put on amatryptoline which made me hilucinate among other nasty side effects, I was then put on to tramadol, 200mg 4xa day,with paracetamol 200mg3x a day, the tramadol proved too high a dosage,making me drousy,forgetfull (I have short term memory loss from the 3 month coma) and generally run down, so i reduced the dosae myself I have been taking 2x 200mg in the morning, it takes 2-3hrs to ease the pain, every28 days I go 2days of hell with no painkillers but paracetamol,to make sure I'm not addicted, ( I'm not going through the morphine gig again!) Just recently I have been taking 200mg before sleeping as my osteo arthritus has become too pain full to sleep. I ran out of my tramadol on the 23rd, so its Time for two days off, yesterday, 25th I went to the pharmecy to restock, they looked at me like a criminal and shouted "no have! By lioy" so i went to lotus pharmecy and they said, "tramadol for addik, take this no more than 8 days" and gave me 120mg of arcoxia and said " this is morphine! " lol,,,,it isn't but it is so dangerous I'm not taking it! Today after two sleepless nights I have asked my village phu-yai-bahn to see if it is possible to buy tramadol any more and if not what do I do? My wife took a stroke 4 month ago and I am the only one who feeds,cleens and toilet,it is becoming,,,,,,,, hard to do while I'm in such pain,lm now considering having my left hand and foot removed, this may help with the pain,,,,,but this is a warning for those who need the pain relief from tramadol,,, don't take the arcoxia! The USA. Will not a prove it because it is so dangerous and the pharmacy will sell you anything else to get your money! Good luck, I will update when the phu-yai-bahn comes back

[munz]

It has been two hrs since my last post, my wife's Auntie, wife of the phu-yai-bahn,has just arrived with 40tablets, she got them from a friend who is a teacher,who got them from a friend who owns a pharmacy, it appears that a Thai person with a respected position can buy them,for now, my advice to anyone that needs to take these is,,,,if you are building up a tolerance, reduce your dosage and take the pain for at least 48hrs then go back to your original dosage, with most painkillers I have used, if you take More than the pain coverage you get a mild narcotic effect but this builds up your tolerance and leads to,,,meybe not addiction but dependance,,,and DO NOT UNDER ANY CICUMSTANCE TRY YAH BAH FOR PAIN, it WILL NOT HELP, and it WILL DESTROY YOUR LIFE AND FAMILY,,,,WITHOUT EXCEPTION! Good luck guys if I come up with anything us full I will post it, my pain is easing now so i need to go shower my wife

[TravelTeach]

Do hospitals prescribe tramadol (for example if you have migraines) or would they just say "go to any pharmacy"? I guess what I mean is, although it's OTC, do doctors prefer you to have a prescription?

[wpcoe]

Hospitals do, indeed, prescribe tramal. (That's where I first got it.) They hope (and pretty much expect) that you will buy it at the hospital pharmacy, due to the high markup they add to the price.

At the various pharmacies I've bought it, no prescription was needed. Just: "How many do you want?"

[Sheryl]

It has long been OTC but there has been discussion of making it prescription ony and soem recent member reports suggest this may have happened.

[uhuh]

Tramadol cannot be sold OTC any more.

This has been the case for about 3-6 months now.

Some pharmacies don't care and still sell old stock. Others will sell it OTC and keep a record of your passport number. Most will not sell it.

[Sceptict11]

Tramadol cannot be sold OTC any more.

This has been the case for about 3-6 months now.

Some pharmacies don't care and still sell old stock. Others will sell it OTC and keep a record of your passport number. Most will not sell it.

Strange !

I bought some just last week without any difficulty.

[uhuh]

as i said

"Some pharmacies don't care and still sell old stock."

It also depends on which city you are in.

In Bangkok it is very difficult to get Tramadol OTC.

[CWMcMurray]

Not really true... I am in BKK and have bought it OTC in Many places over the last year.

Don't take it all the time, just when my back hurts (old car accident) ... Maybe a 10 strip every month and a half or so...

Some places will say they don't have it, but those that do have so far never advised that I needed a prescription

This is even at international chains in shopping malls...

Sent from my iPhone using ThaiVisa app

[Neeranam]

I took this recently when I broke my rib - the most painful thing I ever broke.

Some experts suggested, or warned me not to take for more than 8 days. I took for 10 days and got pretty screwed up. Very addictive. I remember thinking that I didn't care as I was in so much pain and it would be better to take the pain killer then suffer the withdrawal. Then I thought if I was going to have withdrawal from Tramadol, I may as well take some heroin. Be careful.

[Seizhin]

I am a pharmacist, and the answer is "yes, you can still purchase tramadol over the counter."

Last year, we received a letter from Thai FDA asking for cooperation to carefully observe patient who want to buy tramadol, and refuse sale if they look like they will be involve in tramadol abuse. There's no official law forbidding sale for tramadol yet.

Reason why some pharmacy refuses to sell it is, they have to keep record of "stock" and who they "sell" to.
It's big problem, some pharmacy will refuse to keep the record.

[Sheryl]

Post referencing illegal activity deleted.

I have not been able to confirm yet whether tramadol has been reclassified and if so how. (Drugs in Thailand fall into various FDA categories).

It still shows in Mims as category "D" (OTC, no prescription required, but daily sales records are and must have a first grade pharmacist on duty at all times), but Mims is not updates all that often. Nothing on the FDA website about it that I can find. The lists of controlled substances posted dates from 2012.

It is posisble that it is still category D but that the FDA has begun to enforce the category D requirements which usually they don't much bother with, and that would create a headache for pharmacies which might lead some to discontinue selling it. "D" is the most common category of drugs and all the antibiotics fall into it, for example, and these are obviously still being sold and often without much of any record of sales kept, and by non-pharmacists to boot, which doesn't seem to bother anyone. Possibly in light of recent death the FDA is now following up on this requirement for tramadol. Would explain why still sold by some pharmacies but no longer by others. Ones without a first grade pharmacist or unwilling to do the paperwork would have stopped while others continued.

Either that or there has been a recent reclassification which is not mentioned in either Mims or the FDA website.

[Sceptict11]

I just use one Pharmacy . The is always a Pharmacist on duty whilst the Pharmacy is open.

I last purchased Tramadol a couple of weeks ago.

The Pharmacist completed the daily sales record before taking my money.

[Brevity]

Has anybody had success using it for migraine headaches? That's what I really need help with getting some pain relief.

A friend of mine was using it for back pain caused by an accident and swore Tramadol gave him no help whatsoever. I guess it just doesn't work for some people or some types of pain?

[Sheryl]

I just use one Pharmacy . The is always a Pharmacist on duty whilst the Pharmacy is open.

I last purchased Tramadol a couple of weeks ago.

The Pharmacist completed the daily sales record before taking my money.

Sounds then like it is still category D, they have just started to enforce the long-standing Category D requirements. Any well staffed and professionally run pharmacy would then still be able to sell it, but those which have untrained or lower level personnel behind the counter would not.

[Sheryl]

Has anybody had success using it for migraine headaches? That's what I really need help with getting some pain relief. A friend of mine was using it for back pain caused by an accident and swore Tramadol gave him no help whatsoever. I guess it just doesn't work for some people or some types of pain?

See http://www.ncbi.nlm.nih.gov/pubmed/16324164

It does work for some people, but the only way to find out is to try.

Personally I have found it effective for pretty severe pain, e.g. I was able to switch from an IV opiate to oral tramadol within the first 24 hours following surgery and get full relief of incisional pain. But people do vary in their response. In particular I find that people who have been taking opiates for any length of time often say it does not help. Don't know whether this is because the tolerance they have developed to opiates affects their sensitivity to tramadol as well, or whether they are missing the euphoric sense that opiates provide (which tramadol generally does not), or what.

Have you tried triptans? (have to be taken at first sign of onset). As unlike general pain killers these are specific to migraine.

If your migraines are frequent you would also do well to consider preventive medication.

[Nignoy]

Try asking for Zydol,it is the generic brand of tramadol, it is available over the counter

[wpcoe]

Has anybody had success using it for migraine headaches? That's what I really need help with getting some pain relief. A friend of mine was using it for back pain caused by an accident and swore Tramadol gave him no help whatsoever. I guess it just doesn't work for some people or some types of pain?

I get strong, but infrequent, headaches and tramadol definitely gets rid of (masks) the pain effectively. However, for some people, there is a significant time lag before the tramadol kicks in. For me it can be up to three hours. If you need immediate relief it might not work quickly enough. Then again, for you, the time delay might be much shorter.

I can sense when my headaches are about to launch, so can take tramadol early enough to be of value. One 50mg tramadol usually gets rid of my headache pain for almost a day, and sometimes I need to take a second one for a second day. I used to take tramadol for back pain, but the last time I stayed on for too long (a little over two weeks, I think) and had significant withdrawal issues.