Bupe (subutex) & Tramadol?

[chairmanma084]

First off, I've used the search engine. Didn't find anything about this. The only thing I've been able to find was an erowid experience report. That WAS helpful but it was just a report. So I take 4mg of subutex each day. I have been taking gabapentin recently for migraines but stopped after reading some horrific withdrawals stories. I haven't experienced any, so I think l'm in the clear there. I get migraines like 3-4 a week so sub apparently doen't help with that alone. Anyway...

I have some pretty serious pain issues in addition to my migraine situation. I was given tramadol basically as a "breakthrough" pain killer. I took 50mg yesterday and felt absolutely zero relief. I'm 190lbs, male. I have a very high tolerance to opoids from all of my past drug abuse.

Does anyone have experience mixing these two drugs? What dosage should I try? I'm not trying to get high, I just don't want a bad interaction b/c I took too much and I'm tired of the pain, so I wanna take more than 50mg...any help would be greatly appreciated.

 

[Jabberwocky]

I don't see tramadol touching your receptors since you are on bupe, don't mix them, you'll just experience the nasty SNRI part of tramadol, on the opioid level of things it's like you didnt take it at all. bupe has a huge binding affinity compared to tramadol, tramadol itself has for example lower affinity than it's metabolite o-desmethyltramadol which has more on the mu receptors if I remember right, might be mixing it up tho. anyway for breakthrough pain you could have something else than bupe if it doesn't help, talk with a GP. taking more than 50mg would lower the seizure threshold, i'm on tramadol myself, it's not effective at all as a pain killer, the only thing that can be a hint of pain killing is that the SNRI effect make you wired and you are kind of distracted from the pain, but not like a semi-syntethic opioid or a true opiate. with bupe you can't take pretty much anything over it without having to do huge doses and OD and maybe die from respiratory deppresion. methadone users for example face a similar problem themselves.

 

[FutureReference]

4MG of Bupe is enough to completely saturate your opioid-receptors. Tramadol will have zero effect for you aside from anti-depressant properties but I see no need to mix the 2.

Is the same doctor prescribing you the Subutex prescribing the Tramadol? If so, that is very odd. The combination of drugs works but would be better suited if you were on Butrans. In transdermal form the dosage of Bupe is much lower and thus Tramadol will have some receptors to cling to.

As you are in severe pain, my recommendation is as follows: take less Bupe. Seriously. It is the only opioid that genuinely treats pain better in lower doses. It is converted to norbuprenorphine and actually will help you out. Forget the Tramadol. Try taking a 1MG dose instead of 4MG, or even 0.5MG. There is a reason Suboxone is made in such high doses and literally says on the website it is not meant for pain. The higher doses simply fill all receptors to cut cravings for other opioids but are not good for pain.

I was on 32MG of Suboxone for years and once I started taking 1.5MG (1MG morning 0.5 afternoon) I had legitimate relief. Of all the painkillers I was on, Tramadol was the least helpful anyway. Truly not worth it and it carries with it withdrawals of stronger opioids that actually help.

 

[chairmanma084]

That's why I'm on 4mg. They started me on 16mg for some reason. I got sick taking that much. I AM on suboxone for substance abuse. I got hooked on painkillers while treating pain issues stemming from several surgeries and an ongoing situation. Anyway, I got on suboxone to calm that addiction a bit and make life more manageable. If I get down to 1mg/0.5mg a day, will tramadol then help with the pain?