Opioids Let's talk TRAMADOL!

[jonnynobody]

I mistakenly posted this in drug culture before I saw this sub forum, so if there are any moderators listening, you're welcome to close that thread as I think this is the more appropriate section. So here it goes...

This thread is directed at individuals with experience taking Tramadol (brand name Ultram) both positive and negative.

I found tramadol by accident before they became a Schedule 4 controlled substance in the US and was both loving and abusing them for approximately 6 months with a prescription before issues developed. I thought because they weren't controlled, they weren't going to be addictive or habit forming. I initially started with 1 50MG pill and rapidly progressed to 6 tablets in a days time which brought on what I believe was seretonin syndrome which was one of the scariest experiences of my life. I then had to rapidly reduce from 6 pills/day to 2/day. I had to take 6 MG of xanax just to be able to sit on my couch and not convulse...mind you, I don't take nor do I abuse xanax; 6MG would knock me out for 2 days had I not been experiencing such horrendous withdrawal.

After a nightmarish 2-3 days, I finally leveled out. I was then taking 2/day in the morning and nothing else for the rest of the day (100MG). It was pure utopia for me. I had energy, I felt great, I was constantly in a positive state of mind, and was ready to take on the world every single day. Then I refilled my script, noticed the pills were different but didn't think much of it. I took my usual 2 tablets (round AN 627's) which takes 10-15 minutes to hit me (fast metabolism), but after 45 minutes I got none of the usual tramadol symptoms such as elevated mood, increased energy, etc...Instead, I got extremely anxious, nervous, hostile, and aggressive which is unlike anything I've ever experienced taking tramadol before.

I then verified online that the pills I was taking was indeed tramadol as I thought the pharmacy fucked up. They were indeed referenced as tramadol, but from a new INDIAN drug manufacturer called Amneal Pharmaceuticals who flooded the market with their new CHEAP formulation and it is like a completely different drug. I then experienced a 2 day hangover where I was depressed and agitated which is very unlike me. I tried one more dose and threw 150+ pills down the toilet; that's how bad an experience this was.

I then tried a different generic made by an ISRAELI pharmaceutical company called Teva. I took my usual 2 and within 15 minutes, I was so fucked up, I was terrified to drive less than a mile to go home and I subsequently passed out on the couch. My wife thought I had scored some H or something. I assured her, I just took tramadol. Again, I experienced something that was unique to this manufacturer. There was no pleasure, no satisfaction, no energy, no positive feeling; just agitation and severe anxiety. Extremely frustrated and unable to afford the brand name Ultram @ $2.52/pill, I tried another generic by Sun Pharmaceuticals; another INDIAN pharmaceutical company. I got the exact same experience from the Sun Pharmas (round 319's) as I got from the Amneal 627's.

I then decided to do some research online about my little conundrum as I strongly want some tramadol on hand for just 2 tabs once or twice per week, but something is indeed going awry with these generic formulations.

Low and behold, there are many reports online of people being switched to the amneal 627's (pharmacy gets a cheaper price) and reported the same experience I received. Since India can't even provide clean water to their citizens or keep their electrical grid up for a solid 24 hours, even in their capital city, I'm loathe to believe they can produce quality pharmaceuticals of the same quality as the Germans / swiss (i.e. Grunenthal) and my personal experience with their versions of tramadol confirm my suspicions. Both Sun Pharma and Amneal are currently under sanctions by the US FDA for a variety of reasons, none of which are appealing if you happen to be a customer of theirs.

I then called every pharmacy within 30 minutes of me (and I live in a large city) and EVERY single pharmacy was selling either Amneal or Sun Pharma as their generic tramadol. CVS stocks Teva. The previous generic that performed well for me (did lots of pill identification searching to zero in on this) was from a pharmaceutical company called Caraco which was just recently acquired by fucking sun pharmaceuticals (fuck my life). Tramadol is one of the most widely prescribed pain killers in the world and these shit bag Indian companies are snatching up the market by taking some obvious shortcuts in the formulation process that is allowing them to undercut every other manufacturer and my negative experiences (as well as many others) is the end result.

I have an appointment in 3 weeks and I'll be telling the doctor to write brand name only and I will report my experiences to him.

Any other tramadol fans experience this shit?

And before anybody gives me the right act about generics being equivalent to brand names; save your typing. There are a number of generics that have been pulled from the market or can't be prescribed due to the generic not performing the way the brand does. Now let me put this in terms drug users like us can understand:

Have you ever smoked good weed / bad weed?
Have you ever done good / bad coke?

Guess what, when it's chemically tested, it's all coming back positive for the substance it is. There's no good or bad factored into the equation is there? But any drug user knows there's good shit and bunk shit. Please understand this analogy before anybody tells me generics are the same; they're not. If it was indeed the same, Sun Pharma / Amneal could not possibly sell a tablet of 50MG tramadol HCL for 6 cents USD while Grunenthal (brand name) costs $2.52 for the same 50MG tablet. I got news; they're NOT the same.

Oh and another perfect example just came to me. Everybody knows and loves oxycontin right? Of course you do Try to give a generic oxycontin (oxycodone ER is what they're labeled here in the US) to a regular OC enthusiast and they will hand them right back to you and say no thanks. They oxycodone doesn't release the same way and the fucking 80MG oxycodone ER is like 5 times the size of an OC 80...nobody wants them.

I'm very excited to hear the feedback on this and as you can see, I did my homework on this.

 

[Kittycat5]

First, take whatever brand makes you happy. But you did not do enough homework. I wont go into the bioequivalence process but both the FDA and European equivalent have protocols in place addressing this.

But comparing pharmaceuticals to street drugs? You can see the fallacy in this. Street dealers only need to give their customers a good enough product to keep a customer base. They have no qualms in cutting their product with various substances. If you are lucky, these cuts are benign but many times they arent (levamisole in cocaine comes to mind). There are also shadier dealers who will try to pass something off as the original (see MDMA threads for examples) or sell you straight bunk. No pharmaceutical company, whether American, Indian or any place in between is going to put some ketoralac into their tramadol. They wouldnt last a month.

I also do not know where you got many generics are withdrawn, either. Many are recalled for various reasons but many brand name drugs are as well. Many injectable generics have been withdrawn from the market voluntarily for financial reasons, not safety or efficacy. The one example I can think of with no effort was a generic for Wellbutrin called Budeprion XL. After many complaints, the FDA determined that Budeprion XL was not releasing drug into the bloodstream in the same manner as the originator, Wellbutrin. You know who made this drug? Teva.

Now on pricing. You do understand that when brand drugs are brought to market they have a monopoly until the patent runs out, dont you? They can set the price as high as they want, or as high as the market will allow. Drug discovery and approval costs billions. Many fail. This is why Ultram is 2 bucks a pill and the generic six cents. Once that patent runs out, competition comes in and prices drop. And that Teva brand tramadol probably costs CVS less than 6 cents per pill but that is a different issue. (I am aware that companies had to license tramadol, does not make it cheaper).

And your Oxycontin example is ridiculous. The original "OC" Oxycontin has not been available for years. Of course abusers liked it better. It could be crushed, snorted, injected, whatever. But the generics currently available (not true generics, authorized generics) are all the reformulated version and manufactured by Purdue. The tablet, down to the last excipient, is exactly the same.

 

[legaluser]

tried tramadol recreationally once, didn’t find it very appealing at all (it was ok but not that great imo), tried it for pain and it was ok but not that great.


sry for short response.

 

[jonnynobody]

Brand name Ultram definitely makes me happy!

On your second point, I'm not saying that these companies are putting something else in their formulation of tramadol. What I'm saying is they're altering something in their synthesis of the drug that is resulting in a product that does not perform in any manner that resembles the original brand, and in some cases reacts like a completely different drug altogether (i.e. Teva).

If you're a pharmacist, which it sounds like you may be, then you know the generic should perform the same way the brand does and that is simply not occurring with this drug.

As far as generics being withdrawn, do not speak of which you do not know young grasshopper.

Forbes: India Must Fix Its Drug Quality Problem
http://www.forbes.com/sites/theapothecary/2014/09/17/india-must-fix-its-drug-quality-problem/

This is one of my favorite quotes from the article:


"Dr. Reddy’s Laboratories, another major Indian generic manufacturer, has been forced to recall about 58,000 bottles of an ulcer medication because some of the pills were found to be contaminated.

And just this year, Dr. Reddy’s initiated another major recall, withdrawing over 13,500 bottles of a blood pressure medicine because the pills weren’t properly dissolving. Just a few weeks before that, Wockhardt Ltd., another Indian generic maker, recalled nearly 110,000 bottles of the exact same drug for the exact same reason."

I won't berate you for not understanding the Indian generic drug problem that is occurring throughout the world, especially since you're in the industry; it wouldn't be mannerly of me, but allow me to open your eyes a bit as I can consider it my good deed for the day.

Reuters: FDA bans imports from Sun Pharma plant in India crackdown



http://www.reuters.com/article/2014/03/13/us-sun-pharma-india-fda-idUSBREA2C09S20140313

Consumer reports: Are generic drugs like Apotex medication made in India safe
FDA sanctions against some Indian drug plants raise concerns about the U.S. generic-drug supply

http://www.consumerreports.org/cro/news/2014/04/are-generic-drugs-made-in-india-safe/index.htm

One of my favorite quotes:

"Why has the number of FDA sanctions against companies with drug plants in India increased?

One of the main reasons is that inspectors from the U.S. and India have ramped up efforts to make sure that plants in India making the drugs exported to the U.S. adhere to the strict manufacturing standards and regulations required by the FDA. With more and more companies such as Apotex making drugs in other countries, FDA inspectors were spread far too thin. In 2012, Congress passed the FDA Safety and Innovation Act, which among other things, requires the agency to inspect foreign facilities that make drugs sold in the U.S. as frequently as it does domestic plants. Last year, the Indian government approved adding seven new FDA drug investigators, to bring the total up to 19 U.S. staff members working in India."

The Lancet: Indian generic drug manufacturers in the spotlight

http://www.lancet.com/journals/lancet/article/PIIS0140-6736(14)61068-0/fulltext

Fierced Pharma: UPDATED: India's Wockhardt recalls millions of packages of drugs in sweeping recall

http://www.fiercepharma.com/story/i...ion-packages-drugs-sweeping-recall/2015-08-03

New York Times: Generic Versions of Toprol XL, a Heart Drug, Are Recalled

http://www.nytimes.com/2014/06/24/health/warning-unheeded-heart-drugs-are-recalled.html?_r=0

My favorite quote:

"Patient after patient, he said, would visit his office complaining of chest pains or other symptoms after switching from the brand-name version, made by AstraZeneca, to a generic product, often one made in India. When he switched them back to the brand — or to another generic — the symptoms disappeared, he said."

On your next point of pricing:

Tramadol was launched and marketed as Tramal by the German pharmaceutical company Grünenthal GmbH in 1977 in West Germany, and 20 years later it was launched in countries such as the UK, U.S., and Australia.^[7]

So Tramadol has been on the market in some form for 38 years and approved in the US in 1994, so it had been on the market in the US raking in the $$ for 7 years through their patent monopoly, and you're telling me they're still recouping costs for research and so forth as one of the most highly prescribed pain killers in the entire US market? Sorry amigo, I'm not buying that balogna sandwich. In modern pharmaceutical research, engineering, testing, FDA approval, and manufacturing you'd be accurate; not on a drug that's been on the market for 38 years - 7 of which have been a patent monopoly in the US that made Grunenthal massive sums of profits, because just as Purdue Pharma lied to physicians about Oxycontin having no risk of addiction, Grunenthal did the same for tramadol.

On your last point, my Oxycontin example is far from ridiculous. I'm aware they changed their formulation to deter abuse (which is irrelevant because most OC abusers have moved on to far more potent and inexpensive heroin thanks to Purdue Pharma), however the exact situation I described did exist at one point in time prior to the reformulation and if you're in the industry (as I'd suspect you are) then you should already know this. How quickly people like to forget...

I will thoroughly enjoy hashing this out with you as I find this to be a fairly stimulating conversation

 

[Screaming_Skull]

Goes good with other opiates, I have nodded my tits off with hydrocodone and tram, them most vivied closed eye visuals. And at that time I wasn't using every day(every other day) usually 40-50mg of hydro which never made me nod just euphoric, energetic, etc.

Now with Subs, for some reason these two work together. My old Roxi 30 connect lost his doc(he died) and couldn't finda another doc. He got a nurse at the VA to give him Tramadol, I'd heard about the two being on maintaince and getting tired of waiting 3 day withouth taking anything to feel any other opiate I took 300mg of Tram with my Bupe and 4mg of klonopin. Made me energetic, chattty, happy, wanted to clean around the house ALL DAY then the drowsy opiate part kicked in. Now I will usually take 300mg the first dose and 150 the 2nd dose. Benzos(Klonopin,Valium, Xanax) are taken which I'm guesing redudes the risk of seizures since they are given to people who have seizures.....

Edit: Isn't that wierd with the Sub, I just can't get over it..the weakest opiate around, I think weaker thank codiene works with Suboxone Maintiance patients...the only other thing that will do that without wait 3 days is Fent.

 

[jonnynobody]

Interesting experience you had there. I myself find 100MG to be rather strong and lasts me the entire day. I couldn't even imagine taking 300MG in one dose. I imagine your house was sparkling from top to bottom by the time you got done with a 300MG tramadol buzz

 

[Kittycat5]

You are confusing recall with outright withdrawal. Recalls happen every day. Full withdrawal is exceedingly rare. Perhaps it is mincing words, but it is different in this case. I will have more to say but I have to go to work.

 

[Screaming_Skull]

Do you use any other opiates johnnyboy?? I mean if you have a very low tolerance and take trams you will get a buzz at 100-200mg. Me it just really didn't do anything unless I had other opiates with it, with some benzo's or weed...or both. I mean before I had an actual habit 8 years ago I woud take 40-60mg of Hydrocodone a week and 30mg of methadone twice a week. Would take the hydro 3 day in a row then take a few day break and dose the done'. I made a REALLY big jump from just starting on hydros to taking Methadone, which raised my tolerance. Then got on Pod Tea, when the pods were nice,strong and cheap as hell, then back on hydros/percs, then snorting roxis and doing pods, then iv'ing(depending on money 30mg=( to 240mg a day of oxy, and Iv'ing Diludid 4mg/8mg every now and again and Morphine 100mg...now since I'm on suboxone maintiance 300mg Tramadol gives me a litte opiate buzz with 150mg boost later in the day(with some benzos' through out the day,fuck seizures) but certainly dsnt make the room glow...I really wish it did, it woud be so much cheaper

 

[jonnynobody]

I use to enjoy opiates quite a bit, but the addiction was too much for me in the long run to sustain. Not to mention the financial cost. Eventually the heroin got so good and cheap @ $10.00 / cap, my friends and I all got hooked and I sustained my addiction for about 6 months eventually winding up at a methadone clinic. Within 2 weeks of beginning methadone treatment, I no longer needed either the methadone or the heroin. I've never looked back. If I even take 1 vicodin or oxycodone these days, my body reacts with a 2-3 day mini withdrawal the next day. I was once addicted to prescribed valium also and I experience the same mini withdrawal if I so much as take 1 5MG tablet. Very unsettling, so I stay away from valium and opiates these days.

Tramadol is really something of a unique interest to me, and not for the weak opiate properties, but for the methamphetamine like "feel good / energetic" properties that make the most mundane shit extremely interesting and stimulating. The fascinating thing about tramadol is while you're high as a kite, you appear sober as a judge on sunday. It's a different kind of "high" though. It makes you feel as though you're living at your maximum possible potential at all times. You're calm, cool, and collected at the most stressful of times. It convinces you that this is how normal people feel all the time and therein lies the trap of addiction. A lot of people get hooked on coke like that. It makes you feel good, talkative, and you can solve the worlds problems over an 8-ball. But it's addictive and expensive plus it ravages your body and cardiovascular system. I'll never abuse tramadol like I did before, but I'll certainly take it once or twice a week on my shitty days to live a little better through chemistry.

 

[jonnynobody]

You are confusing recall with outright withdrawal. Recalls happen every day. Full withdrawal is exceedingly rare. Perhaps it is mincing words, but it is different in this case. I will have more to say but I have to go to work.

I agree, recall is the correct term. I look forward to your followup.

 

[Usa51]

Can you take tramadol to help suboxone withdraw ?

 

[jonnynobody]

I used tramadol to get through some ugly alcohol withdrawal, but never used it to alleviate opiate withdrawals. It's opiate properties are really not all that potent, so it may help a bit. Try a couple, but don't get yourself into a tramadol dependence, because it's far worse than any opiate withdrawal due to the way it acts as an anti depressant more than a pain medication. If you've ever had to withdraw from an anti depressant, you know that shit is some real mental and physical pain unlike anything else. Benzo withdrawal is probably equal to tramadol withdrawal, however benzo's are very effective at getting through tramadol withdrawals. I hear all these stories about people withdrawing from tramadol with nothing and that would be risking your life due to the seizure potential. I couldn't have done it without xanax and valium..

 

[tnvol44]

I have taken tramadol with and without other opiates and to tell the truth it never did a thing for me!

 

[jonnynobody]

Never used it with anything other than 7.5/325 vicodins and to tell ya the truth, I think the vicodin diminished the feel good quality of the tramadol. For me, tram is basically some "get it done" medicine. It is great for back pain which I have a lot of due to my line of work, but without making you appear or feel inebriated. Imagine a cocaine high without the peaks and valleys, snot running down your nose, massive depression upon coming down, and that is basically what tramadol is like for me. That's why it's so damn easy to become dependent, because you don't feel "fucked up" ever, so you don't feel like you're abusing anything. Then after 6 months of regular use, you decide to just not take any on your day off, and then you realize you're stuck with a massive addiction. Tram is like a benzo to me, as it is to be both respected and feared at the same time. If you fail to follow that policy, you end up like I did suffering through some of the most horrendous withdrawal I've ever experienced. <br><br>All things in moderation is what I'm coming to learn as I get older...

 

[Phil.McKeer]

Yeah just to chime in with my 2¢ I've never felt a thing off Trammies and lordy-lord knows I've tried. I've dosed anywhere from 50mg to 400mg at once and then redosed again after. Still felt nothing.

I should mention that I've never tried it while opiate-naive; I've only tried Tram while my tolerance was high due to using stronger opioids, so someone else's experience may be different.

 

[Kittycat5]

Sorry it took so long jonnynobody to respond but Ive been busy and havent had time to post a lengthy post as this will be.

Let me start with the other issues (Oxycontin and drug pricing) before I tackle Indian manufacturers.

You are not really painting the Oxycontin picture as it happened. Before reformulation, there were generics for the original "OC" Oxycontin. Most of them, however were what is called an authorized generic. What this is is a drug sold and priced as a generic but stilled manufactured by the original company, in this case Purdue. The tablets were exactly the same as Oxycontin down to the last excipient. They did not even bother to change the markings on the tablet. Nobody complained about these as whatever you could do with Oxycontin, you could do with these. There were some actual generics, manufactured by companies other than Purdue, but they also didnt have any abuse deterrents and most people didnt care if they got these (some did, but I imagine it was because the demand for the OCs on the black market was so high). The issue of patients complaining about Oxycontin is when we started dispensing the reformulated OPs. For awhile, wholesalers had both in stock and were allowed to sell off the original versions. If I had a dime for everytime someone asked for the OCs in this time period, I could have retired 5 years ago. But most pharmacies began receiving the reformulated versions even when the original was available for obvious reasons. This is when the whole OC vs OP debate began and I imagine it was largely fueled by people abusing or selling them. And the OPs arent 5 times as big as the OCs. They are flatter and slightly bigger, but not tremendously so.

Now on to pricing. I did not mean to imply that brand name drugs are priced so much higher than generics because they are still trying to recoup R&D costs. Blockbuster drugs cover that in a year or so. It is one of the main reasons why brand drugs are so expensive before generic competion comes out, but we arent talking about that. Originators keep prices high for many reasons. One is simply because there is a segment of the population who cannot be convinced that generics are a less costly but equally safe and efficacious option and will pay the difference in cost. But pharma plays games. It costs pennies per pill to manufacture most drugs at any time during their life cycle. Many of the brand named companies will keep prices high but give rebates to insurance companies, PBMs, and Medicare and Medicaid or offer copay assistance cards to patients. They can keep their top line relatively healthy as these rebates would go as an expense in their accounting. And we all know sales is an important thing to publicly traded companies, as most pharma is. Of course when generics hit the market, the sales of these drugs crumble, but keeping them priced high at least justifies them continuing to produce them. But sometimes they still simply cannot sell enough product and either discontinue them outrightly, or sell them off to smaller companies to either produce or distribute them. It often is generic companies that buy these products, which means if they do not simply distribute the product, it is manufactured at the same place generics are made. But patients still insist on the brand name, when the company making it may be 100th the value of a Pfizer or Merck. These small companies often exist, at least initially, solely for this reason.

Furthermore, prices of brand drugs are kept high to cover the costs of the many drugs that fail in clinical trials (which can cost hundreds of millions of dollars), huge advertising budgets and of course the normal costs of doing business. I forget the exact numbers but it is something like for every drug that makes it to market, 100 other fail. Let us say each of these hundred drugs cost 10 million dollars to develop only to fail. That is a billion dollars down the drain. So it isnt so much covering the cost of R&D for successful drugs, it is to offset the costs of the ones who dont make it. The size of the population of patients being targeted is also a factor. A small patient base will undoubtedly mean an expensive drug. Look up the prices of the new Hepatitis C drug Solvaldi for a great example.

Whew, I am tired already and havent hit the main topic of this discussion.

I am well aware of all of the links you posted, as I am notified of every single drug recall that occurs. (That Wockhardt one was a huge pain in the ass. The list of recalls was 6 pages long!!!!). I must thank you though for the one link where the Indian drug companies were purposefully selling inferior drugs to Africa and other places with less stringent regulations. That is disgraceful and they should be punished as harshly as possible. But here in America and Europe and parts of Asia this is not the main issue. We do have regulations in place to prevent this and any manufacturer better damn well be familiar with them if they want to do business. But not following CGMP (current good manufacturing practices) is systemic throughout all pharma. Of course the main blame goes to the drug companies, but until about two years ago, the FDA had really poor oversight of non-domestic manufacturers. Since corporations exist with the main goal to make money, they will cut corners to save costs whenever possible. It is up to the regulators to enforce the rules, and a disproportionate amount of recalls came from India and other overseas companies simply because they were not inspected with the frequency of American companies. I guarantee if the FDA did not inspect American producers, these numbers would even out. The good news is the FDA is stepping up inspections and says everyone will be treated the same and visited as often as another regardless of where they are located. I hope this is true and by the sheer number of recalls I have seen in the past two to three years, believe it to be so.

I will end with a few examples. The day after I first responded to you, I had two recall notices. One was from an Indian company, Dr. Reddy's. The drug being recalled may not have met certain specifications for staying good through its expiration date. The other one was from Merck (they dont get much bigger or repected than Merck). This particular drug was being recalled because two different strengths may have been mixed in one bottle. In will leave it up to you to decide which is worse, but as you can see, even the giants of pharma are not immune to poor manufacturing at times.

Another prime example is a drug called Daytrana. It is made by a company named Noven that manufactures in Miami, FL. It has probably been recalled 10 times in the past 5 years for various reasons. Is this worse than the Indian corporations?

The absolute worst recall I can remember was many years ago on albuterol inhalers made by Dey Pharmaceuticals. At the time, they were a subsidiary of Schering-Plough, another Pharma behemoth. These inhalers are used by asthmatics to quick stop an attack that can be potentially life threatening. A certain percentage of inhalers were coming off the production line with NO ACTIVE INGREDIENT IN THEM AT ALL. Can you imagine how crazy this is? I admit I do not remember where these were made but do not believe it was India.

So, as someone who deals with these issues daily, I find no greater fault in the Indian companies compared to any other. As mentioned in one of the articles you linked, even if the drug is made in America, the raw ingredients can come from anywhere and do not need to listed as from where they originate. The issue is as I said, systemic to all pharma. India gets much of the attention because to be perfectly honest, they produce the least costly FDA approved generics in the greatest quantities. If you took them away, there would be huge shortages of nearly every drug.

Jonnynobody, you take whatever brand makes you happy. The goal of pharmacy is to get patients to be compliant with their drug therapy, and if Teva tramadol is what you need to be so, ask, no demand it. But be courteous if the pharmacy says the either cannot get it or will not get it because they will sell it at a loss. Say you understand and try and find some place that stocks it. I learned long ago to not argue in such situations. I do my very best to provide whatever drug/brand my patients want and most pharmacist do as well.

I will leave you with a link of my own. Remember that Caraco brand tramadol that worked? Take a look at this.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm169095.htm

I hope you respond. I am no way being condescending towards you, just think this is a discussion right up my alley.

 

[Leelee88]

This is my first time on here so im not sure if i should be replying or creating a thread! Anyway long story short after 2 major surgeries and endone i moved to a different area of qld saw different doctors got into trouble didnt realise i was doctor shopping my main dr apologized to me! For some reason lol.... that i had no options but suboxone now im on 6mg feeling ok still some pain but now im copping migraines from hell ! I was given tramadol for it and got told it wont affect my suboxone It worked like magic. Now im wondering if my dr will subsribe tramadol to me? Anyone thats had a migraine knows panadol and ibuprofen is like eating a tic tac lol. I feel stuck i need something for my migraines and i have a feeling taking more suboxone wouldnt work and wouldnt be worth it. Has anyone taken it with suboxone? Idk why but it works so well just not sure if im "alloowed" as its up there with other heavy pain relief. If i have no tramadol id have to go off sub which woild probably feel like what a nigraine does .... but daily for a fewcweeks ? thanks for listening to my rambling on ppl .

 

[Phil.McKeer]

Leelee, I don't know from experience, but I've heard many people report that they get headaches and other sideffects from suboxone, and that they've narrowed it down to the naloxone it contains. These same people often report having no problems with SUBUTEX, which is essentially the same thing as suboxone except it doesn't have the naloxone (it's buprenorphine only). You might ask your doc to switch you from suboxone to subutex and give that a go. You might be part of the population that can't tolerate the naloxone.

Edit - I'm not 100% sure that this complaint about naloxone from these people isn't psychosomatic in origin. It may very well be. From everything we know about buprenorphine and naloxone, it doesn't make much sense, because the naloxone is known to be pretty much inert due to bupe's MUCH higher binding affinity. I'm just reporting what I've heard.

 

[Leelee88]

Thsnks for that i did ask my doctor that since taskinh it ive had bad headaches/mugraines and have heard a friend whos been on it experience bad headaches on subuxone and like you this is just something i heard but dont officialy know... doctor gave me a script for mobic? instead which left me even more confused.... for some reason subutex is the last thing my dr wants to put me on but i don't know much about it all and sadly he's always in a mad rush /lots of patients!

 

[Phil.McKeer]

He's probably afraid that you want the subutex so you can slam it (they've been told by the drug manufacturer that the naloxone deters abuse via IV administration, which is patently false). Doctors, for how intelligent they should be, sometimes confound me with their stupidity. Sorry to hear you're having this problem.

I do recommend suboxone/subutex only as a rapid taper (7 to 14 days, tapering down to 0.5 or 0.25mg's) so if you can taper down and get off the subs that's probably your best bet.