The only way to make it work better or should I say stay in you long enough and not be totally destroyed by the liver passes and actually work is to drink a good 32 oz of PURE grapefruit juice 1 hour prior to your dose. This will shut off the liver enzymes that break it down and thus out, tram sucks for most because by the time it breaks down into O-desmethyltramadol your body is in the process of expelling it partially into the gut. But in doing this hydration with something that can be good for many before hand, you get much more time, which in turn gives you the means to get pain relief and effect from the O-desmethyltramadol because your liver will be unable to destroy it in the passes it so takes through it because the enzymes responsible for this function are temporary shut off. Basically the old school method to make a normal opiate last longer put to actual use to not make it last longer but make the chemical survive much longer to become an actual pain killer and your body to use it. It has worked for me many times. And like a few others have said, avoid taking more than... I would say 300 mg a day, if you are a small person 140 and under I would say 200mg max, this junk will make you have seizures. It lowers the threshold to have them in any human that ingests it for a matter of a fact. Tremors at the 150mg range is a sign to stop at that dose. shaking hands, or all over is what I mean by that. Crappy stuff, but with a little science you can make it give you a little something and it will not hurt you in any way unless you exceed the recommended daily dosage, and trust me you do not want to go to the ER from seizures from this. Or worse stroke out from those seizures