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Thread: Tramadol + opiate

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    Tramadol + opiate 
    #1
    Bluelighter percozakk's Avatar
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    I have taken 200 mg tramadol, this is a low dose for me, though it should give me a buzz.
    I have also take a low dose of dxm and Doxylamine succinate to increase the effects

    I am supposed to be getting so oxycodone or hydrcodone later and i was wondering how much would get me up to aa good buzz.
    Keep in mind i am going to be around people so i need a functional buzz but i still want to be pretty messed up.

    I was thinking maybe 10 mg's or either one ontop of what i havve already taken.
    Would i feel this?
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    #2
    Bluelighter ro0ga's Avatar
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    i wouldn't mix the tramadol with oxycodone or hydrocodone if you're looking for the best buzz. the effects wouldn't be additive because tramadol is a partial opioid agonist while the other two are full agonists. therefore, the tramadol would competitively block the other drugs from exerting their full effect.

    it's really hard to ask dosage questions concerning opiates because tolerance varies greatly depending on the individual. it's also advisable to stick to just one at a time.
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    #3
    Bluelighter Rexeh's Avatar
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    WARNINGS
    Seizure Risk
    Seizures have been reported in patients receiving tramadol within the recommended dosage range. Spontaneous post-marketing reports indicate that seizure risk is increased with doses of tramadol above the recommended range. Concomitant use of tramadol increases the seizure risk in patients taking:

    •Selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics),
    •Tricyclic antidepressants (TCAs), and other tricyclic compounds (e.g., cyclobenzaprine, promethazine, etc.), or
    •Other opioids.
    Administration of tramadol may enhance the seizure risk in patients taking:

    •MAO inhibitors (see also WARNINGS, Use with MAO Inhibitors and Serotonin Re-uptake Inhibitors),
    •Neuroleptics, or
    •Other drugs that reduce the seizure threshold.
    Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections). In tramadol overdose, naloxone administration may increase the risk of seizure.

    Suicide Risk
    •Do not prescribe ULTRACET® for patients who are suicidal or addiction-prone.
    •Prescribe ULTRACET® with caution for patients taking tranquilizers or antidepressant drugs and patients who use alcohol in excess and who suffer from emotional disturbance or depression.
    The judicious prescribing of tramadol is essential to the safe use of this drug. With patients who are depressed or suicidal, consideration should be given to the use of non-narcotic analgesics.

    Tramadol-related deaths have occurred in patients with previous histories of emotional disturbances or suicidal ideation or attempts as well as histories of misuse of tranquilizers, alcohol, and other CNS-active drugs (see WARNINGS, Risk of Overdosage).

    Serotonin Syndrome Risk
    The development of a potentially life-threatening serotonin syndrome may occur with the use of tramadol products, including ULTRACET®, particularly with concomitant use of serotonergic drugs such as SSRIs, SNRIs, TCAs, MAOIs, and triptans, with drugs which impair metabolism of serotonin (including MAOIs), and with drugs which impair metabolism of tramadol (CYP2D6 and CYP3A4 inhibitors). This may occur within the recommended dose (see CLINICAL PHARMACOLOGY, Pharmacokinetics).

    Serotonin syndrome may include mental-status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination) and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).

    Anaphylactoid Reactions
    Serious and rarely fatal anaphylactoid reactions have been reported in patients receiving therapy with tramadol. When these events do occur it is often following the first dose. Other reported allergic reactions include pruritus, hives, bronchospasm, angioedema, toxic epidermal necrolysis and Stevens-Johnson syndrome. Patients with a history of anaphylactoid reactions to codeine and other opioids may be at increased risk and therefore should not receive ULTRACET® (see CONTRAINDICATIONS).

    Respiratory Depression
    Administer ULTRACET® cautiously in patients at risk for respiratory depression. In these patients, alternative non-opioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures (see WARNINGS, Seizure Risk and OVERDOSAGE).

    Interaction With Central Nervous System (CNS) Depressants
    ULTRACET® should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers or sedative hypnotics. Tramadol increases the risk of CNS and respiratory depression in these patients.

    Interactions with Alcohol and Drugs of Abuse
    Tramadol may be expected to have additive effects when used in conjunction with alcohol, other opioids, or illicit drugs that cause central nervous system depression.

    Increased Intracranial Pressure or Head Trauma
    ULTRACET® should be used with caution in patients with increased intracranial pressure or head injury. The respiratory depressant effects of opioids include carbon dioxide retention and secondary elevation of cerebrospinal fluid pressure and may be markedly exaggerated in these patients. Additionally, pupillary changes (miosis) from tramadol may obscure the existence, extent, or course of intracranial pathology. Clinicians should also maintain a high index of suspicion for adverse drug reaction when evaluating altered mental status in these patients if they are receiving ULTRACET (see WARNINGS, Respiratory Depression).

    Use in Ambulatory Patients
    Tramadol may impair the mental and or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. The patient using this drug should be cautioned accordingly.

    Use With MAO Inhibitors and Serotonin Re-uptake Inhibitors
    Use ULTRACET® with great caution in patients taking monoamine oxidase inhibitors. Animal studies have shown increased deaths with combined administration of MAO inhibitors and tramadol. Concomitant use of tramadol with MAO inhibitors or SSRI's increases the risk of adverse events, including seizure and serotonin syndrome.

    Use With Alcohol
    ULTRACET® should not be used concomitantly with alcohol consumption. The use of ULTRACET® in patients with liver disease is not recommended.

    Use With Other Acetaminophen-containing Products
    Due to the potential for acetaminophen hepatotoxicity at doses higher than the recommended dose, ULTRACET® should not be used concomitantly with other acetaminophen-containing products.

    Misuse, Abuse and Diversion
    Tramadol has mu-opioid agonist activity. ULTRACET, a tramadol-containing product, can be sought by drug abusers and people with addiction disorders and may be subject to criminal diversion. The possibility of illegal or illicit use should be considered when prescribing or dispensing ULTRACET in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.Misuse or abuse poses a significant risk to the abuser that could result in overdose and death (see Drug Abuse And Dependence and OVERDOSAGE).

    Concerns about abuse, addiction, and diversion should not prevent the proper management of pain. The development of addiction to opioid analgesics in properly managed patients with pain has been reported to be rare. However, data are not available to establish the true incidence of addiction in chronic pain patients.

    Risk of Overdosage
    Patients taking tramadol should be warned not to exceed the dose recommended by their physician. Tramadol products in excessive doses, either alone or in combination with other CNS depressants, including alcohol, are a cause of drug-related deaths. Patients should be cautioned about the concomitant use of tramadol products and alcohol because of potentially serious CNS additive effects of these agents. Because of its added depressant effects, tramadol should be prescribed with caution for those patients whose medical condition requires the concomitant administration of sedatives, tranquilizers, muscle relaxants, tricyclic antidepressants, or other CNS depressant drugs. Patients should be advised of the additive depressant effects of these combinations.

    Serious potential consequences of overdosage with tramadol are central nervous system depression, respiratory depression and death. Some deaths have occurred as a consequence of the accidental ingestion of excessive quantities of tramadol alone or in combination with other drugs. In treating an overdose, primary attention should be given to maintaining adequate ventilation along with general supportive treatment (see OVERDOSAGE).

    Serious potential consequences of overdosage with acetaminophen are hepatic (centrilobular) necrosis, leading to hepatic failure and death. Emergency help should be sought immediately and treatment initiated immediately if overdose is suspected, even if symptoms are not apparent.
    Tramadol is also a (mild) SSRI so I would not mix it with DXM due to the danger associated with it. But in combination with doses less than 400 mg and other Opiates (Codeine, OxyContin, Morphine) alone it never has given me any problems although I tend to stay away from Tramadol nowadays (weird stuff IMHO). Doxylamine is an anti-histamine IIRC so I don't know about that but never heard any bad responses from people here.

    The main question is: what is your Opiate tolerance? Oxycontin is a big difference compared to Tramadol or even Morphine IMHO. For comparision: 400 mg Tramadol wouldn't give a buzz, 250-400 mg Codeine is a nice buzz and 20-40 mg of OxyContin hits me hard, so does 400 mg DXM (400 mg / 50 kg = 8 mg per kg bodyweight so would that would mean a nice upper second plateau for me)

    Better to buy some Guarana, Kolanut, Panax Ginseng and Yerba Mate to make some legal social energizers of your own, save the upcoming goodies for a rainy day or use some lighter herbs like kratom or lotus flower (pink is the best), also try searching for wild dagga and remember: I began with Tramadol for chronic pain, now I am hooked on Oxy, and the withdrawals suck a lot more TBH

    Be smart, be safe, be stoned and have fun

    Peace o/
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    #4
    Quote Originally Posted by percozakk View Post
    I have taken 200 mg tramadol, this is a low dose for me, though it should give me a buzz.
    I have also take a low dose of dxm and Doxylamine succinate to increase the effects

    I am supposed to be getting so oxycodone or hydrcodone later and i was wondering how much would get me up to aa good buzz.
    Keep in mind i am going to be around people so i need a functional buzz but i still want to be pretty messed up.

    I was thinking maybe 10 mg's or either one ontop of what i havve already taken.
    Would i feel this?
    do not mix tramadol with DXM! that is asking for a dose of seretonin syndrome! we had a thread in here just a couple of days ago with some guy who mistakingly took the two in combination. he got lucky, though which isn't always going to be the case. please do some more research on these things before rushing into them.

    as for your question we can't even begin to give you an estimate of how much to take, you've given us insufficient information to work with.

    nice info rexeh

    basic dosing question over to BDD
    Last edited by leftwing; 06-01-2010 at 01:51.
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    #5
    Bluelighter avcpl's Avatar
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    Quote Originally Posted by ro0ga View Post
    i wouldn't mix the tramadol with oxycodone or hydrocodone if you're looking for the best buzz. the effects wouldn't be additive because tramadol is a partial opioid agonist while the other two are full agonists. therefore, the tramadol would competitively block the other drugs from exerting their full effect.

    it's really hard to ask dosage questions concerning opiates because tolerance varies greatly depending on the individual. it's also advisable to stick to just one at a time.
    I've found they don't compete, but compliment. 100mg of Tram orally (liver metabolizes it to whatever) and plug 15mg of Hydro is a nice combo. Uppy opiate high with some E feelings too. Then smoked some pot after several hours and laid in bed. Very nice indeed.
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