Opioids Tramadol and Adderall Question (legal script for both, therapeutic use)

[femmefata1e]

I take 200mg of Tramadol daily (100mg every 6 hours, up to 200mg per day). I am also prescribed Adderall (20mg twice daily) but I am afraid to take them together. I do not abuse either drug (or any drugs) and do not take them to get high (no judgement, just isn't my thing). I have legitimate chronic pain and ADHD, and I have taken both Adderall and Tramadol for years, separately, but never together. Currently, I see a pain doctor for the Tramadol and they need both drugs to show up in my drug tests. I know there are other pain meds I could take that may work better with Adderall, but Tramadol is the only one that helps my pain and doesn't make me feel nauseated or zombified.

I need to know if these drugs are dangerous combined in the prescribed dosages, or only if therapeutic dosages are exceeded? Both my pain doctor who prescribes the Tramadol and my regular doctor who prescribes the Adderall are aware I have a script for both and have never mentioned an issue, but I read up on every drug I take and I know these two have warnings associated with seizures. I do not have any seizure related conditions in my family, but I know that doesn't guarantee I won't have one.

Bottom line is this - the Adderall needs to show up in my system when my pain doctor drug tests me. Any help or advice is appreciated.

 

[Jekyl Anhydride]

Generally combing Tramadol and mixed amphetamine salts is a bad idea but seeing as your doses are fairly conservative any overlap shouldn't be overly problematic. Tramadol is more problematic when it exceeds the 500-600mg point regarding seizures or contributing to things like serotonin syndrome, etc. Having taken them for years, within the same 24 hour period I assume, should help reassure you that an overlap of a few hours or even occasional concurrent use is not exceedingly risky. If you should have to increase the dosage of either or both it is a valid point to bring up to the prescribing doctor(s) though.

Here is a thread where the OP was not near as cautious as yourself:

http://www.bluelight.org/vb/threads/643169-how-can-i-have-adderall-with-tramadol

 

[femmefata1e]

Generally combing Tramadol and mixed amphetamine salts is a bad idea but seeing as your doses are fairly conservative any overlap shouldn't be overly problematic. Tramadol is more problematic when it exceeds the 500-600mg point regarding seizures or contributing to things like serotonin syndrome, etc. Having taken them for years, within the same 24 hour period I assume, should help reassure you that an overlap of a few hours or even occasional concurrent use is not exceedingly risky. If you should have to increase the dosage of either or both it is a valid point to bring up to the prescribing doctor(s) though.

Here is a thread where the OP was not near as cautious as yourself:

http://www.bluelight.org/vb/threads/643169-how-can-i-have-adderall-with-tramadol

Thank you! 1600mg of Tramadol is a whole lot. I took Adderall for a few years, then my doc retired and it took a long time to find a new one who was willing to prescribe Adderall. In the year or so gap, I ended up needing to take Tramadol daily for pain, so I have not ever taken the two drugs together (even 24 hrs apart) so that's why I'm nervous. I'm very careful with meds (you all would probably laugh at me as you are clearly far more experienced with all sorts of things). I just want to be able to concentrate and not have pain, but also not have a seizure lol.

 

[Jekyl Anhydride]

Staggering the two as far apart as you are able to and staying mindful of your doses when taking both in close proximity is probably the best way to proceed. If you are just now beginning to use the Adderall again there is nothing wrong with taking it slow till you have some more experience of how well you do with both meds on board. Any indications of increased or exacerbated side effects should warrant a call to the prescribing doctor immediately though.

Best of Luck and welcome to BlueLight

 

[femmefata1e]

Thanks, Jekyl.

 

[femmefata1e]

Thought I would update... been taking Tramadol 100mg around 8am, then Adderall 20mg around 4pm, then second Tramadol dose around 10pm. I have not had any hints of seizures or other dangerous side effects - however, the Tramadol seems to up the side effects of the Adderall, which I don't like. Adderall does not usually make me feel wired or speedy (I only ever take 20mg at a time, my regular dose every 4-6 hours) and it seems that combined with the Tramadol it is giving me headaches, jaw clenching and general discomfort of feeling 'upped'. Normally, Adderall makes me quite calm and focused, without any unpleasant side effects. I may have to speak to my doc about lowering the Adderall dose (back to what it was when I first started taking it, 10mg) because the dose I am on now is just way too much for me in combination with the Tramadol.

 

[GingerKitty]

Thought I would update... been taking Tramadol 100mg around 8am, then Adderall 20mg around 4pm, then second Tramadol dose around 10pm. I have not had any hints of seizures or other dangerous side effects - however, the Tramadol seems to up the side effects of the Adderall, which I don't like. Adderall does not usually make me feel wired or speedy (I only ever take 20mg at a time, my regular dose every 4-6 hours) and it seems that combined with the Tramadol it is giving me headaches, jaw clenching and general discomfort of feeling 'upped'. Normally, Adderall makes me quite calm and focused, without any unpleasant side effects. I may have to speak to my doc about lowering the Adderall dose (back to what it was when I first started taking it, 10mg) because the dose I am on now is just way too much for me in combination with the Tramadol.

You said it’s been a year or so since you have been prescribed Adderall which is probably what is giving you the nasty side effects. You are starting over on a clean slate with absolutely no tolerance. Have you tried cutting the adderall dosage in half yourself? If I had had such a hard time finding a dr to prescribe me a med I know I need and was prescribed previously, I would be leary of asking him to mess with the dose. I would be scared that he wouldn’t put me back on the dose that I know I will need once my tolerance starts to build again with daily use. You could also maybe try staggering the 1/2 doses. Take 10mgs then a couple hours later take the other 1/2.

 

[Tek4242]

I second the opinion that you shouldn't tell the dr to lower the dose, but simply do it yourself until your body adjusts to the drug and the now new combo. I think you'll find that since your tolerance is zero to adderall your just noticing the side effects more than you would after you stabilize on a dose. The amounts your taking should be fine together btw. Half your adderall for a bit and get stable on that and if you need the other half later to get the focus or whatever effect your seeking then you'll have it and won't have to ask to be upped again after being lowered. Asking to go up in dose will probably cause issues unfortunately. Sorry for rambling. Good luck with everything and be safe.

 

[Jekyl Anhydride]

I'm sorry to hear you're having problems with the two Femmefata1e, but it's good that you are spacing it out in intervals at least. Is there one or the other that seems to be more valuable as far as helping you? You might be able to look into a strong NSAID, like Diclofenac sodium to use instead of the Tramadol with a possible breakthrough pain medicine like Hydrocodone or Codeine for for rough spots.

On the other hand if you think the Tramadol is more important, something like Methylphenidate or Modafinil might fit the bill with less side effects. In any case it was a good idea to proceed slowly like you did with as much time as possible between them as immediate release Adderall lasts around 6 hours but having it carry over into the night might affect your sleep and that could contribute to more problems during the day reducing any benefit you might be obtaining from it. Dropping the dose and giving it a little more time is one option, but a conversation about the side effects with your Doctor and possibly switching to another pain med or stimulant might be the better option if jaw clenching or bruxism combined with headaches and a general "tweaked" feeling remains persistent. If you decide to go back up with the Adderall remain cautious as it can reduce the seizure threshold and they occur without warning. Sure hope everything works out.

 

[Trichocereuslyfried]

I realize this is an old thread. But for any future readers who stumble upon this slightly unique topic, I'd like to say, I take LOW dose tramadol (25-50mg per dose. No more than 150 total. And amp salt xr 30s twice daily, or sometimes only once, or an ir dose instead, but about 45-60 mg in a day tops. I have had only positive experiences thus far . They compliment eachother beautifully, especially with a dose of Klonopin, temazepam, pregabalin as needed and particularly at night. My docs and pharmacists said this was safe to do. They said. , Six or 8 trams a day would be dangerous, but 1-3, or even four...perfectly safe. I also combine my morphine with all the above. No issues. And several times a week as needed , .25-1mg buperenorphine for opiate induced hyperalgesia ...it keeps it at Bay and keeps you in better control of pain and mood all t ogether

 

[Calder]

I realize this is an old thread. But for any future readers who stumble upon this slightly unique topic, I'd like to say, I take LOW dose tramadol (25-50mg per dose. No more than 150 total. And amp salt xr 30s twice daily, or sometimes only once, or an ir dose instead, but about 45-60 mg in a day tops. I have had only positive experiences thus far . They compliment eachother beautifully, especially with a dose of Klonopin, temazepam, pregabalin as needed and particularly at night. My docs and pharmacists said this was safe to do. They said. , Six or 8 trams a day would be dangerous, but 1-3, or even four...perfectly safe. I also combine my morphine with all the above. No issues. And several times a week as needed , .25-1mg buperenorphine for opiate induced hyperalgesia ...it keeps it at Bay and keeps you in better control of pain and mood all t ogether

Hey, i just got a small question, you take morphine AND bupre at the same time? Or you take morphine like 2 days before bupre?
Thanks for answer, just curious? Have a nice day!