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  • BDD Moderators: Keif’ Richards | negrogesic

Codeine vs tramadol for pain

R

Renald

Bluelighter
Joined
Jul 8, 2015
Messages
222
My girlfriend has painful menses, and no non opiate/opioid analgesic is helping her. We noticed a fact, that tramadol 50 mg fully stops the pain, but codeine at 60 mg even with 1000 mg of paracetamol has no influence. As I found codeine is almost equivalent to tramadol by weight basis.
As she uses duloxetine (SNRI antidepressant, a moderate CYP2D6 ihnibitor), I thought the inhibition of a ferment converting codeine to morphine may play a role here, but tramadol also is metabolized to desmetyltramadol via the same ferment.
What can be the mechanism of tolerance to antinociceptive effects of codeine and normal reaction to tramadol?

PS. We know about the possibility of serotonin syndrome form mixing SNRI and tramadol, but at the doses she use it seems there are no symptoms of SS.
 
People react differently to Opioids and prescriptions drugs in general. You're right about the equivalency between Codeine and Tramadol, in theory 60mg of Codeine should work just fine. However, Tramadol itself is not really an "Opiate" by full standards, it acts as an SNRI and the mechanism of action is quite different to other Opiates, this is probably the reason why she feels more analgesic effects.

I do not know the exact pharmacological reason since I'm not a doctor and haven't read studies on Tramadol, but yes I would exercise caution with the serotonin syndrome problem, it would be best to avoid increasing the dosages of Tramadol or take another safer Opiate medication. Tramadol itself isn't really "safe" since it lowers the threshold for seizures.
Your best option is to get an appointment with a doctor, just to clarify everything.
 
She was, but the only available opiod/opiate the doctor can prescribe her is codeine (with paracetamol), menstrual pain in our country cannot be treated by tramadol or other stronger pain medicines. The other way is to use hormones, but it is questionable what is less dangerous to the body - all time hormone drug usage or several days a month tramadol (or other opiod/opiate) low dose usage.
I was prescribed tianeptine for depression and read it is also a weak opiod drug (this is the cause it is abused in former SU countries by injecting large doses). Anybody tried tianeptine for pain?
 
:\ Bless her heart...I know her pain. Thank you for your efforts to help her ease her pain.

Has she tried Toradol (anti-inflammatory by script) It is very helpful for me, whereas opiates haven't been.

Hormone therapy is a whole separate hornet's nest!
 
I know this thread is 9 months old but if she's still having the same problems i'd try a higher dose of the codeine maybe combined with a NSAID like naproxen,ibuprofen etc. Unfortunately she can't take the tramadol while taking an antidepressant, unless she's only gonna be taking a low amount of tramadol occasionally then its fine but otherwise i'd try upping the codeine dose. I Hope this problem has been resolved by now, best of luck.
 
everyone's different but i find tramadol is better for pain, whereas codeine is just fun.
 
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