Naproxen/Omeprazole/Codine/Amitriptyline/Tramadol

[Medikate]

Hi, None Recreational use for Trapped Nerve.

Ok, So I've been having pain like cramp but constant for 2 weeks and only able to get an hours sleep a night so looking to at least relive pain so I don't wake up at 1.am not able to sleep and meds have only after 2 weeks started to reduce pain but would like advice on a few things as it seems there is a vast knowledge base on this forum as I've browsed a read quite a bit on here over the past few days especially as I'm not sleeping.

Ok so firstly. Seems excessive to be on so many pills to relieve pain. I started with Doctors prescribed meds as follows.

Naproxen 500mg x 2 daily and Omeprazole which he only gave as thought I was on other meds which is another story. Have diagnosed bipolar and been off meds so quite some months. No problems there. NO PAIN RELIEF what so ever, so I was Given Zapain. 2x30mg 4x daily. First 2 days not much in Pain relief just sort of felt uncomfortable. Don't know how else to explain.

I will say I don't ever hardly take pain killers don't drink alcohol anymore and have had numerous variations of meds in past for Bipolar. Too many to mention. I'm 46 and holding a fair bit or weight but have not always been big, Thus why I stopped my last meds. Depikote and Respiridone. Was one this for 8 months since my last relapse in hospital. My Bipolar is not really the issue here as been diagnosed since i was 20 and now pretty stable and have a fairly ok team who regularly check my situation.

I digress, So was intense for the first few days or more and I was also given Amotriptoline to take at night 30mg starting at 10mg dose first night. Still no relief so I was told to give them time but after anther 2 days still nothing. So out of hours GP gave me Tramadol as initially the Zapain wasn't helping too much. I only took 2 x 50mg as prescribed but I was had some strange reactions and anxieties with breathing and numbness in arm. I was advised to go to A and E but it turned out all routine and I was sent home with more Zapain. I stirred from the tramadol but it was not said that I should not be taking it or could have had a bad reaction to it. So as it turns out I ran out of zapping and had 2x 50 mg tramadol yesterday at about 11am Not much change in the pain but I just kept popping the pills in hope They might eventually help. Well last might I fell asleep and woke an hour later gasping for air. Bit uncomfortable as was struggling to breath every 5 mins so I wasn't going back to sleep. So Not taken any pain killers since my last dose of Amatriptaline last night. I'm guessing from what I later looked into Tramadol probably doesn't agree with me. Pain actually dropped a but today as I went for long walk but stating t creep back. It's no way near as intense as it was initially but I'm not going to take to Tramadol and I'm not even sure to take the Amotriptoline and it I get really desperate just take one 30mg on Zapine. I will see my local GP on Monday but I know when I went to see my Ostepath he said that oromorph would be my best bet. i not sure wether the GP would prescribe it as anyway. So at least the pain is not so bad but i can only sleep on back and as soon as I move I can't sleep for shit. Sorry for the long windedness of this. But I guess I'd like to know on what people might think of these meds to the pain I'm having and the fact last night I woke gasping for air which was a bit concerning. What would be the best way forward and If I can shift pain or it comes back and I can't get Oromoph would Zomorph help as I would get elsewhere. The fact I've not sleep more than an hour a night in 2 weeks and I usually sleep easy 8 - 10 hours so its less than ideal for my bipolar as lack of sleep tends to drive manic episodes.

Any thoughts or advise will be gratefully received. Great forum by the way and so glad to find it as reading through some of the threads here is actually so helpful. wish I had this resource 20 plus years ago

Thanks again.

K

 

[Snafu in the Void]

Tramadol is a weird atypical painkiller with complex pharmacology. It can cause all sorts of interactions and reactions like you appeared to have. It will negatively interact (and dangerously) with A LOT of other medications and drugs. I suspect the amitriptyline interacted with the tramadol, but just guessing here.

Is this nerve pain or muscle pain? I've had severe cramps before that were fixed with an NSAID (stronger than naproxen) + cyclobenzaprine. But that was for my shoulder/back.

Are you looking for options other than opioids such as oromorph? Trying to narrow down your question.

 

[Medikate]

Thanks for reply.

It's been narrowed down to nerve pain. I read that Amitripoline can take a few weeks to kick in. So I don't know wether to keep taking it as will the tramadol still battle with it and should I still take Zapain. Definitely not going near Tramadol especially so of the stuff I've read on this forum.

The opioids we making a little difference but the Tramadol and lack of sleep as left me a bit wired today so I'm open to suggestion. It seems the Amitripaline is the right sort of prescribed meds for nero-pain from what I gather. I know there are others I think Gabapetin and Pregabalin but I know my local GP was less keen on those as there are more stimulant which is not great for my bipolar.

Basically I want something strong which I don't think my GP will per scrip to knock me out so I can sleep more than 1 hour and totally numbs pain. Even if I can get a few nights sleep. 2 Weeks with 14 hours sleep is not good for me. I just want a break from this blood pain as can only lay on bed on back and go for occasional walk. Sorry if I 'm repeating but also advise as to wether I should not take Amitripoline with zapping till Today when I can see GP or look on DW for advise recommendation.

Hope that help?

Thanks

 

[Medikate]

Also I only have 7 Zapain 30mg till today unless I'm no better in morning I will ring out of hour GP. I'm just concerned if I take codine the tramadol is still going to screw with my chemistry. Really would like to take 2 now as they actually help more than they did the first 5 days. So at least some relief and with any luck make me drowsy?

 

[Medikate]

Also I've taken a lot of Diazepam many many years ago Loraripam, and even Nitrazapam. Not sure if they will help sleep. Well the Nitrazipam might but would the pain just make worse as I don't want to feel supper sedated and not be able to sleep. Just don't know. I think I will have to have two Zapain as from what I've read probably not a good idea to suddenly stop especially when I've been taking maximum dose. Will ring out of hours GP tomorrow, Thanks.

 

[Cream Gravy?]

I read that Amitripoline can take a few weeks to kick in.

Not if it's working... amitriptyline is a TCA and they don't take one to two months to start 'working' like SSRIs or SNRIs. They start working immediately. I was given amitriptyline for nerve pain before, and it started working on day one... had the worst side-effects of any drug I've ever taken, but it worked for the immediate nerve pain.

Also, whoever co-prescribed the tramadol with a TCA... they should lose their license to practice. You're lucky you didn't get serotonin syndrome. Also, tramadol has simulating effects (as do most anti-depressants aside from TCAs) that are likely further contributing to your insomnia. I cannot sleep on tramadol until the main effects wear off... hardly good for night time pain.

 

[Medikate]

No, I did think. The GP that prescribed didn't question Tramadol. I know my Local GP would not have. Fucking crazy really. I think I will have to take to 2 zapping as perhaps that may help one the pain and two the mania. Unless you would advise otherwise as I'd rather be slightly manic for a night it there could be the same drama as last nigh. To treat was very hard at points and was just trying to stay calm if honest but as tired as i was no way was I going to sleep again after waking up as i did. Quite frightening

Thanks for help. Means alot. Just as to wether I take more Zapain tonight. Thoughts please?

 

[Medikate]

Will stop the Amatriptyine also.

 

[Cream Gravy?]

Just as to wether I take more Zapain tonight. Thoughts please?

Codeine shouldn't have any negative interactions with any of the other medications you listed. You could also keep taking amitriptyline with it, if it is working for your nerve pain. If it isn't working, why take it?

If you're indeed suffering from nerve pain issues, a GP is likely to keep trying stuff like amitriptyline or other off-label anti-depressants. I assume you're in the U.K. since you have Zapain (no codeine here in U.S.); I'm not sure why they're so scared of gabapentenoids there but gabapentin or pregabalin would likely do a better job for your pain. Whether or not that's dangerous given your bipolar disorder, that's up to a (well informed) doctor to decide.

 

[Medikate]

Thank you very much for very helpful advise. I will take zapain and decide how i feel later as to Amitriptyline but as you say if is not helping pain not much point in taking it. So thanks again. A real help.

 

[Burnt Offerings]

Amitryptaline is a dirty drug.

Don't really have anything to add other than that. It's the only one in that list that I have experience with other than codeine, which I've only had like a couple experiences with.

 

[Medikate]

Thanks for advise on that friend. I will not be taking that. Just the Zapain till see local GP on Monday. Had 60mg about 30 mins ago and it has removed some pain so hope to get better sleep than last night. But I think best not to stop all the meds after taking 120mg daily of Zopain. Especially reading here and elsewhere as not good to suddenly stop. But they are not long term answer if it doesn’t get any better. Not sure what your thoughts on Omophine are but I know my osteopath said it’s probably the one thing that will help. But he also said not many GP s will prescribe it depending on doctor

I had a history of drug misuse in past but I’m was a long time ago and never opioid based. . Great forum. Thanks all for swift and sound advise.

 

[emkee_reinvented]

I still take Zapain. Definitely not going near Tramadol especially so of the stuff I've read on this forum.

Zapain is a combination product of APAP/ Paracetamol and Codeine. I never heard of it!

Pregabalin is ime not stimulating so your dr. has some weird view on this med. Imo its a downer, apperently good for nerve pain and GAD. But will help with anxiety in general.

 

[Medikate]

Well. I actually had no sleep last night and with my little doctors knowledge and a load of research. I think now the pain is more pronounced on chest as in spasms so perhaps Cyclobenzaprine or Metaxalone might help but can’t see gp till Monday. I actually braved 6 hours in a and e as was advise ha by yet another doctor as ask if aforementioned meds might be worth a try. I had a young woman doctor in a and e check me out and she was in fairness very thorough and she came to conclusion I’m right but she was unable to prescribe them as out of her hand. She was a little amazed as the why I was given Tramadol but again couldn’t say too much as she was just doing her job without getting in to heated debate of dangers I could have faced.
Anyway I had Zomorph 10mg sheet in post. So probably worth trying them. Not what dose. But if anyone thinks major bad idea and advise on dose as 10mg is very little and slow release. So might pop one and see if anything. I have old diaz also as other option. I also said I want to stop codine as not really help a great deal so at least they gave me script for that so I can tapper off 2x30mg twice day for 8 days.

Any advice appreciated. Will double check myself but I’d pop 3 or more if it wasn’t gonna kill me. I can’t imagine a thing I do with Zomorph or Diaz would be worse than Tramadol experience.

Thoughts kindly revived. Thanks.

 

[Medikate]

I’m not going to rush decision as clueless with prescription drugs mostly and I’m not on a suicide mission. Just only have today and Tommie to get through with fuck any if any sleep. Less than ideal but possible.

 

[Medikate]

One more thing. There was a chart that was interesting but can’t for life of me find it a remember where I saw. It suggesting which substances to ovoid together and risks. The Tamabol Amitriptiline and codine were all in danger zone. Only saw that after unfortunately. Hey hi.

 

[Medikate]

Ok. Just responding to my own happenings. Turns out the Zomorph and Diaz can stay out of accusation as prob not a great idea considering this is primarily a non recreational resolution to ease pain. As it turns out I was given what I delivered to be the generic Codine Phosphate in tablet form. The Zapain was in caps.

So not found out what the difference is and if there is. But I know the generic ones have actually done wonders. Got 2 hours sleep yesterday at about 6 and 8 pm after taking 2x30mg at around 2pm and then took 2x30mg at 11pm and ended up gettng close to 5 hours sleep without pain waking me.

So for sure the genre c non brand tablet form really have help. Ok the pain was far worse in the first week but still glad I’m actuallly getting the benefit and I am not in unbearable pain now but the pain never totally goes just the new tablets seem to make me high enough so I can easily cope and sleep pretty decent to especially after the past two weeks.


So Zomorph and Diaz can go away and will take 2x30mg of new Codine Phosphate tablets. As the Zapain was not so good as the Zapain caps. IMHO

Peace