As much as I hate posting in ADD due to unfriendly responses from some or a lack of any comments, the scepticism when discussing my unusual symptoms and being made to feel like im intruding in an area of the forum where some think they have ownership to...yet unfortunately I'm here once again without choice simply because Im stuck with stupid uncommon symptoms to drugs and dont know anywhere else I can turn to for help...so I'm posting this in hope that the few friendly kind people who have helped me in the past would once again make an effort to help me out again....
The problem I'm having is very specicfic and a very confusing one and difficult to explain....It usually happens only with Tramadol and Oxycodone although I havent really tried it with others....My body seems to be ok when I take one single dose dose of 50 mg Tramadol at once or one dose of 10mg Oxycodone but if I attempt to redose an hour or 2 later with smaller portion of the same medication to control the pain I end up having an adverse reaction simply due to the redosing process....for example....
Single dose of 50mg tramadol = no problem
50mg devided into 5 parts and taken at smaller portions of 10mg per hour rate = an adverse reaction
10mg oxy taken at once or every 4 hours = no problem
10mg oxy devided into 5 parts of 2mg per part and taken at smaller portions of 2mg per hour = an adverse reaction
10mg oxy taken at once = no problem + an additional 2mg taken 2 hours after the 10mg = an adverse reaction
This is the very reason why Im never able to take any slow release meds and only stick to instant release...Now you may ask if this is a problem then why not just stick to one single dose rather than redosing or taking smaller portions and the answer is because often after taking a single dose of 10mg oxy it wears of quickly and the pain comes back requiring an earlier dose. Also deviding my medication up into smaller portions is what I do to desensitise myself to gain tolerance. But even if I take smaller dose like 2mg following the initial larger dose of 10mg I still end up having an adverse reaction although initially the 10mg on its own caused me no problems whatsoever.
My theory from what I can see is that my body is exteremely sensitive to metobolisation process of the medication even if it is smaller doses. It seems it has no problem metobolising one single large dose but has difficulty with frequent smaller doses due to a build up perhaps ? I've read that Cytochrome P450 enzyme system in the liveris metabolized to the very active opioid analgesic oxymorphone some people are fast metabolizers resulting in reduced analgesic effect but increased adverse effects, while others are slow metabolisers resulting in increased toxicity without improved analgesia. Does the CYP2D6 sound like the reason for my symptoms ?
The problem I'm having is very specicfic and a very confusing one and difficult to explain....It usually happens only with Tramadol and Oxycodone although I havent really tried it with others....My body seems to be ok when I take one single dose dose of 50 mg Tramadol at once or one dose of 10mg Oxycodone but if I attempt to redose an hour or 2 later with smaller portion of the same medication to control the pain I end up having an adverse reaction simply due to the redosing process....for example....
Single dose of 50mg tramadol = no problem
50mg devided into 5 parts and taken at smaller portions of 10mg per hour rate = an adverse reaction
10mg oxy taken at once or every 4 hours = no problem
10mg oxy devided into 5 parts of 2mg per part and taken at smaller portions of 2mg per hour = an adverse reaction
10mg oxy taken at once = no problem
+ an additional 2mg taken 2 hours after the 10mg = an adverse reaction This is the very reason why Im never able to take any slow release meds and only stick to instant release...Now you may ask if this is a problem then why not just stick to one single dose rather than redosing or taking smaller portions and the answer is because often after taking a single dose of 10mg oxy it wears of quickly and the pain comes back requiring an earlier dose. Also deviding my medication up into smaller portions is what I do to desensitise myself to gain tolerance. But even if I take smaller dose like 2mg following the initial larger dose of 10mg I still end up having an adverse reaction although initially the 10mg on its own caused me no problems whatsoever.
My theory from what I can see is that my body is exteremely sensitive to metobolisation process of the medication even if it is smaller doses. It seems it has no problem metobolising one single large dose but has difficulty with frequent smaller doses due to a build up perhaps ? I've read that Cytochrome P450 enzyme system in the liveris metabolized to the very active opioid analgesic oxymorphone some people are fast metabolizers resulting in reduced analgesic effect but increased adverse effects, while others are slow metabolisers resulting in increased toxicity without improved analgesia. Does the CYP2D6 sound like the reason for my symptoms ?
![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")