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  • BDD Moderators: Keif’ Richards | negrogesic

Something a step up from tramadol?

BlackOnWhite

BlackOnWhite

Bluelighter
Joined
May 4, 2010
Messages
91
Location
Perth
Hey guys, so I was on oxycodone and hydromorphone for a while for severe testicular pain and have been taken off them because my doctor is trying out a few medications for neuropathic pain instead. I am on amitriptyline at night and he's going to give me something else which is an anticonvulsant today. Meanwhile, I've been given tramadol or paracetamol w/ codeine and neither are doing anything for the pain.

So, what is a step up from tramadol? I don't know how far up the ladder my doctor wants to go because I have been taken off the stronger opiates. Would taking dihydrocodeine be better than the panadeine fortes etc?
 
I would say hydrocodone(vicodin, lorcet, etc.) is a step up from tramadol. I have very severe neuropathic pain in my mid-body, legs, and feet. Your doctor should have put you on neurontin or lyrica if he trying to treat neuropathic pain. I take amitriptyline as well, but I dont think it contributes to my relief, atleast much.
 
yeah i was thinking dhc could be just that little bit better but i dunno. what about pethidine? i've heard that being used below oxycodone, morphine, oxymorphone and hydromorphone.
 
BlackOnWhite said:
So, what is a step up from tramadol? I don't know how far up the ladder my doctor wants to go because I have been taken off the stronger opiates. Would taking dihydrocodeine be better than the panadeine fortes etc?
Click to expand...

I would have to say Vicodin would be the next step. And I'd ask about some Neurontin for the neuropathy part.
 
Oxycodone is probably a step up from hydrocodone. If your current doctor is not helping you I would try to see a different one. If the pain gets too severe you can go to an emergency room to see if they would help you. If you were to go to an emergency room I would ask the doctors there if they could refer you to a doctor to follow up with. I would tell them you dont have a current doctor. They may refer you to a doctor they believe will help you.
 
The problem with this poster is that he has lied to his doctor/blers before, abusing his oxycodone and hydromorphone, then his mother told his doctor. I assume he got cut off and was told he can only use opiates less potent than oxy and isn't happy with tramadol/codeine.
 
Your dr. should not be prescribing amitriptyline and tramadol at the same time. Both affect serotonin and norepinephrine and the combination could cause serotonin syndrome or seizures. Maybe your doc thinks its safe, but odds are he just isn't familiar with the pharmacology of tramadol...you might want to bring this up with your doctor, especially since the tramadol isn't working anyways.

To answer your question, a step up from tramadol and codeine would be hydrocodone (Vicodin). Morphine, oxycodone, oxymorphone and hydromorphone are generally considered a step up from hydrocodone.
 
Mally I am not even going to go there, the threads about IV'ing were posted by me yes but the information was passed on to someone else, but I really couldn't care less if anyone believes me or not. My doctor believes me and that is all that matters, I am off the strong opiates because he believes it is now neuropathic pain and is trying to deal with that.

As for ami and tramadol, yeah I use to get worried about taking the two but to be honest I think I have an extremely high threshold to serotonin syndrome, I have taken upto 2500mg of tramadol, ami, my daily lexapro and 3 hits of LSD all at once and did not even have a near symptom of SS (which I am extremely grateful for).
 
BlackOnWhite said:
Hey guys, so I was on oxycodone and hydromorphone for a while for severe testicular pain and have been taken off them because my doctor is trying out a few medications for neuropathic pain instead. I am on amitriptyline at night and he's going to give me something else which is an anticonvulsant today. Meanwhile, I've been given tramadol or paracetamol w/ codeine and neither are doing anything for the pain.

So, what is a step up from tramadol? I don't know how far up the ladder my doctor wants to go because I have been taken off the stronger opiates. Would taking dihydrocodeine be better than the panadeine fortes etc?
Click to expand...

I'm surprised he didn't prescribe Lyrica (pregabalin) along with the Tramadol if dealing with neuropathic pain.

The next step up from Tramadol would be Codeine and then Hydrocodone.

Propoxyphene > Tramadol > Codeine/Dihydrocodeine > Hydrocodone > The Rest
 
to the op, you should have posted this in the autralian DD because a lot of the meds people are recommending simply aren't available here, hydrocodone for instance... dihydrocodeine is inly available otc in the form of a syrup called rikcodeine.

the next step up would be endone(oxycodone), but you could sugest buprenorphine in the form of a patch.... it's called Norspan and it comes in 3 different strengths. if your current doctor isn't willing to prescribe you oxycodone of any form, then try buprenorphine... ask him, personally the 5microgram/per hour patch did bugger all for me and i ended up eating it and getting i nice bupe buzz(long half life) but maybe the 20mics an hour patch will sufice? suggest it to him, or find another doctor.

i am in knee pain and went into my doctor after telling him tramadol and codeine does nothing for my pain, and almost begged him for endone, and he tell me to find another doctor, and what do you know? i did, and with in 4 months i've gone from endone to 20mg oc 3 times daily.... we all make bad choices, you shouldn't have to suffer and put up with this doctor thats got your drug misuse in the back of his mind every time you see him. if you really are in a lot of pain and the medication isn't working then you need to be honest with yourself and get the right treatment. its up to you.
 
I am sorry but what happened to your testicles?

I can't really answer your question because I don't know what's available in Australia... Perhaps Nucynta which is actually the next step up from tramadol but I dont know if its available there in Aussie.. However I would say a man with chronic pain to the testicles deserves Oxy.
 
darvocet!

not sure about it's strength compared to tramdol, but i know it's a tad weaker then hydrocodone, so if that's too much then try asking your doc about darvocet.


EDIT:
well i just read a post a few up and found...

Propoxyphene > Tramadol > Codeine/Dihydrocodeine > Hydrocodone > The Rest

and propxyphene is darvocet, so i guess scratch my whole post.
 
ok so should I ask for dihydrocodeine then? violenza, i had a bad infection of chlyamidia and they diagnosed me with epidymitis and unfortunately the pain is still there but the infection is gone. my doctor doesnt want me to go onto the stronger ones like oxycodone again because he doesnt know how long the pain is going to be there for. any suggestions on how I could change his mind about that? because i am in severe pain, its getting worse week by week :( oxycodone and dilaudid were the only two that killed the pain completely
 
Depends. I would try to find some tram to try to see if it works for you before you switch. Tram doesn't work for everyone but if it does it may be very effective. But you don't want to give up your scripts if they don't. It isn't controlled right now so you can even order a little online if you wanted to.

Edit: But I'm not sure what the law is exactly in Aus. Anyone know?
 
Last edited:
Pillthrill said:
Depends. I would try to find some tram to try to see if it works for you before you switch. Tram doesn't work for everyone but if it does it may be very effective. But you don't want to give up your scripts if they don't. It isn't controlled right now so you can even order a little online if you wanted to.

Edit: But I'm not sure what the law is exactly in Aus. Anyone know?
Click to expand...

He's currently getting tramadol/codeine and wants to know what's next on the ladder...

OP: Next up, for you, would be what you were on and cut off of - oxycodone, since no hydrocodone is available in Australia - but good luck getting that with the whole mom/doctor/lying situation... :\
 
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