Opioids Tramadol and codeine

[Pandabear47]

Hi there

i take 600 mg of codeine at once and have no side effects or problem but am losing the “buzz”. I have tramadol. I have taken 500 mg with little reaction at all. Can I mix the two? How much can I take of each together? I’m looking for a good “buzz!”

anyone got suggestions? ( I can’t get hold of OxyContin or similar)

 

[Nicomorphinist]

One can mix the two, and to good effect as I remember, but are you getting ringing in the ears or dizziness from the 500 mg of tramadol at once?

Taking 600 mg of codeine at once in all likelihood, depending on individual metabolism, means that some of it, maybe 200 mg is just floating around and having no chance of being biotransformed into morphine, and pacing oneself like taking it in two doses two hours apart really won't help, which was why I added 150 mg of tramadol to the 390 mg of codeine hydrochloride I was taking at one point, then up to 200 mg, and switched to dihydrocodeine and a dose of tramadol which declined to 38 mg then slowly crept up to 100 mg again then the doctor put me on dextromoramide back in the day.

Tramadol is also partially metabolised by the same Cytochrome P450 pathway as codeine, so I say take them at the same time just like it helps to put all of one's codeine dose down their gullet in one go. I had good results from chewing the 100 mg extended-release tablets, by the way. Some extended-release effect left, but also more of a blast of tramadol at the outset too.

 

[Pandabear47]

So you’re saying that the 200 mg of codeine (from the 600mg I’m taking) is having no real effect?

I don’t get ringing in ears. Could I take 400mg of tramadol and 300mg codeine at once?

 

[Pandabear47]

Thanks for your reply, by the way!!!!

 

[Nicomorphinist]

So you’re saying that the 200 mg of codeine (from the 600mg I’m taking) is having no real effect?

I don’t get ringing in ears. Could I take 400mg of tramadol and 300mg codeine at once?

There is that distinct possibility, though there are dissenting voices about the Cytochrome P450 II-D-6 saturation issue, and also some different figures ranging from 350 to 900 mg . . . actually a suggestion I could make is 300 mg of tramadol and 360 mg of codeine and see if that does the trick. I hear some people speak of the human body acquiring an enhanced ability to destroy codeine; that was the debate in the 1920s and 1930s especially and I still wonder myself. But enough to expand the saturation level by 50 or more per cent does not seem likely but like the extreme tolerance that people can grow, there could be surprises there too. What I remember of times that I took 750 mg of codeine at once was waking up the next morning looking like I had been to the visitors' centre in Hell from all of the scratches on my face, but not much more pain relief or reverie . . .

 

[JessFR]

I don't think it would be dangerous to take the two together outside of the inherent danger from the effects of opioids in general. And it sounds like your tolerance means that risk is low.

There is of course the seizure risk from tramadol at higher doses, but that's the case with or without the codeine.

The main problem I can see is that, as I recall both codeine and tramadol need to be metabolized to become active, and both use the same enzyme to do it. So they both have a ceiling dose where taking more won't increase the effect. And that ceiling is probably shared between the two.

So you may not notice much extra effect.

 

[KS78]

Do you have really high tolerance? I get that Codeine isn't doing much but 500mg of Tramadol doesn't do much for you? Tramadol has opioid and antidepressant effects; even if the opioid effect doesn't do much, the antidepressant effect should hit you pretty hard (if you don't use it regularly at high doses).
You should be able to combine them keeping in mind the increasing seizure possibility, especially past 400mg. If I took this combination for the first time, I would take half of each medication to be safe.

 

[JessFR]

Do you have really high tolerance? I get that Codeine isn't doing much but 500mg of Tramadol doesn't do much for you? Tramadol has opioid and antidepressant effects; even if the opioid effect doesn't do much, the antidepressant effect should hit you pretty hard (if you don't use it regularly at high doses).
You should be able to combine them keeping in mind the increasing seizure possibility, especially past 400mg. If I took this combination for the first time, I would take half of each medication to be safe.

I dunno about you but the opioid effect is all I've ever noticed from tramadol.

As for tolerance, it's all relative. But I'd call even a pretty high codeine tolerance a virtually nothing tolerance relative to the more serious opioids.

 

[Pandabear47]

I dunno about you but the opioid effect is all I've ever noticed from tramadol.

As for tolerance, it's all relative. But I'd call even a pretty high codeine tolerance a virtually nothing tolerance relative to the more serious opioids.

I’ll try both together at slightly lower dose to start with and see. Yes, my tolerance to codeine is v high. I do notice that nurofen plus has more of an effect but obviously there’s the danger of taking too much ibuprofen. Thanks to everybody that’s replied. I’ll let u know how I get on!!!!

 

[Pandabear47]

Do you have really high tolerance? I get that Codeine isn't doing much but 500mg of Tramadol doesn't do much for you? Tramadol has opioid and antidepressant effects; even if the opioid effect doesn't do much, the antidepressant effect should hit you pretty hard (if you don't use it regularly at high doses).
You should be able to combine them keeping in mind the increasing seizure possibility, especially past 400mg. If I took this combination for the first time, I would take half of each medication to be safe.

Yep, really high! I’ll try the two together and see how I get on. (I’ve noticed nurofen plus has more effect but there’s the ibuprofen to worry about. !!!

 

[Pandabear47]

Do you have really high tolerance? I get that Codeine isn't doing much but 500mg of Tramadol doesn't do much for you? Tramadol has opioid and antidepressant effects; even if the opioid effect doesn't do much, the antidepressant effect should hit you pretty hard (if you don't use it regularly at high doses).
You should be able to combine them keeping in mind the increasing seizure possibility, especially past 400mg. If I took this combination for the first time, I would take half of each medication to be safe.

Thanks - I’ll try that - plus see my other replies!!!

 

[Nicomorphinist]

I’ll try both together at slightly lower dose to start with and see. Yes, my tolerance to codeine is v high. I do notice that nurofen plus has more of an effect but obviously there’s the danger of taking too much ibuprofen. Thanks to everybody that’s replied. I’ll let u know how I get on!!!!

There could be a metabolic assist of some source, but ibuprofen, being an analgesic, can produce what can sometimes be called slight euphoria, one reason I think that a non-euphorigenic effective analgesic will never be found -- euphoria is part of pain relief because people like being out of pain. I used to like to wash my 30 mg codeine HCl neat tablets, 120 mg DHC and/or tramadol with 500 mg naproxen -- it was groovy! I could swear I could still feel the effect of naproxen even with morphine, dextromoramide, nicomorphine, hydromorphone. Actually I still can, even to this day, and it helps with taking shots in the leg and arse cheek . . .

 

[Pandabear47]

There is that distinct possibility, though there are dissenting voices about the Cytochrome P450 II-D-6 saturation issue, and also some different figures ranging from 350 to 900 mg . . . actually a suggestion I could make is 300 mg of tramadol and 360 mg of codeine and see if that does the trick. I hear some people speak of the human body acquiring an enhanced ability to destroy codeine; that was the debate in the 1920s and 1930s especially and I still wonder myself. But enough to expand the saturation level by 50 or more per cent does not seem likely but like the extreme tolerance that people can grow, there could be surprises there too. What I remember of times that I took 750 mg of codeine at once was waking up the next morning looking like I had been to the visitors' centre in Hell from all of the scratches on my face, but not much more pain relief or reverie . . .

thanks- no idea about cytochrome...... I’ll have to look it up!!!

 

[Pandabear47]

I dunno about you but the opioid effect is all I've ever noticed from tramadol.

As for tolerance, it's all relative. But I'd call even a pretty high codeine tolerance a virtually nothing tolerance relative to the more serious opioids.

never tried other stronger opioids. V hard to get hold of!!!

 

[Pandabear47]

There could be a metabolic assist of some source, but ibuprofen, being an analgesic, can produce what can sometimes be called slight euphoria, one reason I think that a non-euphorigenic effective analgesic will never be found -- euphoria is part of pain relief because people like being out of pain. I used to like to wash my 30 mg codeine HCl neat tablets, 120 mg DHC and/or tramadol with 500 mg naproxen -- it was groovy! I could swear I could still feel the effect of naproxen even with morphine, dextromoramide, nicomorphine, hydromorphone.

i might try that! Thanks!

 

[supersonic89]

I am not an expert but I think of two options: maybe they do not potentiate much since both are metabolized by the same enzyme or there is a lot of cross tolerance between both drugs.
Also according to this page (https://clincalc.com/Opioids/) 600 mg of Codeine equals more than 500 mg of Tramadol. In any case, it is quite weird that you do not feel anything for 500 mg of Tramadol. Is it the first time you took it or did you already have experience with Tramadol? Do you take it in a single dose or divided into several doses?

 

[GetMeOutOfThisCRAP]

I'm sure you know this already but this is the problem with opioids. They do have an amazing irreplaceable world in medicine and recreational purposes but they lose their effects fast. Eventually I'm worried that you'll be leaning towards taking more tramadol and can end up in a potential seizing situation.

Codeine seems to be not easily metabolized in comparison to the others. Could be wrong though.

 

[LopLover]

A couple of thoughts. Those are fairly high doses, and there really is a seizure threshold with Tramadol. I've had a seizure from it, although I was also getting off benzos, so it didn't take much to put me into a seizure. With the codeine, are you taking T3s or 4s? If so, that's a lot of acetaminophen and taken over a period of time, may cause liver damage. There's a way to separate the codeine out listed on this site. If I were to ever go back to Vicodin or Percocet, I'd look it up and separate them, as I already have a compromised liver.

 

[Nicomorphinist]

i might try that! Thanks!

Have you also tried potentiating the codeine with things like various antihistamines, depressants, some metabolic agents &c? A lot of the same ones stretch out a given dose of tramadol as well. One thing that is relevant especially in chronic pain control is what carbamazepine does to tramadol, i.e. it has a combination of effects which make it necessary to double the tramadol dose but the impact if any on codeine is not as dramatic if indeed it does appear. Promethazine increases the amount of codeine turned into morphine, tramadol into O-DSMT, and has an anti-serotoninergic effect that could reduce some of the risk of higher doses of tramadol. Cyproheptadine and phenindamine are other antihistamines with some degree of anti-serotoninergic effect and so do hydroxyzine and the other piperazine antihistamines like cyclizine and meclozine to a slightly lesser degree.

 

[negrogesic]

euphoria is part of pain relief because people like being out of pain

This is an interesting distinction you make, i wonder to what extent this is true in those not in pain. For those that dont need a muscle relaxant, a muscle relaxant is still enjoyable, so is it true that the analgesic is still enjoyable to those not in need of analgesia? The only nsaid i know of that it outright enjoyable is benzydamine, and that seems through other mechanisms...