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Tramadol cause Loperamide Withdrawal?

rmadrid24

Greenlighter
Joined
May 27, 2010
Messages
4
After extensive online research, I did not think it was possible to have precipitated withdrawal from Loperamide. However, after the last week of hell - I'm convinced. After years of heavy opiate use (Oxy, hydrocodone, Morphine, etc), I was switched to Tramadol, at about 16-18 pills a day - no seizures luckily - which turned out to have the worst withdrawals of all. Then I got laid off and had to stop cold turkey.

When I was withdrawing, i was taking high doses of loperamide (about 60-80 mg) with cimetidine along with Seroquel and Gabapentin, noticing mild euphoria and then went down to about 30 mg for about 4 months. Every time I went down lower -serious depression and withdrawal kicked in. I finally decided, after I got a high stress job position, I will go back to tramadol until i can detox with help of a therapist since I was failing miserably and worried about all the loperamide I was taking. I ordered tramadol from a well known and trusted IOP - obviously I won't identify here - and it came last week. here is how it went down:

Thurs morning - 40 mg Loperamide
Thurs evening - see my Tramadol cam e- do a happy jig and take a small amount since its been about 5 months - 100 mg
Fri morning - take 100 more and 300 mg more throughout the day until I go to sleep
Sat morning take more - but feel oddly shaky and wiry at the gym.. by nightime at rabbit rescue where I volunteer - sweating, shaky and cold/hot..absolutely nothing like tramadol feels for me. Worry the IOP sent me something else or I'm having a heart attack at age 39. Almost faint on the subway..everyone staring at me and asking, "are you ok?" These were more intense symptoms then normal and they went on and on (maybe due to Lopes long half life???).
By Sunday and then Monday I was so sick I was sent home from my new job (I said I had food poisoning) and each night I soaked all of my sheets and shivered like hell. This felt nothing like Tram but this IOP has a spotless rep and I felt oddly buzzed while sick, if that makes sense.
Deciding to see if its because I stopped Lope - I took 30 mg and then reintroduced the Tram. Sure enough - the sickness stopped and I am taking 400 mg tram a day and tapering off the Lope and its going well. I am confident it was Tram i got and stopping Lope is what did it.

How can this be? I did not have many withdrawal symptoms using Lope to withdraw from Tram and for Pete's sake, it is diarrhea medicine we are talking about here!
 
Well you can definitely withdraw from loperamide since it's an opioid, and the dose you were on as well as the length you had been taking it for were definitely enough to cause withdrawals.

Homeless --> Other Drugs
 
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Thanks for the input..yes wont ever underestimate loperamide again. But i wonder why the tramadol didnt stop the lope withdrawals since the lope stopped the tram withdrawals for me months ago. Thats what is strange to me
 
Tramadol is an SNRI opioid so withdrawal will include opiate withdrawal symptoms as well as SNRI withdrawal symptoms. I'd think the reverse of your situation would make sense in this case but perhaps the lope doses were just much higher than you could get with tramadol without having a seizure.
 
Hey rmadrid,

I don't think the tramadol is causing a loperamide withdrawal so much as the tramadol is not sufficient to cover up the loperamide withdrawal.

Loperamide is actually very potent in its own unique way, and my own subjective experiences tell me that it has a ridiculously long half life AND withdrawal symptoms that are disproportionate to any good feelings that it may offer.

Tramadol is not a very strong opioid. I'm afraid that 30mg of loperamide for a few months would be enough, IME, to warrant a nasty and long withdrawal which would pretty much swallow up any effect that tramadol could offer. Hence:


I felt oddly buzzed while sick, if that makes sense.

A bit of tramadol's mood enhancing properties came through but were crushed by the lope WDs.


I seem to be one of the few (lucky?) people who get a huge effect from even tiny doses of loperamide. I've been addicted to opiates for years now, and when I'm in a tight spot I'll take a little bit of loperamide to keep WDs at bay - and I'm amazed at how well it works. It takes forever to take effect, but when it does come in it clears up most of my physical WD symptoms and even gives me a bit of energy.

Then, when it's time to switch back to my DOC, I'll often notice a subtle but unmistakable feeling of uneasiness and dysphoria as the lope makes its exit. This is noticeable even while on other potent opiates, so I imagine that tramadol would have a hard time fighting 30mg daily of lope...

Thus: you may need to reintroduce a very small amount of lope as a taper. Take a tiny bit and see if your symptoms don't disappear within a few hours.

Good luck and take care.
 
I don't think the tramadol is causing a loperamide withdrawal so much as the tramadol is not sufficient to cover up the loperamide withdrawal.

exactly what i was thinking.

the tramadol doses arent enough to stave off your wds from the lope dosing.
 
Thank you so much for the input everyone. I was starting to think I was losing my mind, but this really gives me a strategy. Its 7 days later and I am down to 20 mg of Lope a day and up to 400 mg tramadol and it seems to be working. As long as i dont get back up to 18 trams a day it should be ok. Thanks again

I just never anticipated the intensity of the withdrawals... they were not like oxy or hydro withdrawals I had in the past. They were extremely intense and the cold sweats and trembling were unlike I ever experienced. Thats why I thought they may be precipitated withdrawals.. but I guess not since it happened 18 hours or so days later...not right away..
 
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^Good to hear you're back on track. Don't lose hope. It takes a lot of determination to taper down.

Lope withdrawal is absolutely fucking hideous. AND.... tramadol withdrawal is also hideous in a different way.

Unfortunately, there is nothing that will provide a 'get out of jail free' card when it comes to opioids/opiates. Any option that provides noticeable relief comes with a heavy price tag if it isn't used for a very short time and then dropped immediately.

It's a rough road back to full independence. No shortcuts. Slow and steady wins the ...blah blah.

Take care and good luck.
 
Thank you for all your support. I apreciate it tremendously. For my particular biochemistry, tramadol and loperamide do not go well together. Now tram and kratom...thats another story lol
 
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