Tramadol & Dihydrocodeine

[Away with the fairies...]

Hi there all
Am looking for some advice, Lulu has been suffering with long term pain now for 5+ years.
Lulu was prescibed Dihdrocodeine 60mg 4xdaily & Paracetemol 500mgx2 4xdaily, also takes escitalopram for depression
Lulu now got shingles and due to long term use, dihydrocodeine no longer works. Years ago was given Tramadol to try instead of codeine, found that they made Lulu a little hyper and didint really hep with pain.
As lulu now in extreme pain due to shingles, wants to know if it is safe to take the Dihdrocodeine (60mg) with Paracetemol and Tramadol 100mg?
Any advice greatly appreciated

[Ale]

It sure is..as long as you stick to the recommended dosage..but why would Lulu want to take Dihydrocodeine when she can't get any wrthy effect out of it and/or Tramadol when she just claimed it's only good to make her hyper and nothing more?

[samuraigecko]

If tramadol doesnt help with the pain and only makes SWIyou hyper (one is hearing this more and more lately) then one would suggest that SWIyou go back to the doc and tell him and discontinue the use of the Tramadol and go back to the dihydrocodine for a while. perhaps now that SWIyou have not used the dihydro for a little bit SWIyou may find that the tolerance for it is gone and it may well work again.

However, if one is dealing with long term pain that is severe one would suggest again to go back to SWIyour doctor and discuss it with him. Something may be able to be worked out that ends up getting SWIyou a much more effective pain killer.

Taking dihydro and Tramadol at the same time probably wont hurt SWIyou too much but there definitely can be undesired effects with mixing any drug so one would not recommend taking both.

Hope this has been of help

[Away with the fairies...]

Thanks for your replies guys

Ale,

In answer to your query,Lulu decided that even tho tramadol has not been of much use in the past, with current amount of pain she was experiencing, anything was worth a try!!


When Lulu last used tramadol for any amount of time(bout 2yrs ago),it was because the codeine no longer worked, so doc said try tramadol instead for a while. Lulu did as doc said and found that only effect was hyper-ness, not nice hyper either, sorta freak yourself out hyper, sooo, went back to doc and was told tramadol affects some peeps in this way so best to stop taking and go back to dihydrocodeine.
That was about 2 years ago and since then Lulu has been using dihydrocodeine 60mg x4 each day with Paracetemol 2x500mg x 4 each day pretty much every day throughout that whole 2 year period. (except when Lulu had to have an operation on her jaw and for 2 months after the op was prescribed morphine as was recognised by doc that codeine wouldnt help.) After that was back to the dihdrocodeine Paracetemol mix.
Lulu now reached a point where have to take Dihydrocodeine & Paracetemol all the time just to feel "normal", (if dont take then pain very bad and also suffer headaches, irritability and a general feeling of being unwell) but even after taking only getting minimal pain relief and lots of breakthrough pain. Doc informs Lulu that only alternative is morphine but doesnt want to prescribe as will end up on it for life for chronic pain, a decision Lulu agrees with. HOwever, that leaves Lulu in a situation where she is constantly taking meds that have no real benefit with regard to the reason for which they are prescribed.
Having now been ill for a month with shingles on top of everything else, Lulu is in a bit of a state and deosnt know what to do, (Lulu's doc is not the most helpful)
Tried Tramadol with Dihdrocodiene but found that just made Lulu hyper and no difference to pain. Hyper is not needed or helpful at this stage as Lulu not able to sleep due to pain and needs to sleeeeeeeeeeeep!!
Lulu heard that combining grapefruit juice with dihydrocodeine can boost effect? is there anything that Lulu can do to make dihydrocodeine work again?
Lulu has been known to, in recent weeks, take 90mg dihydrocodiene but has found still doesnt help. Guess Lulu is now immune to it? Lulu cant settle down and is desperate to just relax and be pain free to sleep a couple of hours....!!

[samuraigecko]

grape fruit juice can work good for people whom metabolize codeine and its derivitives well. Since SWIyou used to get good effects from the dihydro then perhaps one should have a look around a bit at the various potentiation threads.

hope this has been of help

[Ale]

Originally Posted by Fairygirrly

[..]Lulu now reached a point where have to take Dihydrocodeine & Paracetemol all the time just to feel "normal", (if dont take then pain very bad and also suffer headaches, irritability and a general feeling of being unwell) but even after taking only getting minimal pain relief and lots of breakthrough pain. Doc informs Lulu that only alternative is morphine but doesnt want to prescribe as will end up on it for life for chronic pain, a decision Lulu agrees with.[..]

What about trying some other opiates...such as...say..Oxycodone Hydrochloride?Did Lulu take into consideration this possibility?

[bloodred1889]

there are other opioids stronger then dihydrocodeine.
infact dihydrocodeine comes in stronger doses then 60mg it goes upto 120mg a pill, so maybe ask doc for the stronger ones and take them 4x a day this would be much stronger and may help.

failing that your doctor says the only alternative is morphine, but thats wrong because there are many inbetween opioids from dihydro to morphine such as oxycodone, hydrocodone and others.
perhaps just ask for one of these and see if it helps.

also has he tried you on any anti inflamatories aswell as the dihydrocodeine.

swim was on dihydrocodeine and diclofenec for her back, arms and leg pain.

other then that swiy could see another doctor of a pain managment specialist or ask for tests to be done to see if you have somthing that can be treated.

hope this helps.

[samuraigecko]

Originally Posted by bloodred1889

failing that your doctor says the only alternative is morphine, but thats wrong because there are many inbetween opioids from dihydro to morphine such as oxycodone, hydrocodone and others.

Not entirely correct. Oxycodone and other opiate are quite often stronger per MG than Morphine. Oxycodone is 1.5x to 2x the strength of Morphine for example. MScontin would be prescribed before Oxycontin is considered usually unless the patient in question has adverse effects to opiates then Oxycodone would be the usual choice because it was designed to have less side effects in the majority of peoples. So therefor as one can see the drugs named are definitely not "in between level opiates".

Morphine only remains the standard to which other opiates are gaged because it was the original analgesic of choice and a great break though at the time, ever since then morphine has been the standard to which other opiates are compared. This does not necessarily mean that it is better, it just means that it is the X in the equation.

Hope this has been of insight.

[Away with the fairies...]

Thanks for all your help guys,
am back again and full of pain, only now its because Lulu has just had major stomach surgery (obviously Lulu's nickname is not Lucky!! lol)
So at first after operation they put Lulu back on the morphine coz they mucked the operation up and pain was ridiculous, and Lulu has now just come off it and gone back to the usual Dihydrocodiene & paracetemol mix and sometimes accompanied by ibuprofen or diclofenac.
lulu noticed that Bloodred mentions Dihydrocodiene comes in doses up to 120mg per pill, as Lulu has asked Doc previously, and has always been told that 60mg is the limit I wondered if that info is based on UK law?
Lulu has also decided that must change doc's, to cut long story short Lulu's doc accidentally nearly killed Lulu earlier this year by failing to realise that Lulu had perforated Gall Bladder, and left Lulu for 4 months in agony before deciding original diagnosis might be wrong!! thus Lulu has just had surgery and as soon as fit enough is planning to register with nice new doctor who doesnt want to kill Lulu !! )
With that in mind, Lulu wants to be best informed as to what dosage in mg of Dihydrocodiene is legally available in UK, so can try and sort out with (hopefully) nice new competant Doctor. ;-)
Bloodred, is that info based on Uk law do you know? Or do any of you other experts know this one?
Many thanks
Lulu