Tramadol and codeine are pretty high strength pain killers. There are not many pain killers that are stronger if the correct does is used.

Without knowing exactly what you’ve tried and in what combination it would be very difficult to make recommendations about what else you could try. It would seem that by trying triptans and amitriptyline that your doctors have suspected migraine but are now trying nerve stabilisers.

I’d suggest you go back to your doctors and ask what else you can try and what the risks and likely benefits of each option are.

Thanks for your response. My GP said that he is not allowed to prescribe combinations. It could be a cost factor so he prescribed masses of paracetamol and Tramadol. I am not particularly happy with this as it appears not to work the same.

Regard
Lisa

GPs working for the NHS are allowed to prescribe Tramacet on a national level however there may be other factors such as local guidance, practice policy and clinician preferences for which medication to prescribe.

If your GP says he is not allowed to prescribe it ask him or her why not and they should be able to justify the decision with their reasoning.

Perocet is similar to Tramacet. It is an opiate style pain killer mixed with paracetamol (acetominophen). If you are okay using Perocet there is no reason to be afraid to try Tramacet.

The only way you’ll find out how effective it is for you is by trying it. It may work better or it may be less effective. If it is the latter then let your doctor know and he can try something else.

There are many strategies you can adopt for pain management that don’t involve pain killing medication. It will depend what is available in your local area but it’s worth talking to your doctor about physiotherapy and accupuncture for example.

Pain killers may still be required occasionally, or perhaps all the time, but my feeling has always been that the long term aim should be to minimise your use of pain killers so that when your symptoms are really bad you have a fall back position.

If you have these sorts of concerns you really should be speaking to your own doctor.

There should be no long term problems caused by taking a regular dose of co-codamol 30/500mg of up to 8 tablets per day.

Co-codamol 30/500mg would not be my first choice as a treatment for IBS but I don’t have access to your medical history and have no idea what else you have tried. As I said above, discuss your concerns with your own doctor and they will be able to advise you.

Many thanks

Sean

When the hounded Dr. Kelly used co-proxamol to commit suicide, causing the short-sighted govmt to recind its licence, I was panicking badly about what possible replacement I might be given. It turned out to be Tramadol.

I was put on 2 standard 50mg capsules twice daily, and though the pain relief was not as great as via co-proxamol, it was better (and less nauseating) than co-codamol and a hell of a lot cheaper for me than ibuprofen+codeine!

Anyway the point I wanted to make was that in March this year I fell down some steps and re-traumatised the knee. For the next 3 months until just a week ago, I was in excruciating pain day and night. Tramadol wasn’t very effective, either in 50mg standard caps or 200mg slow release form, so the doctor put me on Tramacet.

Brilliant! It works for some reason much faster than Tramadol hydrochloride on its own in a gel capsule. Perhaps its the combo of paracetamol? In any case it gives faster, more effective relief than any other form of this drug.

FYI the slow-release caps are next to useless for severe pain. Although the blood plasma levels are supposed to be maintained at a constant amount, the perceived pain relief is more like a bell curve; no relief for 2 hrs after taking the capsule. Then gradually-increasing relief until it peaks for an hour, before falling off again. One is in horrible pain again well before the next capsule is due.