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Pharmacology - How to avoid rapid arising tolerance to tramadol?

Discussion in 'Tramadol' started by tramalover, Jan 29, 2014.

  1. tramalover

    tramalover Newbie

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    hey guys ..
    it's my first post in this forum .. I've been on tramadol for 2 years now but not continuously for resistant depression that was never relieved with SSRIs and SNRIs .. I usually break trama usage by 2 to 3 months free to avoid addiction .. I'm a medical student and know something you know can help me getting away from addiction
    but still the experience here I've read could be so helpful as well as the medical basis ..
    any suggestions to avoid rapid arising tolerance with the 2nd or 3rd week of using trama continuously for 200 mg per day ???
    and till the moment , with every break I can handle the withdrawal , any bad experiences about when does it become out of control ??
    thank you , and I hope I didn't make any troubles against the rule's issues
     
  2. Totse

    Totse Newbie

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    Re: how to avoid rapid arising tolerance to trama ?

    It's been posted that DXM can lower tolerance, but I wouldn't use it a whole lot
     
  3. tramalover

    tramalover Newbie

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    Re: how to avoid rapid arising tolerance to trama ?

    DXM is not easily available in my country :(
     
  4. Delfonic-the33rd

    Delfonic-the33rd Titanium Member

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    Re: how to avoid rapid arising tolerance to trama ?

    You might look into potentiators other than DXM to keep yourself from using or needing as much to get the desired effects. Such as sodium bicarbinate( tums or rolaids) or white grapefruit juice. These two mentioned are taken an hour or so before consuming your meds to slow the process of metabolization. There are numerous threads on the subject in many of the different opioid threads. In the very least your intake would be less. Tolerance is an issue everyone must deal with and eventually it can and will catch up to you. Remember, though, that with every opioid you run the risk of addiction, so perhaps you might look for an alternative to opioids entirely to alleviate your depression symptoms. I wish you the best of luck in med school, and welcome to DF!
     
  5. Totse

    Totse Newbie

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    Re: how to avoid rapid arising tolerance to trama ?

    ^^ I second this, I'm going to withdrawals right now, trying to quit a 5 year bupe habit. NOT fun
     
  6. tramalover

    tramalover Newbie

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    Re: how to avoid rapid arising tolerance to trama ?

    I saw some stuff about opiate potentiation , certainly about potentiating the opiate like effect of trama than its SNRI action , I tried some methods especially taking your desired dose as 3 or 4 sub-doses each 30 mins , it was fun but for being serious I need the SNRI action for my depression , for the tolerance thing , I think I'm gonna try your mentioned potentiators as soon as possible and as much as availability allows me .. I'm thankful to you :)
     
  7. Mindless

    Mindless Gold Member

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    The cytochrome-inhibitor approach will not objectively increase or prolong the effects of tramadol. White or any other grapefruit juice is not a cytochrome inhibitor (of tramadol's metabolism).

    Anything which might be thought to retard or inhibit the metabolism of tramadol seems unlikely to potentiate its effects. Tramadol and codeine share (in part) the same metabolic pathway via cytochrome P450 2D6. There is no evidence that grapefruit juice acts as a cytochrome P450 2D6 (CYP2D6) inhibitor. See:

    Grapefruit juice / CYP2D6: clarifying a common misconception.

    Horn and Hansten say:
    Drug Interactions: insights and observations. Understanding an Important Variable in Patient Response. John R. Horn, PharmD, FCCP, and Philip D. Hansten, PharmD, Pharmacy Times 2006.

    CYP2D6 poor metabolisers have been shown to derive less analgesia and euphoria from tramadol's active metabolite O-desmethyltramadol. Any agents giving rise to CYP2D6 inhibition would not increase and may impair tramadol's metabolism and efficacy.

    The hypoalgesic effect of tramadol in relation to CYP2D6. Poulsen L, Arendt-Nielsen L, Brosen K, et al. Clin Pharmacol Ther 1996; 60 (6): 636-44.
    Tramadol Hydrochloride Extended Release Tablets, monograph, Biovail Laboratories International SRL. 2005.

    I can appreciate how valuable the antidepressant effects of tramadol can be. I have used this drug off and on over more than ten years, more recently at a daily dose of 100mg. The most effective way I've found to avoid increases in tolerance is to avoid increases in dose.

    I have ceased use abruptly at a daily dose of 200mg with no discernible negative effects, although others may experience some degree of withdrawal. However, it may be necessary to reduce dose in a tapered fashion in increments of 50mg (the usual smallest capsule strength). Perhaps a few weeks or months between reductions could make this a fairly comfortable process. The taper could cease at a dose which suits you, or on total cessation.

    It may be helpful to discuss this with your own doctor or a suitably qualified substance misuse worker.


     
  8. Legion666

    Legion666 Newbie

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    For me, tramadol tolerance maxes out at about 500mg. Taking any more than that is a waste and just asking for a seizure. I have a very very large opiate tolerance and for some reason tramadol tolerance has never increased like my other opiates I use. I have been on tramadol for about 9 years.

    Legion666 added 1 Minutes and 33 Seconds later...

    And yes, avoid increasing the dose. That's a good way to avoid getting a large tolerance to drugs.
     
    Last edited: Feb 2, 2014