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Drug info - Potentiating Tramadol?

Discussion in 'Tramadol' started by whocaresdude91, Feb 11, 2012.

  1. whocaresdude91

    whocaresdude91 Silver Member

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    For a casual Heroin user, Tramadol does not seem to give him that nice opiate feeling anymore. SWIM has read on another thread that Cimetidine (Tagamet) is a tramadol potentiator. But is this an over the counter medication that one can buy at a drug store? Or is it prescription only? Tramadol is the "black sheep" of opiates/opiods and does not know if conventional potentiators (DXM, diphenhyrdamine, tums, ect.) will work. What is a nice tramadol pontentiator that one can have easy access to? ---> no prescription required.

    Thanks for the help! :)
     
  2. firehouse

    firehouse Silver Member

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    SWIM uses benadryl a lot to potentiate opiods of all sorts. Sort of got the idea from the antihistamine in Tussionex - the two together were a wonderful combo. SWIM uses one benadryl with 2 50mg tablets of tramadol to what for him is a good effect. Your mileage may vary.
     
  3. Calliope

    Calliope κυνική

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    One good thread to look at is "harmlessly potentiation tramadol" http://www.drugs-forum.com/forum/showthread.php?t=85138

    You want to avoid Dextromethorphan, since it interacts with tramadol's serotonergic effects, and serotonin syndrome is a possible outcome. See the dangerous interactions section of the DXM Wiki for this (it doesn't mention tramadol specifically, but discusses DXM's own serotonin syndrome risk).

    In the above thread you will see that there are conflicting accounts of tramadol potentiation from cimetidine. Benzodiazapines and gabapentin are suggested as potentiators. I don't see much about otc non-prescription methods.

    There seems to be less information around about tramadol potentiation than other opiate/oids. This might be because many potential methods of potentiation could increase tramadol's risk of seizure at doses higher than 400 mg/day. The risk may outweigh any upside to potentiating.
     
  4. Petri6

    Petri6

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    Cimetidine is not a good potentiator for tramadol since it inhibits CYP2D6 enzyme which is responsible for the metabolisation of tramadol into O-desmethyltramadol (M1) which in turn is responsible for most of the opioid effects of tramadol.

    That being said, any conventional opioid potentiators, which don't inhibit CYP2D6, don't affect the serotonergic effects or lower the seizure threshold should also work with tramadol. Personally SWIM prefers pregabalin, titzanidine and cyclizine. Also, it should be kept in mind that even though tramadol is a relatively weak opioid (but not in any way safe because of the high tendency to cause seizures), combining it with other cns-depressants can lead to respiratory arrest and death.
     
  5. Xanahalf

    Xanahalf Silver Member

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    attempting to potentiate tramadol can be dangerous if you take CYP2D6 inhibitors:

    "Besides significantly weakening the opiate-like effects of tramadol, CYP2D6 inhibitors also increase the risk of serotonin syndrome and seizure, because these are caused by tramadol itself (and CYP2D6 inhibitors make the metabolization of tramadol slower).

    CYP2D6 inhibitors include: fluoxetine, paroxetine, sertraline, chlorpheniramine, other first-generation antihistamines (in high doses), bupropion, amiodarone, haloperidol, ritonavir, indinavir, methadone, quinidine, celecoxib, cimetidine (Tagamet), DXM and codeine (the latter two are probably only relevant in recreational doses).

    As a side note, codeine and tramadol has been reported to cause a seizure, while codeine after the tramadol peak (when levels of O-desmethyltramadol are highest) is reported to be quite enojyable (for both reports, search for "codeine tramadol synergy").
     
  6. halftone

    halftone Newbie

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    swim says you might look into methoxetamine. swim hasn't personally tried mxe with Tramadol, but did find that it potentiated codeine quite well... and from what swim has read on forums, methoxetamine seems to be a good potentiator of opiates in general.
     
  7. Xanahalf

    Xanahalf Silver Member

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    DO NOT MIX MXE AND TRAMADOL

    You could end up in the ER fighting for your life. All theoretical literature says it gives you serotonin syndrome and there are a few cases of hospitalization from this combo (tho i am having trouble finding a reliable source for this now...) This is a VERY dangerous combo and one of the ones to absolutely avoid.

    Tramadol is a tricky drug on its own, let alone combined with other tricky drugs. Tramadol +DXM is bad news as well. I have read about at least one user doing MXE on the tail end of a tramadol experience who did not notice any negative effect but it is not worth messing about with this. Not a ton of info on ketamine + tramadol but likely also not a smart combo.

    Tramadol tends to be on the milder side while dissociative tend NOT to be; best case scenrio, you will end up high on a dissociative and hardly feel the tramadol. Worst case scenario: you will end up high on a dissociative and be too messed up to notice the potentially life threatening symptoms of serotonin syndrome...
     
    Last edited: Apr 18, 2012