Kickas.org Forums Treatments, Drugs and Alternatives AS Pharmacy codeine or tramadol, lack of pain relief?

hello all,

wondering if others have noticed little to no pain relief upon taking codeine or tramadol?

a mutation in the P450 (enzymes in the liver that process many of our drugs) CYP2D6 could be the culprit.

http://en.wikipedia.org/wiki/CYP2D6

the doctors gave me tylenol with codeine when i was in my early 20s (hand slammed in car door). did nothing (and i mean nothing) for the pain, but did knock me out. i was young and naive regarding drugs back then, thought everyone had same response. thought its "pain relieving" effects were just that it knocked you out. but then a few years later, saw my sister entertaining friends the night after her wisdom teeth were out while on codeine and i thought that was odd. turns out i'm the one that had the odd response. it was several years later that i was reading about this enzyme and how polymorphisms in the encoding gene is actually very common (up to 10% of the population). so i've suspected for years that i have this problem.

now reading that this P450 also the enzyme that metabolizes tramadol. interesting, as that was the only drug doctors would consider giving me a script for when i was in severe pain. decided to fill the LDN script instead as both given to me on same day by same doc and can't take both. good thing i didn't try using the tramadol, probably wouldn't have worked anyway, considering that the codeine did nothing for me.

anyway, if you have had little to no response on codeine or tramadol, you may want to let the doctors know. you may have a mutation in your CYP2D6 and need a different pain reliever. too bad, as the tramadol is supposed to be a less addictive drug, but hey, if it doesn't work, what's the point?

Tramadol helps me but it takes the edge off more than anything. I'm on 300 er pills once a day

Hi Sue,
I'm not a true expert, but I do know that tramadol is quite opoid-like. It is not as strong as codeine either.
tramadol = Ultram + Ultram ER (extended release)
tramadol + acetaminophen (apap) = Ultracet
I know from experience that there are some issues with most of the US generic tramadols -- they just don't work. (this from personal experience, my mom, other AS sufferers, my pharmacist and even my doctor).
That said, I can share with you that the generic tramadol+apap sold by Ivax is actually identical tablet to the brand Ultracet, and the generic tramadol ER sold by Patriot is identical to brand Ultram ER tablet.
Maybe this tip can be useful to your or someone else who needs effective Tramadol!!
It's a shame that your doctor won't consider other options for your severe pain. I sometimes use lidocaine ointment topically and this can be helpful. And I see a pain mgmt doctor in addition to the rheumatologist, as I find most rheumatologists are really not sensitive to the pain of their patients.
May you find some relief....
Best of health to you, Jessica

I started taking Ultram back in 1997 when I was having UC symptoms. My GP took me off of all NSAIDS and put me on Ultram. When I first started taking it, it made me real groggy and I slept most of the time. I learned to break them in half. Later, after it went generic, in noticed that it didn't seam to work as well. I had to move up to Vicoden and then, years later. I moved up to Norco.

It never dawned on my that the generic Tramidol wasn't as effective as the Ultram. Now that you mention it, I think you are right. Unfortunately, my insurance (Medco) has me using their mail-order pharmacy. They always send generic when the can.

Donna

I'm stuck with the same mail order program.

Brandon, I really can't complain, they approved Humira without any problems. I only pay $50 for a three month supply.
Donna

Talk to your doctor about the copay card. I only pay 5.00 a month for mine thanks to the humira copay card

thanks jessica,

currently i'm on LDN, so ultram/tramedol not an option, but if in the future it is, will ask for the brand name instead. i know if my doctors check the box that says the prescription has to be dispensed as written, even my mail order "pharmacy" must comply. that's what we do for my synthroid.

Just to clarify for all -- Some of the generics may not work as effectively as the brand, but what I can tell you is that the following generics are completely identical to the brand:

tramadol+apap (ultracet) generic sold by Ivax
tramadol er (ultram er) generic sold by Patriot

If you ask your pharmacy specifically for the generic sold by company x, they may be able to accommodate you.

KR, Jess

WOW, I never even thought of that...I think I have always been told that generic is just the same just cheaper.

I fill a script 1 time a month for Tramadol 50mgs qty 100 for $1.46..very cheap!

I need to read up on some of this.

Thanks