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what pain meds can you take with LDN?


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#1 Guest_katkatrina_*

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Posted 24 April 2010 - 01:32 AM

If you have to be off Hydrocodone & other opiods (opiates?) before starting LDN, what pain meds are okay to take with
LDN? thanks !! ~kat

#2 Sherri

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Posted 27 April 2010 - 06:06 PM

It's okay to take Tramadol while on LDN. I take 50mg as needed for pain. I sometimes take two tablets a day, but most of the time it's only one. I found that it works better for me than Vicodin.

#3 ruby2

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Posted 29 April 2010 - 08:21 AM

what about when you need pain relieve at the dentist

#4 Globespy

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Posted 07 October 2010 - 05:11 AM

YOU CANNOT TAKE ULTRAM (TRAMADOL) WHILST ON LDN!!!
YOUR INFORMATION IS INCORRECT AND COULD HARM PEOPLE!

From lowdosenaltrexone.org

"Because LDN blocks opioid receptors throughout the body for three or four hours, people using
narcotic medication such as Ultram, morphine, Percocet, Tramadol, Duragesic patch or codeine
should not take LDN until such medicine is completely out of the system."

#5 Sherri

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Posted 08 October 2010 - 03:57 AM

My Harvard-trained neurologist put me on tramadol (50 mg PRN) when I went on LDN (4.5 mg HS) 18 months ago. I have suffered no side effects whatsoever. Although tramadol is a synthetic opiate, it does not act on the brain in the same way natural opiates do. It also is gut-neutral (i.e. it doesn't cause nausea or constipation). Why would you come on here and accuse me of trying to harm people? Is your name GLUCK? Let me tell you something, Globespy, Joel Gluck, the owner of lowdosenaltrexone.org, is not a physician. His old man is. Joel is just a wannabe and a jerk who bills himself as a "life coach" (read it, BS artist). That you find an affinity for his pap should surprise no one.

#6 Guest_Lee_*

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Posted 09 October 2010 - 05:39 PM

Our medical advisor, pharmacist Stephen Dickson, has informed us that the general advice is that slow release Tramadol CANNOT be used alongside LDN, however you can use instant release Tramadol upto 6 hours before a dose of LDN.

#7 greta2960

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Posted 18 October 2010 - 08:16 PM

This was Skips farmacy`s answer when I sent them a mail about LDN and Tramadol±

It is okay to take tramadol for the pain
you can separate it by an hour but it really isn't necessary, naltrexone does not block the receptorsites 100% so you will still get an analgesic effect for the pain.
The naltrexone indirectly helps with the pain by boosting the immune system.
If you have any questions at any time always feel free to shoot an e-mail.
I hope this helped, have a nice day.

Sincerely,

Brooke Hutchison, Pharm.D.
brooke@skipspharmacy.com

#8 J Dickson MRPharmS

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Posted 19 October 2010 - 03:52 PM

This was Skips farmacy`s answer when I sent them a mail about LDN and Tramadol±

It is okay to take tramadol for the pain
you can separate it by an hour but it really isn't necessary, naltrexone does not block the receptorsites 100% so you will still get an analgesic effect for the pain.
The naltrexone indirectly helps with the pain by boosting the immune system.
If you have any questions at any time always feel free to shoot an e-mail.
I hope this helped, have a nice day.

Sincerely,

Brooke Hutchison, Pharm.D.
brooke@skipspharmacy.com




What they do not mention here, is that if you are on a stable dose of tramadol - where you are generally pain free - taking an LDN tablet will likely increase your experienced pain significantly and could potentiate a small amout of withdrawal symptoms.

Tramadol is a U (read mu) Opioid weak Receptor Agonist - and derives its pain control from that method, as well as about 10 other pathways. (Noradrenaline, seretonin, nicotinic pathways etc etc etc)

It also has a tendency to build up in the bloodstream - over a period of time - making it a good, and stable, long term painkiller.

"Plasma concentrations of racemic tramadol are predictable over a 50 mg to 100 mg single-dose range. This is also true under multiple-dose conditions. Steady state is achieved after two days of dosing Ultram by a 100 mg q.i.d. regimen (maximum plasma concentration was 592 ± 177 ng/ml). The plasma half-life of tramadol following a single and multiple dosing was 6 and 7 hours, respectively. This increase in half-life upon multiple dosing is not considered to be clinically significant or to warrant dosage adjustment for chronic use." (Ultram Datasheet)


As you can read above, the half-life of tramadol is about 6 hours - meaning, the time for the amount of tramadol in your system to drop to half of where it was at peak.

This is also a touch complicated, by the fact that tramadol is metabolised into several active "metabolites", that start becoming "active", at different periods during the time after administration. Some metabolites forming at up to 3 hours after administration.

The pharmacokinetics (and dynamics) of tramadol are actually very interesting - and the entire mechanism of action is not entirely understood.
In fact, the long duration of action of tramadol has actually been repeatedly accused of potentially worsening autoimmune disease - by possibly potentiating "Immune Tolerance"

(link: http://www.anesthesi...6/1411.abstract and Collett, BJ (2001). "Chronic opioid therapy for non-cancer pain". British journal of anaesthesia 87 (1): 133–43. doi:10.1093/bja/87.1.133. PMID 11460802)


For these reasons, when asked if Tramadol was suitable for patients who want to take LDN, we always say:

If you only take it occasionally, then its probably fine.

1) No Long Acting - Slow Release preparations
2) Instead take instant release (up to four times a day), and leave 4-6 hours after last dose of tramadol before taking LDN.

In the UK, the vast majority of people taking Tramadol are on slow release forms of the medication, therefore it is not really a good idea to take the LDN with Tramadol at all.

(I, personally, am a great fan of tramadol as a painkiller - as not only is it quite a good painkiller, I find it has anti-depressant and mood stabilising effects too. People are "happy and pain free" - sometimes a little too happy!)


Finally, we have seen 1 patient who was on 400mg daily, via m/r tablets, who took LDN and had a nasty withdrawal reaction. Felt dizzy, "high", and experienced pain / jitteryness.

I hope this makes sense!


J Stephen Dickson MRPharmS

#9 mommabean

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Posted 31 December 2010 - 07:51 PM

Hi,

New to all of this...have been taking LDN for my rrrms (rapidly relapsing remitting ms) since 5th November, and am on 3mg at the moment.

My legs have been incredibly painful when walking since i had a massive relapse 1 and a half years ago.
I still get really bad pains in my legs every day, and i stopped taking tramadol for it on advice from E-Med, who i get the prescription for my LDN from.
The painkillers i am taking currenty are pregabalin (although my consultant told me to try stopping them as i dont feel like they are having such a good effect on the pain, amytriptiline (30mg at night) and baclofen (2 tablets per night)
But i feel like none of these work as well as Tramadol used to. I am really unsure where to turn now, as i am in lots of pain every day, and just want some effective painkillers that i can "top up" with when i am in unbearable pain.

Can anyone offer me any advice?

I would be extremely grateful!

thank you
Anna

#10 Derek

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Posted 02 January 2011 - 12:00 AM

Hello Anna,
According to the above post from Stephen Dickson (who is a respected pharmacist), it should be ok to take instant release tramadol, as long as you leave 4/6 hours before taking ldn. The slow release version should definitely be avoided. This is based on the understanding that ldn only stays in the body for about 4 hours.
Please let us know if you find a workable solution to this miserable problem.

#11 Nuno Zimas

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Posted 06 January 2011 - 04:46 PM

Hello all,

My mother is currently taking 50 mg of generic Tramadol around 4 AM every day.
Give the fact that she goes to sleep early, usually before 8 PM, I am wondering of LDN's metabolzation will be completed by the time Tramadol is taken.
in her case Tramadol is meant to relief moderate pain unrelated to cancer.

I do not know if she is taking the extended or the quick release version.

#12 Derek

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Posted 07 January 2011 - 11:04 AM

I think you need to establish what form of tramadol your mother is taking before deciding on any action. The detailed post from Stephen Dickson is well worth reading in my view.
I hope you find a solution to the problem.

#13 Nuno Zimas

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Posted 08 January 2011 - 02:10 PM

The detailed post from Stephen Dickson is well worth reading in my view.


I have read that post time and time again. It is indeed extremely insightful.
Was just wondering if the relatively low dose of Tramadol my mother takes, no matter its release time, could be coped with LDN, not concomitantly. of course, but throughout the day.

She's now phasing out Tramadol in favour of a non-opiate painkiller. We are trying Ibuprofen. If it turns out ineffective for moderate pain management, we will move to Celecoxib.

Thanks for your input!

#14 mommabean

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Posted 22 January 2011 - 09:17 AM

Hi Derek,

Many thanks for your reply and sorry it has taken me so long to reply!

I am unsure if I am taking slow release tramadol, but as it is just generic, i am suspecting it is...it is difficult in some ways in that my G.P. refused to prescribe me LDN, so I am reluctant to go back to them with any issue regarding LDN. I know that they had never heard of LDN before I approached them about it!

However, my Neuro had previously taken me off tramadol, as he thought it was contributing to my constant headaches at the time (which totally stopped the day after my first dose of LDN!!) he also thought it may be making me constipated.

I think I will go back to my G.P. and request that they prescribe me instant release tramadol. I do get all tongue tied and inarticulate when I get a little stressed, so I think I may print off this discussion to take with me, as it explains it all FAR better than i can! :blush:

thanks again, and i will keep you updated!
Anna

#15 Derek

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Posted 22 January 2011 - 09:11 PM

Hello Anna,

Please don’t worry about going back to see your GP, because I am sure they will only have your best interests as a patient at heart. My GP was not familiar with ldn, but the information sheet soon sorted that out and she has now been prescribing for seven years.
I hope your trip is successful and look forward to the update.

Derek
P.S. Glad to hear the headaches have stopped.

#16 Gary

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Posted 29 January 2011 - 09:01 PM

what about when you need pain relieve at the dentist

I've wondered about this what affect will a local anaesthetic have with LDN?

#17 Derek

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Posted 30 January 2011 - 09:55 PM

On the understanding that ldn only stays in the system for four hours, it will be out of your system by morning, so should be fine.

#18 Catherine

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Posted 02 February 2011 - 12:42 PM

Pain relief is a difficult one. I've always been too scared to try anything remotely addictive. I did try dihydrocodeine at the very beginning, but it's a horrible drug.

I take Ibuprofen, Paracetamol and Gabapentin. I get moderate relief, but still live with 24/7 pain which is extremely exhausting to live with.

#19 tumteetum

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Posted 29 March 2011 - 02:46 PM

For these reasons, when asked if Tramadol was suitable for patients who want to take LDN, we always say:

If you only take it occasionally, then its probably fine.

1) No Long Acting - Slow Release preparations
2) Instead take instant release (up to four times a day), and leave 4-6 hours after last dose of tramadol before taking LDN.

In the UK, the vast majority of people taking Tramadol are on slow release forms of the medication, therefore it is not really a good idea to take the LDN with Tramadol at all.


Is there an easy way to tell if the tramadol I have been prescribed is instant release or slow release?

I have been prescribed Zydol 50mg caspules. I see they also make a Zydol SR (slow release) so do I assume the standard capsules are instant?
I've read the patient info leaflet and it doesn't state which it is and neither does the manufacturer's web site. I have emailed the makers to check but not sure how long it might take to hear back from them.

Meanwhile I am taking Zydol at night and LDN in the morning hoping that it *is* instant release so the elapsed time means it's ok to take it.

I had a very bad flare on my sciatica a few days ago and have Zydol (100mg daily) to try at night plus Solpadol during the day. Having to balance out my accute need for pain relief with the long term benefits of LDN on my ME/CFS.

Thanks.

#20 Derek

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Posted 29 March 2011 - 06:54 PM

I would have thought the issuing pharmacy should know, so why not give them a call and ask? I hope you get a swift response.




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