I'm a physicist, not an MD. I've been to the ER for back and wrap-around chest pain on my left side twice in the past 1-1/2 months. The first trip concluded with the ER doc finding, via CT scan, that I have bone lesions on my ribs. He didn't prescribe anything effective: Norco's. I went to another ER at our other local hospital. The ER doc there prescribed Gabapentin (300mg 2x daily) and Tramadol (50mg every 4 to 6 hours), both intended to get me to an upcoming visit to a new GP. Beautiful! Pain gone... till the new GP rx'd long term Gabapentin, but refused me the Tramadol. The result? I ended up using the Gabapentin in increasing numbers till they were used up in half the time. Now I'm stuck with the pain returning and it's unbearable to the degree that I have difficulty sleeping without sneaking my wife's Zolpidem, (She doesn't use them anymore and wants to see me out of the pain.)
I'm going to find a new GP in hopes of long term Gabapentin/Tramadol rx's. I have polyneuropathy along with the bone lesions now. I'm a big fellow. I have no seizures, but do have fasciculations just about everywhere. Is this a safe med combination?
I take Gabapentin 300 and tramadol daily pain I.s Gone
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RA
Ramrodwoman
10 Feb 2019
Just be careful when you take both of these drugs because they potentiate each other. I personally had moments where I was "blinking out". On some kind of autopilot (and not a very good one) where I had absolutely no recall of that time period. My friend thought I had dementia. So did I. My longest period of being on autopilot lasted more than 30 minutes, and I was driving! I didn't come out of it until I was pulled over. I was not asleep at the wheel. It was like I had a prolonged petite mal seizure. I have no idea where I went for that time period at all. Needless to say, I failed a field sobriety test (I blew a 0.00, but I could not walk a straight line, and the eye test revealed nystagmus, which is a side effect of both drugs) and was arrested. DUI is DUI, no matter the drug, and no matter if it is prescribed or not. This is just my little precautionary tale in response to your question as to whether it it's a safe combination. Good luck to you sir.
Votes: +0
JB
jbarth53
19 Jan 2019
I have a cough that I’ve had sine November of last year. My Pulmonology doctor said to try gabapentin for the cough. I have Fibromyalgia and back pain. I started at 300 mg twice a day for a week. Now I’m st 600 mg twice a day Amazing my cough is almost gone!!! My back and Fibromyalgia is about the same. I am doing physical therapy for my lower back and inncontinence that I’ve been dealing with for years. The gabapentin makes me really tired. I’m going to cut back to 300 mg twice a day. Years ago I was on Tramadol for pain and Nucynta. I got off of those Tramadol and Necenta as they were Narcotics.
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TU
tuon
4 Oct 2017
I've been taking the maximum dosage of both Ultracet (Tramadol and Tylenol combo) and Neurontin (Gabapentin) for several years. About this time my blood pressure jumped *a lot*. Never new what was raising my BP until just a few days ago. I visited my new neurologist (I recently moved to another city) after a stroke. While in the hospital, my BP jumped up to just under 200/90. My new neuro went over my files because BP that high could cause another stroke or heart attack. He looked at my meds and told me it was no wonder why my BP was so high. My old doctor had sent his files. The Ultracet and Tramadol mix is what it likely raising my BP. He gave me Tylenol 3 immediately and told me to dump the Tramadol right then. I have a new BP machine. I haven't used it yet as I'm still not feeling all that well and sleep most of the day. But suddenly my constant headaches are gone. They were likely from the elevated blood pressure.
I have a feeling that's why you can't get an Rx for the Tramadol. It's not a good mix. Especially at high dosages like I was taking. I'm epileptic and have hereditary neuropathy so dumping the Neuortin is a no-go for me. I use the gabapetin and a newer drug, Aptiom together and my seizure symptoms have been gone almost a year. If you are blessed enough to take NSAIDs I'd say talk to the doctor about presciption strength NSAIDs. Or Tylenol 3 or ever 4 if you pain level is really high. I don't like the codeine in the Tylenol 3 but it's doing the job so far. I just have to take them sparingly. I can't take any type of NSAID. Not even Pepto Bismol. It has salicylates in it. I'm that sensitive to them. But talk to your doctor about dumping the Tramadol and taking something else.
Votes: +1
DE
Delila
5 June 2014
Hi, if approved and prescribed by your doctor, the interactions checker shows that Tramadol could be combined with Gabapentin successfully, depending on dosing and individual reaction to the combination. With a 'moderate' risk, it is something that can be attempted if your doctor agrees. You could find it a very helpful dual treatment option. I have provided the link from the information i looked at, i have also factored in the Zolpidem, and this came up with the same potential risk information. Obviously i have to advise you not to take any medication that isn't prescribed for you. I hope your pain is soon under better control
I use gabapentin long term for muscle pain and spasms as I had lyme disease and my nervous system was damaged. I have just started on tramadol (when pain is severe) and the combination seems to work well. My doctor has signed me up to pain management clinic so they can assess my meds and help create the best plan to combat constant pain. I would suggest you get referred if you can.. I live in Scotland. Hope you find answers and help soon :-)
DE
DemoninDC
4 June 2014
You don't say where in Indiana you live but it may be worth a drive, Indianapolis is 5 hours, or a quick plane trip over to Cleveland. I would see a doctor at the Cleveland Clinic Main Campus by the name of David Polston, MD. He can be reached at 216-444-5551. Make sure to bring all of your CAT scans, X-rays, and medical tests with write-ups. You can ask him if he wants to see them early so he can review them before you come. He may want you to see some other doctors while you are there. If you need to stay the night there are 2 InterContinental hotels on campus. I would propose that you need to find an Internist instead of a GP.
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KA
kaismama
16 May 2014
GPs won't order pain medicines, they risk their licenses. Although tramadol isn't a controlled drug by the federal government, about half the states do consider it controlled. If you want pain control you have to see a pain management dr. What are they doing about your ribs? How much gabapentin is ordered? But you know that's for nerve pain and it isn't a pain medication.
Votes: +1
DR
DrCharbonneau
16 May 2014
Personally, I think many fields, even my own, have become hyper-specialized. By "risk," though, it doesn't put it out of the question? If he were called on the carpet, could he reasonably justify his decision?
FI
fitchick1961
16 May 2014
I live in PA, and have been to the same internal medicine MD, for years, ( same as gp), and they have always prescribed any pain medication I have needed short term, however I've been on Ultram for about 5 yrs or so and they refill it, never been to pain management MD ever, my mom was prescribed gabapentin and Tramadol for back pain also without problem
DR
DrCharbonneau
16 May 2014
That's good to know. Back in '81 I worked on an technical manual project for the Philadelphia Transit Authority while Tech Media was still in business doing that type work. As much as I hate to say it, I live in an Indiana medium-sized city that has the proud title of lowest SAT's in the nation, so it's not surprising that PA has a better system. Ironically, I was born and raised in a city of about 20,000 in Michigan having one of the highest SAT statistics in the nation. Imagine that...
As for the rib lesions, it could be they're puzzled about the bone erosion. We've been wanting to sell and move back to MI. This town is folly for intellectuals unless they work at the college.
Yesterday the thought crossed my mind this might be Aspergillus Spores, but the whole house has been gutted and new drywall installed, but we're not completely out of the woods in some areas in the back. The other hospital and medical arts group are better, so more hopeful. The one on this end of town has the convenience of being two blocks away...
DA
Davethefed
6 June 2015
I have found for myself, at least, the combination of Tylenol 1000mgs Ibuprofen 800mgs and Tramadol 100mgs provides me with an almost pain free 8-10 hour period. I have had no problems with combining these. Again, I am not a doc, but a patient, and this works wonderfully for me.
RA
Ramrodwoman
10 Feb 2019
I think as kaismama states, it's a state kind of thing. You might get lucky and find a GP that will do it, but in my experience that only happens after a long rapport has been established with that doctor. And yes, in some states the DEA comes down very hard on the doctors. They can really destroy a doctor's practice. I suggest you find a good pain management physician.
Yes you can combine the two. With you having nerve pain as well I agree with you that they do work better together. If your doctor doesn't want to continue giving you the tramadol see if he/she will refere you to a pain management Dr. Best wishes, pamee
Votes: +2
DR
DrCharbonneau
16 May 2014
I take it an ER doctor can order the short term management without risk, so that's the difference? The GP, though, was right to refuse them?
RA
Ramrodwoman
10 Feb 2019
These days most GPs will refer you to someone credentialed in pain management.
