Question about stopping Tramadol and starting Cymbalta

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CajunGrl
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   Posted 8/10/2010 2:12 PM (GMT -7)   
Does anyone know if I have to be off of Tramadol for a certain amount of time before starting Cymbalta? I completely forgot to ask my doctor and hate to bug him again.
Lyme disease, Fibromyalgia, Hashimoto's Thyroiditis, Adrenal Fatigue, Rheumatoid Arthritis(Just diagnosed)
Prescription Meds: Savella, Tramadol, Hydrocortisone, Plaquenil
Supplements: Thyro-complex, Magnesium, Calcium, Potassium, Folic Acid, Fish Oil, Vitamin C, Probiotics, GI Repair, Vitamin D 50,000IU and Joint Supplement

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getting by
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   Posted 8/10/2010 5:34 PM (GMT -7)   
I think that you can go on one and even take them together, but maybe you should call your pharmacy and ask them if you don't want to bother your doctor. But from what I know, they are two different types of medications. Tramadol is a pain medication and cymbalta is an antidepressant. But please check with a professional before starting. Though imo I think it would be safe or he would have told you otherwise.

Best wishes for success with cymbalta.

Hugs, Karen
  Moderator-Depression and fibromyalgia
 
fibromyalgia, Chronic fatigue, depression,allergies

Alcie
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   Posted 8/10/2010 5:42 PM (GMT -7)   
Check the "duration of action" or the half-life for tramadol. I would guess a day or 2 ought to be enough. I have gotten into trouble taking meds on the same day as tramadol, even 12 hours apart.
Alcie
 
 

vestabula
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   Posted 8/10/2010 7:43 PM (GMT -7)   

Considerations

  • Tramadol may increase the level of liver enzymes and may decrease creatinine and hemoglobin levels due to Tramadol's potentially toxic effect on the liver. Monitoring of these levels should be done in patients who take Tramadol on a regular basis. Caution should be used in patients who are also prescribed a selective serotonin reuptake inhibitor (SSRI) as Tramadol may increase the risk of serotonin syndrome.


  • Read more: What is Tramadol? | eHow.com http://www.ehow.com/about_4572008_what-is-tramadol.html#ixzz0wGGEoLHi
    This info came off Tramadol's site and I would ask your doctor or pharmacist how long you should wait...you don't want serotonin syndrome!
     
    Donna
    fibro, menieres disease, RLS, anxiety disorder, disc compression, scoliosis, spinal stenosis TMJ  Meds: valium Advil
     
    Reach out and touch someone.  If they don't touch you back it's because you still  have brownie batter on your face.

    MsBunky
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       Posted 8/10/2010 9:11 PM (GMT -7)   
    Sorry, I take them together so I'm not sure about a weaning process, or how easy/difficult it would be.

    I am curious about the answer though!

    Pam

    CajunGrl
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    Date Joined Mar 2009
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       Posted 8/11/2010 11:22 AM (GMT -7)   
    Thanks so much everyone!

    Karen- Sorry, I didn't explain myself well. I was worried about serotonin syndrome and was wondering how long I had to be off of Tramadol to avoid this.

    vestabula- Thanks for the link. I actually had liver problems before the Tramadol. My Rheumy thinks it's lack of Vitamin D. I'm not sure about that because I've had this for a while and he is the first doctor to ever say that.

    I guess I will call the pharmacist today and ask. I don't want to risk getting serotonin syndrome. I took Tramadol with Savella and I was okay, but I won't risk doing that with Cymbalta.
    Lyme disease, Fibromyalgia, Hashimoto's Thyroiditis, Adrenal Fatigue, Rheumatoid Arthritis(Just diagnosed)
    Prescription Meds: Savella, Tramadol, Hydrocortisone, Plaquenil
    Supplements: Thyro-complex, Magnesium, Calcium, Potassium, Folic Acid, Fish Oil, Vitamin C, Probiotics, GI Repair, Vitamin D 50,000IU and Joint Supplement

    Co-Moderator Lyme Disease Forum

    getting by
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    Date Joined Sep 2007
    Total Posts : 40587
       Posted 8/11/2010 2:57 PM (GMT -7)   
    I am glad that there was so much helpful information on this thread. I didn't realize that you could have problems with the seratonin with tramadol. You learn something new every day.

    Donna, thanks for the links. They are very helpful.

    Hugs, Karen
      Moderator-Depression and fibromyalgia
     
    fibromyalgia, Chronic fatigue, depression,allergies

    Dagger
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    Date Joined Apr 2008
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       Posted 8/11/2010 3:11 PM (GMT -7)   
    If you've been on the tramadol for a while, you may go through withdrawal when you stop. I'm only taking between 100-150mg/day but I have withdrawal symptoms when I stop. I am currently tapering off slowly so it's not so bad.

    If you stop the tramadol then immediately start a new med, you might think the new med is causing problems when it is really withdrawal symptoms from the tramadol. Not everyone gets withdrawal symptoms when they stop tramadol but some of us do.

    GSDgirl
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       Posted 8/11/2010 6:34 PM (GMT -7)   
    about the seratonin syndrome????  I have been taking zoloft for a year now and do take tramadol, I can take up to 6 a day.  I don't usually take that many but I have.
     
    My question is: if I have not had a problem in a little over a year do you all think that I still might one day?
     
    I have heard of withdrawls problems from Tramadol but like dagger said, not everyone has a problem
     
    Thanks Dagger
    Denise from Pittsburgh, Pa
     ***diagnosis: high blood pressure, gastritis, fibromyalgia, hepatitis (SVR/cleared),  disc problems in neck, depression, anxiety & stress, cervical headaches, porphyria-PCT, IBS
     ***meds: metroplol 25mg, zoloft 150mg, gabapentin 300mg 3x a day zocor , (soma, fioronal, tramadol, as needed).
     ***other supps: calcium, vit D 2,000-4,000 per, milk thistle, vit C &E, acidopholos (sp?),  
    CO-Q 10,  flax or fish oil, ginsing, magnesium, B complex,
     

    Post Edited (GSDgirl) : 8/12/2010 1:29:07 PM (GMT-6)


    Dagger
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       Posted 8/12/2010 10:49 AM (GMT -7)   
    GSDgirl - I've read that you are most likely to get serotonin syndrome when you start, change, or increase meds. That is when it is most likely to happen but it can happen anytime.

    It is supposed to be rare but one of our local fibro specialists has been warning his patients about it telling them that he is seeing it a lot more often.

    CajunGrl
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    Date Joined Mar 2009
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       Posted 8/12/2010 12:19 PM (GMT -7)   
    Dagger,

    Thanks. I agree. I wouldn't mess with mixing the two, but most doctor's don't even warn their patients since it is rare. The problem I have with that is if they do get it, they do not know the warning signs.

    I sure hope that I do not go through withdrawals from getting off of the Tramadol. I've gotten down to one pill a day and never felt any different. I definitely don't need wtihdrawal symptoms on top of all of this. Thanks for reminding me though. I will be looking out for it.
    Lyme disease, Fibromyalgia, Hashimoto's Thyroiditis, Adrenal Fatigue, Rheumatoid Arthritis(Just diagnosed)
    Prescription Meds: Savella, Tramadol, Hydrocortisone, Plaquenil
    Supplements: Thyro-complex, Magnesium, Calcium, Potassium, Folic Acid, Fish Oil, Vitamin C, Probiotics, GI Repair, Vitamin D 50,000IU and Joint Supplement

    Co-Moderator Lyme Disease Forum

    mama6
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    Date Joined Jul 2010
    Total Posts : 416
       Posted 8/12/2010 12:38 PM (GMT -7)   
    Nope I take Cymbalta and Tramadol. Personally..just an FYI..I hate the Cymbalta. Horrid side effects if you forget to take just one dose. I don't have much luck with the Tramadol either but don't have side effects from it. Some people have had great luck, but not me so I Just thought I'd weigh in on this, Take care and good luck, Heather
    Big Hugs, Mama6

    DX. with Fibromyalgia, Narcolepsy, Poss. RA or Psoratic Arthritis, Herniated disc 3x in last 7 months
    Meds: Nuvigl, Cymbalta, Tramadol

    Mother to 5 wonderfull kids. Oldest is 18 and just left the nest for animation school. Youngest just started 2nd grade. So I am crazy, and feeling my age plus some.

    JayBespoke
    Regular Member


    Date Joined Jul 2010
    Total Posts : 297
       Posted 8/20/2010 7:00 AM (GMT -7)   
    A ward of warning - Tramadol can cause SSRI/SNRI discontinuation syndrome, it did for me when I was 2 days without, and was extremely unpleasant. Trying to time the beginning of the Cymbalta for as soon as the Tramadol has diminished enough in quantity from your body (have a look at the half-life) would probably alleviate this. The best course of action would be to follow a physicians advice!

    Taking them both together could prove risky, serotonin toxicity can be dangerous.

    Are you switching from Tramadol to another pain med?

    Take care :)
    21, Male, England.
    Dx: Psoriatic Arthritis, Chronic Back Pain, Dyspraxia
    Rx: 25mg Methotrexate Sub-Cut Injection & 50mg Etanercept (Enbrel) Sub-Cut Injection

    Oh, and plenty of Tramadol, Codeine, Diclofenac, Dihydrocodeine, Paracetamol, Diphenhydramide, and scotch

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    Alcie
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    Date Joined Oct 2009
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       Posted 8/20/2010 8:17 AM (GMT -7)   
    Elimination half-life for tramadol is supposed to be 9 hours. 
     
    If you stop for a day and have no withdrawal symptoms I'd guess it would be fine to start something else.  I've never had withdrawal when going off tramadol, except that my pain comes back! 
     
    If you start having muscle twitching with tramadol or tram + something else, you can get it to stop with 1 or 2 mg of diazepam (Valium), which hits the same receptors.  Of course that's not a great idea except in an emergency.  Muscle twitching is the least of the serotonin syndrome symptoms.  If you start getting really hot, get red in the face, maybe all over, you are in trouble.  That's what happened to me once and I took the diazepam (which I use for sleep - excellent muscle relaxant), and avoided a trip to the ER.  Of course I stopped the tramadol and the Flexeril and don't take Flexeril anymore!
     
    (Then I was put on Darvocet-N, and a half pill made me throw up.  I went back to tramadol which isn't really enough, but I haven't found anything else that I tolerate and actually works.)
    Alcie
     
     

    CajunGrl
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    Date Joined Mar 2009
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       Posted 8/20/2010 12:41 PM (GMT -7)   
    I tried Darvon and could not take it. It made me feel awful. I was in so much more pain and taking it more often than the Tramadol so I am back on the Tramadol again. I can sleep through the night with Tramadol and not have to wake up and take a pill. I called my doctor and he said that I can take Cymbalta and Tramadol together. That the amount I am on is not alot and that serotonin syndrome is rare. I am still scared though and haven't started the cymbalta yet. I did take Tramadol with Savella and had no problems with it.
    , Rheumatoid Arthritis(Just diagnosed)
    Prescription Meds: Cymbalta, Darvon-N, Hydrocortisone, Plaquenil

    Supplements: Thyro-complex, Magnesium, Calcium, Potassium, Folic Acid, Fish Oil, Vitamin C, Probiotics, GI Repair, Vitamin D 50,000IU and Joint Supplement

    Co-Moderator Lyme Disease Forum
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