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kittens4

ultram vs hydrocodone?

14 posts in this topic

Dr Dyann...Duckie..Trina...calling all medical peeps! Here's another question for ya! My back goes out from time to time...although much less now with weight loss. Still, the last time it went out one of my docs told me to take Ultram. (we have samples at our office). I didn't do that then, because I knew I had Lortab at home, so I lived with the pain until I got home. Also, I have a Rx for hydrocodone that my doctor gave me for when this happens. I notice the Ultram is extended release, so was wondering, will it even work for gastric bypass peeps like us? The hydrocodone helps, but I have to take one every 3 hours...it seems to wear off fast now. It's weird, before surgery, I never gave it a thought...now I'm paranoid about taking anything until I run it by my TT forum friends. :)

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Well for me Elaine, Ultram did not touch my pain. I have no idea why. I really wanted to be managed on it because it is not as addictive as other choices. I know it helps alot of people. I do not get the Ultram ER. I had the regular Ultram.....generic is tramadol. I think it's because of the way it is made up as to whether it helps certain pain or not. But for me Darvocet is what I had to settle with. My choice....DEFINITELY hydrocodone, BUTTTTT it's majorly addictive and you will just eventually want more and more and NOT worth the addiction Elaine. I still need hydrocodone to manage the pain sometimes, but my doc refuses to treat chronic pain with it, so I have to suffer through and just alter my lifestyle til I can deal with it again. So try to get some of the regular Ultram even if your doc has to write a script for it. Try it first because it is definitely a better choice for you. Some people to great on it! On a side note, I have noticed that my med does not feel it helps for as long and the pain does come back alot faster on anything I have tried. I know it has to be because of the surgery, but cannot get double doses and take the chance of hurting my liver or kidneys because of it. I could easily take more a day than I do, but it's just not worth it, so I suffer every day. :( On another side note.....keep this in mind. If you are on hydrocodone on a regular basis, it's harder to control your pain if something major happens to you because you have built up a tolerance..(ie have surgery, broken bone, etc) This is the reason I had to stay in the hospital an extra day after my WLS because I could not be weaned off the morphine pump because the pain felt so intense to me where it would not have hurt so bad in someone that had not been taking chronic pain meds before surgery. I could not tolerate just taking the Lortab to control the pain at first for this reason. It's not a good thing all the way around.....even though it "feels" like a good thing at the time.

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Have you tried the anti inflammatory agents that are not GI upsetting like celebrex and vioxx. Torodol is even good. Used for 5-7 days, there is minimal risk of the cardiac and ischemic events that were published in the news and they actually treat the cause of your pain and not just the pain. Protect your tummy just to be sure with an acid inhibitor. Ultram is sustained releaed you won't get the benefits. DON'T break or chew them as it will give you an uncontrolled amount of opoids into your system and that can be very dangerous. So out of the two I would pick hydrocodone, but would rather see you on something else (especially considering your earlier thread). Mixing all of these can be concerning.

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I think I'll only take the hydrocodone when needed..which luckily isn't too often. I've had a bottle of 20 for a few months now, and have about 15 left..so I'm not really needing them too often. I just worry about taking pills...because of the paxil and xanax I already take. I work for GI docs...and don't want to be one of our patients!! The liver and digestive system are of concern to me. I feel great and have had no problems in that area, but don't want to push my luck. Thanks for the advice. xoxoxo

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Dyann, is there not a short-acting and long-acting Ultram? I think it's called Ultram ER, taken once a day. I was offered the long-acting by my pain management dr. after the short-acting did not not help my pain (dont ask why he assumed the long-acting would if the other didn't). I told him I could not taking anything long-acting, so he just changed me to Darvocet N 100. This scares me too because I had, not one, but TWO, doctors tell me th break them up (Including my surgeon) because I was not supposed to swallow anything larger than 4 mm in diameter right after my scope. My surgeon even told me to crush it! :o Now that IS scary.

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My pain pill of preference is dilaudid. The 2 mg pills are so tiny and they work like a charm. High potential for addiction just like all of them. I took them for my plastic surgery and gall bladder and liked it a lot if you know what I mean. I am conscious of it and put them away to avoid temptation. One thing this whole journey has made me do is cut the B.S. out of my life and I am not into fooling myself about anything.

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I noticed that with any time released pain med that it doesn't work properly for me since wls. I also think that it is true that we don't get the full effect of the drug.

I noticed that I have to go through more than one course of anitibiotics to get rid of infections, etc.

I talk about this a lot with a few friends who had wls and take meds and we all agree that a study should be done on the way we take medications and how much of it is actually absorbed, etc.

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Well, here goes my take on it from my experience. I have severe arthritis in my knees and a hip from my days playing college football, really messed me up. I have been taking ultram ER for over a year before surgery and now do not because it just did not work for me with the wls, I also chased the ultram with oxycodone, these however still work and combined with my weight loss I now feel I no longer need the help of the ultram(if it would work), hopefully soon I will no longer need the oxycodone, one thing that did help was to go to a pain management DR. He really got me on the right doses for my size. Good luck.

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I noticed that with any time released pain med that it doesn't work properly for me since wls. I also think that it is true that we don't get the full effect of the drug.

I noticed that I have to go through more than one course of anitibiotics to get rid of infections, etc.

.

I found the same thing to be true. When I need a medicine to absolutely work (antibiotics), I get the suspension form and one course does the trick. They are all sweetened with sugar alcohol, but not much.

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I take Ultram daily to control Fibromyalgia pain. It has never worked on its own but if I take it with tylenol it works. Synergistic results or something like that. I've been able to cut it from 3 times a day to once in the evening for enough pain control to fall asleep. But as everyone has noticed, pain meds sure don't work as long! In fact, I had a chiro treatment yesterday where he massaged some of my fibro trigger points and I woke up again in such pain at 4 AM, I've been HERE ever since. LOL

Oh, Ultram is not NEARLY as good as hydrocodone for serious pain events, its just a step above the over the counter meds.

Anyway, the combo of Ultram w/tylenol may help with more effective pain relief.

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My Dr prescribed me buy ultram, as I have tried MOST of the diet pills to no avail....

I am only on day 4 and have felt NO side effects at all....

I have lost my appetite and am only eating small portions. BUT The big thing for me is I haven't thought about food AT ALL....

I was on Retuctil last year for a month, but had to come off it due to my blood pressure. But I did loose a stone in weight.

I did use this site when I was on Reductil for help and support, which was GREAT for me, as I haven't told anuyone I am taking anything.....only my partner.

Edited by laimonas123

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I am a big believer in ultram. It has been my daily pain med I have been using for years and years. I have vicodin for days of extreme pain but not more than one or two a week.

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It's worth mentioning that for some, a gastric bypass can impact the efficacy of medications.

I was lucky to have a doc who was aware of this as a possibility when I was having a problem getting the "normal" period of pain relief from Percocet.

...........

The solubility of a drug, surface area for absorption, and blood flow to the gastrointestinal tract influence oral absorption and bioavailability. Drug solubility and surface area for absorption are affected by gastric bypass procedures. Drugs in aqueous solution are more rapidly absorbed than those in oily solutions, suspensions, or solid form.15 When medications are given as tablets, the times to disintegration and dissolution of the tablet affect absorption. In early drug trials, these factors are accounted and adjusted for to ensure adequate absorption in patients with unaltered gastrointestinal tracts. However, reductions in the amount of functioning gastrointestinal tract after gastric bypass surgery lead to decreased time to drug absorption and reduced drug bioavailability.

The solubility of drugs is affected by pH. Drugs that are more soluble at an acidic pH are absorbed in the stomach, and those soluble in al kaline environments are absorbed in the small intestine. In addition, some drugs depend on the enzymes in the small intestine to aid in their absorption. In patients who have had gastric bypass surgery, the small pouch located at the top of the stomach produces much less hydrochloric acid than the stomach previously did, possibly decreasing the absorption of medications dependent on acidic environments for solubility or absorption.

By bypassing major portions of the small intestine, Roux-en-Y bypass procedures drastically reduce the surface area for absorption. Villi and microvilli give the small intestine a much greater surface area than the large intestine.16 Thus, bypassing of the duodenum and jejenum represents a large loss of surface area for absorption. These changes may warrant manipulation in drug route or dose to ensure adequate delivery. Drugs with long absorptive phases that remain in the intestine for extended periods are likely to exhibit decreased bioavailability in patients who have undergone this procedure. Therefore, products with prolonged dissolution times, such as extended-release formulations, should be avoided in this population.

.....

This is the link to the full article: Medication and nutrient administration considerations after bariatric surgery -- Miller and Smith 63 (19): 1852 -- American Journal of Health-System Pharmacy

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I found out when I was 17 and had viral menengitis that it absorbs quicker putting it under the tongue and letting it disolve. I was taking morphine at that time and since my surgery and knowing that I had to chew all meds I just naturally started placing them under my tongue and enjoying the fine flavors meds come in.

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