Health Problems

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pharmakos

soʞɐɯɹɐɥd
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Yes, tramadol is dumb to combine with all sorts of things from MDMA to cocaine to even LSD (many googleable seizures from that combination), but in my literally decade of reading anecdotal reports on tramadol and touting it as awful medicine, I have never once seen anyone say they got serotonin syndrome from that combination... Probably the most common combination anyone does with tramadol.

The reason I hate tramadol is because it is a prodrug... The prodrug is a strong SNRI with some SERT activity and has basically zero opioid activity, and needs to be metabolized by CYP3A4 in order to be activated as an opioid. The problem there being that it also functions as a major CYP3A4 inhibitor, so in addition to it's risks as a SNRI/SERT ligand it carries the same anecdotal risks as drinking excessive amounts of grapefruit, which can fuck with a LOT of medicines. It is over prescribed in the elderly, who take a lot of other medications that need to pass through CYP3A4, and I believe that it is largely responsible for a lot of ideosyncratic drug responses in elderly people... one of whom was my grandfather, whose dementia improved greatly when I convinced the doctors to take him off of it.

So in summary, tramadol is basically toxic garbage compared to the tried-and-true opiates that we have nearly a century of research on... But is it unsafe to mix with marijuana? Big fat "no."
 

jayrebb

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Well I don't think actual clinical serotonin syndrome is seen very much in any combination, regardless of the interactions or various classes of drugs involved (outside of MDMA and people abusing drugs combined with heavy SSRIs)

But I still wouldn't pop 150mg-200mg of tramadol and go hit 5-6 dabs every day while popping Tramadol like candy and smashing the bong inbetween, as inhibiting 5HT-1 is going to cause some cumulative buildup. The warning I gave stemmed from the relative unknowns that come with marijuana use itself that vary from person to person. I'd bank on sub-clinical serotonin syndrome without a lot of effort with Tramadol involved. We're talking more of an annoyance than health risk. Some vision things, some hot ears and hot head which is obnoxious, etc.

I would never say never with 5HT-1 inhibition involved and that is why I had to speak up about your absolute
 
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Mrs. Gravy

Quite Saucy
<QUITE SAUCY>
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I have had a monster headache for a week. Air quality pollen/mold is the likely cause. Excedrin with its combo acetaminophen/aspirin/caffeine is the otc that helps offer some relief. My pre surgery consult nurse told me to not take it d/t aspirin. I am 8 days out, seems a bit over cautious for a wee outpatient surgery. My head hurts. :(
 

iannis

Musty Nester
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Seems extreme. Three days should be plenty for aspirin to clear your blood. PLENTY.
 
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Woefully Inept

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Well this is happening now. This is from last night and this morning I now have welts on my legs and my back feels worse. I have no clue wtf is going on. Put in a call to my VNA and she's calling my doctors. A trip to Boston isn't really an option. Kind of freaking out.

back.jpg
 

Woefully Inept

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They're from me scratching. It's that damn bad. I didn't realize I had hives and shit so I've stopped scratching since we found out what's going on. Shit is driving me insane.
 

a_skeleton_03

<Banned>
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That is how I looked when I found out I was allergic to Allopurinol. I was itching like a meth addict even after multiple Benadryl. Took a day or two to get over it and I was about to go to the ER it was so bad.
 

Woefully Inept

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Back from the doctors. I've got some steroid cream and some Claritin pills. Everyone seems to think it's reaction to the Tramadol so I've stopped taking that. Now I'm going to bed and not getting up unless I've gotta take a dump until tomorrow. Fuck this shit!
 

Kuriin

Just a Nurse
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If you're having an allergic reaction, please just go to the ER. You will have an automatic ESI 2 which means no wait time.
 
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iannis

Musty Nester
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And unfortunately benadryl won't do very much once the hives are formed. You need steroids for that, which you have. Benadryl works best if you can get it as you feel them starting to form.

Which, overnight in your sleep, ain't gonna happen.

Benadryl is more prophylactic. But you already phylacted. It'll stop them getting bigger, at least. But to reduce them... Its not how it works.
 

jayrebb

Naxxramas 1.0 Raider
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Trunk + Legs typical of a drug rash as a_skeleton_03 indicated.

One of the prime metabolites of Tramadol is known to cause some issues for some. The O-Desmethyltramadol, or simply O-DT.

A wheel reaction, a type of histamine release from an opioid, is not special. So a rash from itching, or being made to itch by an opioid or opiate is not uncommon. But naturally the majority of people have manageable itching while using any of these opioids available on the market. Certain opioids have a higher potential for a wheel response, which creates a large release of histamine all over your body. This response would be every time you take it. A wheel reaction isn't to be confused to an IGE antibody mediated allergic reaction, which presents as a "drug rash".

Its not clear from what you've given me whether this is an aggressive wheel response with some mild pre-existing contact dermatitis involved, or a predominantly a standalone IGE mediated reaction which is a little more "serious", but will resolve in a few weeks once you stop taking the drug and wait the period of time necessary for the antibodies its produced against this drug to go away.

A wheel reaction will clear up in a matter of days if you STOP itching. So you will be able to tell if its a drug rash or a really aggressive wheel reaction (IF YOU STOP ITCHING IT) by whether it clears up fast or not. Many people will ignore a strong wheel reaction and keep taking the medication, in this circumstance I'm leaning heavily towards an IGE mediated reaction so even if you were a knucklehead-- Its time to stop taking the medication as continuing to spike IGE mediated reactions can only produce bad things.

The hospital will probably be right that Tramadol is the cause. And I'm looking forward to congratulating you on your first drug allergy in a week from now when you are able to report back in.

Histamine-releasing and allergenic properties of opioid analgesic drugs: resolving the two. - PubMed - NCBI
 
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Woefully Inept

Ssraeszha Raider
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Just had my drain removed. Thing was barely draining anything since I got out. Maybe 5-10cc per day total.
And the rash and hives are rapidly clearing after stopping the tramadol and using the cream they gave me. What a cluster fuck.
Hopefully clear sailing going forward.
 
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Oldbased

> Than U
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After Xrays/PT/MRI and specialists I now know my back pain is moderate to severe bilateral neural foraminal stenosis L5-S1 and lumbosacral spondylolisthesis in the L5 and mild to moderate in 3 others( L2 L3 and T8 ). Explains all the burning pain I have in my feet and why it only appeared a year ago and is progressively getting worse. Decompression surgery may help as them putting cement into some other places but doesn't sound hopeful for the nerve pain/back pain. This is in addition to the thrombosis/swelling of upper extremity and heart failure. It'll be 2 more weeks before I meet with the specialist to see if and what surgeries are suggested or pain management direction from current.

I do know I've known 3 people who has had the cement put into their backs/back surgery and in all 3 cases they were worse off than before and 2 of those are now dead. It can easily be argued their death was other causes but in both they blamed it for the worsening condition by lack of mobility and quality of life.
 

Voyce

Shit Lord Supreme
<Donor>
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Dad's in the hospital for a foot infection...again. Doesn't take care of himself, to busy taking care of everybody else, like he's got martyrdom syndrome.


My family is a fucking mess.
 

Mrs. Gravy

Quite Saucy
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Dang Oldbased Oldbased that is quite the list. :(

It is "make Mrs. G's left boob smaller" day.
The pre-surg show began last night with shower, clorahexadrine gluconate wipes and clean sheets...getting ready for round 2 of shower and more of those gross wipes plus fingernail scrub.
Hospital arrive time 6:30.
Hope my surgeon and his team are having a good morning.
 
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