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Tramadol Transition for Fibromyalgia / Nerve Pain Sufferers:

IMPORTANT NOTE: This information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other health care provider. It should not be construed to indicate that the use of the medication(s) shown are safe, appropriate, or effective for you. The information shown is general and does not cover all directions, possible drug integrations, or precautions. Information on this site cannot be used for self-treatment and/or self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care provider. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site nor will we be held responsible for consequences of self-treatment. Consult your health care provider before using any drug.

Fibromyalgia is classified as a disorder of pain processing due to abnormalities in how pain signals are processed in the central nervous system.

Withdrawal effects may be managed for those who took Tramadol regularly, but it is still possible to experience symptoms. It it better not to stop Tramadol "cold turkey" but to wean off by 50-100mg weekly, along with an alternative medication. Examples of transition programs are listed below. In some cases, anti-depressants may be needed to help with the side effects.

Depending on your health condition various options may be available. Listed below are some common examples of treatments. Please use our FREE Physician Contact Form so that a network physician can tailor treatment options for your medical condition.

For Fibromyalgia / Nerve Pain:

** Gabapentin (generic Neurontin) - Off label use: take one or two tablets every four hours as needed for pain, as tolerated while reducing Tramadol by 50 to 100mg weekly. May be useful to schedule * in some cases anti-depressants may be needed to help with the side effects.

** Cymbalta (duloxetine) - Those who were treated with 60mg or 120mg daily experienced greater reductions in the severity of their pain one week after starting medication.

** Cyclobenzaprine (generic Flexeril) - low dosage at bedtime, while reducing Tramadol by 50 to 100mg weekly. May be useful to schedule *Gabapentin in low dosage during the weaning to help with Restless legs and muscle pain.

** Amitriptyline (generic Elavil) - Take 25-50mg, Off-label uses include prevention of migraine headaches, neuropathic pain disorders, Fibromyalgia and insomnia. May increase to 100mg while reducing Tramadol by 50 to 100mg weekly. May be useful to schedule *Gabapentin in low dosage during the weaning to help with Restless legs and muscle pain. The usual maintenance dosage of Amitriptyline HCl is 50 to 100 mg per day. In some patients 40 mg per day is sufficient. For maintenance therapy the total daily dosage may be given in a single dose preferably at bedtime. When satisfactory improvement has been reached, dosage should be reduced to the lowest amount that will maintain relief of symptoms. It is appropriate to continue maintenance therapy 3 months or longer to lessen the possibility of relapse. Must be taken at bedtime.

**These options are examples. Only a licensed health care provider can determine your health care needs.



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