Something weird going on - need to roll head, shake hands, pace. badly

[TheNameTaker]

and rock back and forth, move head up and down to releive a horrid feeling, and kick my legs. it's almost involuntary. I can't stop it. It started this evening but hands been feeling funny all day like I been typing too much at work. Awful pain in fingers of one hand.

Background - been taking tramadol slow release capsules forever (for back pain) been on just 100mg slow release (or modified release also known as) in the morning, to tide over the pain and manage without at night time (used to take one in evening and one at night).

If I miss a dose, I sometimes get 'withdrawal' which involves sneezing (for some reason) and some vague flu like feelings. I have tried to withdraw completely before when I was stubborn and would not accept I still have pain. And then I got 'restless legs' but that was after like 3 days.

Anyway, been on 100mg and manage fine on this. few weeks ago, I was given tablets not capsule by pharmacist. Not deliberately, I guess that was what they had in. Since then I have felt it has not been right, it has not felt as strong, so pain crept back in a little, and it runs out before 12 hours so I start to get a bit withdrawn by the morning (24hrs) and in fact by 12 hours feeling it's running out. This is not a problem on the capsules, I can take those one dose in 24 hrs, or sometimes as long as 36 hours without any withdrawal at all. But these tablets don't feel right.

So this evening I came home early as I felt horrible, tired, lethargic, increased back pain. I didn't want to take any more as it makes me very awake at night which is why I don't take it then. So, I cut into half, and took the slightly smaller half (will take the other tomorrow morning instead of normal dose). And within 30 mins (bearing in mind it is slow release) I suddenly started feeling like this.

I can't sit, stand, move, nothing is comfortable or stops me wanting to rock. Even typing this, I am on my knees lent forward and rocking forward.

It's actually starting to hurt.

Is it the tramadol? Never had this before ever while on tramadol (been on it about 8/9 months and at times up to 400mg of normal release when pain has been bad).

Name changed as it's a bit embarrassing.

[DeafLeopard]

I'd be calling OOH / 111 if I were you.

It is possible that it is the tramadol as it is strong stuff.

[TheNameTaker]

I've tried googling but not come up with anything that makes sense, apart from opiod withdrawal, but I should not be withdrawing as I have not missed any doses.

[Freddiemisagreatshag]

Ring ooh

[TheNameTaker]

deaf thing is though, what I took, the half of it, I am prescribed to take the full amount of it. I just haven't been. I have not exceeded by prescribed dose. I am prescribed 100mg x 2 daily. and I normally take just one, I did use to take the full dose but felt I no longer needed it. So, this half is just under 50mg of the 100mg I am ok to take...

it doesnt make sense.

I have thought of OOH as I feel a bit anxious about what the hell is going on.

[MrsLettuce]

Yes, it'd be best to get in touch with the OOH service, really doesn't sound right.

[TheNameTaker]

I am going to give it half hour. I feel hot, skin is hot to touch, but I suspect no fever. headache now, The feeling is subsiding a little. Not much, but just been still enough to tuck children into bed and ignore the sensation and anxiety that it's something really serious is abating a little. Which probably means the slow release has released a little?

That's withdrawal isn't it? Do you think that means the meds have been flawed? Is that even possible to get a bad batch? I took my usual dose this morning, but, given how I feel, it would make sense that it would be around 24hrs since last dose and given how these tablets (rather than the capsules with the tiny balls of medicine inside) have been they don't seem to work as well?

Jeez. I can only imagine what the drug users I work with must experience giving up their drugs of choice, when they take much higher doses than this

[Freddiemisagreatshag]

You need to ring ooh ASAP

[stomp]

are they 'slow release' and you've overdosed by cutting one up?

[TheNameTaker]

heart is pounding now! can feel it in my throat! think I had a panic attack with whatever the hell has just happened to me .

ok, i can sit ok now. the feeling is still there, the urge, but I can manage it now. Before when I posted, I had been like that for about an hour! and I had no control. It was like my muscles had to stretch or something and I could not stop it, even my eyes went weird. It looked a bit like I was having a fit or something for about 10 mins at it's worst!

[TheNameTaker]

stomp no, I took my last slow release this morning as usual, just 100mg. If I choose to take the second dose, I would be due to take it when I did at 100mg, so I actually took half the dose or less by cutting it. If that makes sense. I know cutting is not an exact science as the meds would not be evenly distributed around the tablet, but it would be no more than the normal 100mg and certainly less. I just normally miss the evening dose, unless I am in a lot of pain and then I will add it back in.

I have to date been able to increase and decrease that second dose as I have needed. I sometimes even take an additional normal release dose too as I can take up 400mg in a day. I have rarely ever gone that high, but when I have, reducing back again has been no problem, perhaps a little groggy for a day or so if I have been that high for several days, but nothing like this.

[TheNameTaker]

Hi. Ok no I didn't call ooh, as the symptoms eased. I then felt tired and my muscles hurt! Slept til prob 2am then awake for ages.

Dh thinks that maybe me cutting the tablet messed the 'slow release' he said perhaps they have a coating on them that promotes the slow release of them and I broke that and therefore it all released straight away. That makes sense as I did read it can be as a result of something called 'seretonin syndrome' which is basically on overload of serotonin. Usually caused by taking too much or multiple meds that are serotonin reuptate inhibitors.

Serotonin syndrome is actually really really dangerous, so, what I should have done is as the symptoms started, called 999. I didn't do that, as by the time I read about it, I was on the downside and feeling ok.

I am not going to take the other half. I am going to miss these tablets completely this morning and see my gp have a chat about what happened, get a new prescription and make sure I get the normal capsule form that I know are ok. I really don't like this drug so I am going to ask him to give me a lower slow release drug and get the hell off it. I never wanted it in the first place but at the time I started it my pain was so severe and I was having some trouble with codiene as used it for a while. Gp persuaded me after I refused for ages.

[TheNameTaker]

leverette meant to say not taking anti depressants, or St. John's wort. I take berrocca, but not remembered to take it for a few days! And that's normally fine with it/nothing to suggest I can't take that.

[TheNameTaker]

Also meant to say leverette that serotonin syndrome is the name of the symptoms you talk about if taking St. John's wort or anti depressants!

[NotALondoner]

I think it is because you cut it in half, and cut through the slow release 'layers' as it were.

[stomp]

Yes that is what I meant, slow release have layers which the acid in the gut dissolve over time 'releasing' a dose over a period of time, if the coating is damaged- by cutting the tablet- the acid in your stomach will dissolve the 'dose' in one go. Sounds like you did overdose. It is a common mistake, so common i'm surprised the leaflets with these type of tablets doesn't give a warning.

[Poledra]

DO NOT cut slow release tablets in half! Basically what you've done is allow the whole dose to be released at once, leading to side-effects of an overdose. The tablets are formulated to be broken down in the gut, and breaking, chewing or crushing them destroys the slow-release mechaism.

Glad you're feeling better now.

[Poledra]

Sorry, didn't read the whole thread - i see you'd worked it out yourself.

stomp these sort of tablets do have warnings in the instruction leaflet not to chew, break or crush - however, people don't always read them especially when it's a medicine they've been on for some time and are comfortable with.

[CajaDeLaMemoria]

Is the packet not covered in warnings about not cutting Tramadol up? It certainly should be. It's all over my boxes, and in capital letters in the leaflet.

You overdosed due to destroying the layers. It's horrid, but it sounds like you are over the worst of it.

Your doctor might tell you to withdraw for a day now, to get it out of your system, or they may put you on something weaker. Make sure you tell them that there are no warnings on cutting them though, because that is really, really dangerous.

[minmooch]

Agree with other posters - cutting the tablet will have corrupted the slow release layers.

The last time I took some tramadol I had a horrible reaction to it (taken while and not previously reacted). I felt wierd, dizzy, thought I was going to fall off the sofa, had to crawl up the stairs because I was frightened to stand, was sick about 5 times and had to call my mother over to look after my disabled sick child. Horrid, horrid stuff and I will never take it again.

Hope you are feeling better.

[TheNameTaker]

poledra your exactly right about not reading the leaflet. I read the one for capsules cover to cover multiple times, googled side effects etc, proper thorough. But, as you said, been on for a long time, thought I knew it all, and didnt consider that the tablets would be different. Wel, they are not different, but of course I have never cut a capsule in half! I didn't think for a second about the slow release aspect of it.

I have a doc appt this morning. Is there a chance he is going to say I can't take tramadol anymore? I know I want to wean off it, but aware that I can't just stop it either (tried that already!). I am going to ask for a lowest dose of it too.

Seeing it was quite a low overdose, is there a possibility it could have damaged kidneys etc? I only have one but its nice and healthy, would like it to stay that way!

A huge lesson learnt. I might ask MN to put the word tramadol in the title so it can be flagged to others who use it.

[TheNameTaker]

There is no warning on the box itself about cutting it. But also no instruction leaflet as it's been out in a generic box. Sometimes when I get meds there are no instructions at this particular pharmacy for example with diclofenac, no warnings about taking with food etc, but I wonder if its because they are repeat prescriptions so presume I already have that info? I don't think it's a gp thing, I think it's something I need to take with the pharmacy if there is nothing on the box/inside when I get the next lot.

But regardless of it being on the box or not, I do need to take responsibility for it as I should have checked online if nothing on the box before cutting it. I didn't think about it being slow release.

[CajaDeLaMemoria]

It's possible. Tramadol is strong, and not taking it properly is dangerous. Typically one incident won't mean you get taken off a drug, but it's at the doctors discretion. The other concern is that if you are sensitive to Tramadol, it's best not to be taking it at all.

You are on such a low dose, the chances of damage are really, really low. I have bad kidneys, they are literally falling apart, and I take a lot more than you! It was a very small overdose, but it feels extreme because your body wasn't ready for it.