Tramadol, Ibuprofen and Paracetamol

[ChillySundays]

My DM has had an operation and has been given tramadol and ibuprofen for the pain. She has already been taking tramadol long term. It is all still painful so I asked if she was able to take paracetamol as well as ibuprofen - I thought you could although not sure about paracetamol and tramadol although if I remember rightly my doctor told me I could. Apparently she can't as she is on the highest dosage of ibuprofen.

Is this right? She tends not to listen to what she has been told so could possibly have misunderstood. I live to far away to sort out in person.

Before anyone says I shouldn't be taking anyone's advice here I wasn't planning to tell her to go ahead on the basis of answers here but depending on the answers on here I was going to tell her to speak to the doctor

Thanks

[Freeriver]

I'm not suggesting it - but I was given Tramadol, paracetamol and codeine together for pain after an op. I took them all together for a few weeks. Codeine works better with paracetamol so I was told at the hospital. I was also on Tramadol long term.

Hth.

[MegGriffin]

I have been taking all three for a disc problem and I am recovering from an operation. I was asked to stop taking the ibuprofen pre op for 12 hours though. Hope she is ok.

[PavlovtheCat]

I take all three for a back problem . Not sure why she would not be able to take paracetamol. I would have thought the worse one would be ibuprofen for long term use, due to the potential stomach issues.

So, yes, I would suggest she revisits this with her GP. As said by freeriver, opiates often work better with paracetamol, for some reason. But, perhaps there is a specific reason she can't have it.

[ChillySundays]

Thanks everyone.

She said she couldn't take paracetamol because of the high dosage of ibuprofen. I am wondering whether she thinks they are both the same so thinks she can't take one if she takes the other.

I think she doesn't understand and certainly doesn't listen. She didn't like way co-codamol made her feel which is why she on tramadol. Personally I prefer co-codamol to tramadol as neither completely takes the pain away the fact I feel woozy on co-damol makes me care less about it.

I will be suggesting a chat with her GP

[ChillySundays]

Give me strength!

Going on about high blood pressure now as if that is the reason now not the high strength ibuprofen?! My DH has high blood pressure and other associated ills and is on tablets and his doctor told him not ibuprofen but paracetamol if he needs pain relief. So I don't know.

She won't be asking as it's different here and all doctors are different.

I tried to help

[GloopyGhoul]

Co-codamol is codeine + paracetemol, so should not be taken with additional paracetemol. Ibuprofen can be safely taken with paracetemol.

To the above poster taking tramadol and codeine together, please check this with your doctor as they are both opiate-based medicines and ought not to be taken together.

[ChillySundays]

DM is on tramdol not co-codamol

[PavlovtheCat]

gloupy you can take tramadol and codeine together for severe pain with GP guidance (I stress that as I would not ever advocate it without GP advice), and with caution, and for acute phases, not long term (due to the increased risk of seretonin syndrome).

But, I wouldn't suggest the OPs mum adds anything like that to her mix, especially if she is already confused about what can be taken together.

General rule of excellent multi-working benefits, taking into account individual choice and individual medical issues (some can't take certain meds) is: NSAID + Opiate + Paracetamol. And, actually, if you take these three at their lowest possible doses, together, it can reduce the chance of needing higher doses of the meds on their own. Again, always, always with HCP guidance.

[MegGriffin]

[emwithme]

I was on tramadol, codeine, paracetamol and ibuprofen last year. It's a rather odd combination (taken only under advisement from a Pain Consultant) but it worked for me - I took the tramadol and the paracetamol at the same time, and the codeine and ibuprofen together, but staggered through the day, so even though I was going 8 hours between each dose of the same thing, I was taking something every four hours.

If she's taking ibuprofen regularly, is she taking something (omeprazole or similar) to protect her stomach from the extra acid or whatever it is that causes it to eat itself ?

I've since managed to come off the tramadol and the ibuprofen, and am working on the codeine.

[MountainDweller]

It's fine to take all 3 together. Max dose of ibuprofen makes no difference to whether she can take paracetamol.. The usual max prescription dose of ibuprofen is 2,400mg - usually 600mg 4 times a day. I agree she would need to take omeprazole with a high dose .