On Tramadol & Codeine post op - which would you drop first when reducing doses

[Milliways]

If nerve pain was your main pain, and your stomach is making very loud gurgly noises, when I feel brave enough to start reducing doses would you drop the codeine first?
I think it is bunging me up, and only been on it 2 days, but originally I was to just be on codeine & paracetamol, but pain was uncontrolled and had to stay in overnight, given loads of Tramadol and gabapentin on top to control pain and sent home with paracetamol, codeine & Tramadol and told to start experimenting with stepping them down after 3 or 4 days.
Where would you start?

[ohnonotanothernewbie]

Definitely with dropping the codeine if you can bear it! Good luck

[Milliways]

That's what I thought, I think it has the worst side effects and least effect in pain, but at the moment I am clock watching like a junkie for next doses.
It's going to be a boring recovery too, not allowed crutches as they encourage you to do too much, so have to hobble to loo which is all that's allowed the first few days.

[gingeroots]

Aren't codeine and tramadol both opiates and therefore both constipating ?

My view is that tramadol is a stronger drug and in my unscientific thinking more a culprit when it comes to constipation .So I'd vote for reducing the tramadol first .
I had awful withdrawal symptoms when I dropped tramadol - no one told me to take care and taper .Maybe I was unlucky ,atypical .But would strogly recommend reuction not stopping .

Can you load up on movicol/laxido and keep taking ? Parecetomol is not to be understimated for it's painkilling properties .

Sorry you're going through this - it's grim . +

[Milliways]

I have got some Senna, don't want to let things get too bad so started that last night (first night home)
I know they are both opiates but hadn't heard about Tramadol causing constipation before. Am managing on just 1 50mg tramadol inbetween 2 30mg codeine with paracetamol, so maybe to 1 codeine would be first step.
Think I should have pushed for gabapentin to come home with, I used to take regular pregabalin so aware of problems with that but they are great for nerve pain and I have had a nerve cut.

[MatildaTheCat]

That does sound grim. Any chance your GP would prescribe you some more pregablin on Monday which would probably be more effective anyway? I find a good slug of lactulose does the trick regarding the stomach but certainly doesn't reduce gurgling noises.

Get well soon.

[Milliways]

Thank you
I'm hoping it will have settled more by Monday, but have to phone to book stitches out date so will do if needed.

[JellyBabiesSaveLives]

Are you allowed ibuprofen in place of the codeine?
I'm on tramadol at the moment - codeine made me sick and constipated but tramadol doesn't.

[Xmasbaby11]

I'm 10 days post op and just on codeine and paracetamol.
It works well for me. I'm not in much pain and I'm not constipated.

[Milliways]

I have missed a dose of codeine now and doing ok. I can take ibuprofen and even have diclofenac in cupboard if needed, but my stomach was growling terribly and I was getting banged up so think will stop codeine completely. The Tramadol is strong so should be ok along with paracetamol.
Thanks everyone

[Thankfulforeveryday]

I moved to amitriptyline after for nerve pain after moving/reducing from the codeine/tramadol. It's hard coming off it when everything still bloody hurts!! Definitely add in some paracetamol etc too. Hope it goes ok! Constipation is awful on both of those!!

[TheFuzz]

I'm not taking any drugs for nerve pain having tried the lot. Side effects are worse and Ami, pregablin and duloxetine are horrible. Tramadol is stronger than codeine so I would come off that first.