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?

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

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.

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 . +

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.

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.

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.

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.

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.

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

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!!

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.