Fibromyalgia Drugs Part 3

I’d like to discuss some other medications that are commonly prescribed for patients with Fibromyalgia. I’m doing this not to get you depressed, but because I feel that education is important the the more educated you are the better choices you will make.

Tramadol:  It Is known by it’s trade names Ultram and Tramal and was created in the 1970’s, therefore it is manufactured by different companies now. Tramadol is a central nervous system acting opioid and it is used to treat moderate to severe pain. In reality it is a synthetic version of codeine.

Some of the side effects:

  • agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;
  • seizure (convulsions);
  • a red, blistering, peeling skin rash; or
  • shallow breathing, weak pulse.
  • dizziness, spinning sensation;
  • constipation, upset stomach;
  • headache;
  • drowsiness; or
  • feeling nervous or anxious

Tramadol should not be taken when you are using:

  • alcohol or street drugs;
  • narcotic pain medicine;
  • sedatives or tranquilizers (such as Valium);
  • medicine for depression or anxiety; or
  • medicine for mental illness (such as bipolar disorder, schizophrenia)

Tramadol can cause seizures, thus if you have a history of this, Tramadol is not for you. Your Doctor should not prescribe this if you have a history of kidney and or liver disease, stomach disorders or if you have thoughts of suicide. As with most most strong medications, blood and urine tests are not only important but should be mandatory. Remind your prescribing doctor of this and insist if he/she is a bit lax. Lastly, as with all opiates, Tramadol is addicting and never stop cold turkey!

Ibuprofen: Also know as Motrin, Nuprin, Advil and 50 or more other names across the world. Ibuprofen has a very interesting history. Though this can be purchased over the counter, I feel it is important to speak about this med. The point is that just because something can be purchased without a prescription, does not mean that it is a safe med or is safer than a prescription only drug.

Ibuprofen first became available in the U.K. in the late 60’s and in the U.S. in the early seventies as a non-steroidal anti-inflammatory drug. In other words, unlike Cortisone or Prednisone which is anti-inflammatory but a steroid, Ibuprofen is not a steroid. (the word steroid has a negative connotation, but in reality, steroids do have their place.) It became an over the counter medication in the mid 80’s. My own opinion is that this was done to make it more available to the public after the patents expired. Thus the motive was monetary, not to help more people.

Ibuprofen basically works by reducing hormones which cause or increase inflammation, thus it brings down pain which is almost synonymous with inflammation. AH but here is the rub. With Fibromyalgia pain is due to a hyperactive nervous system causing the pain nerves to fire. This is one of the very few cases where inflammation is not causing the pain. This is why Ibuprofen most times won’t even touch the pain a Fibro person is suffering with.

Ibuprofen is meant to be taken for 7 to 10 days, 3 times a day as it needs to build up in the blood. After 10 days you stop. However the problem is that people take it daily or whenever they have a pain or a headache, believing that it is totally safe, this just is not true.

Some Side Effects:

Ibuprofen may  cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking ibuprofen, especially in older adults.

Ibuprofen is also very hard on the kidneys and preliminary studies are just coming out showing links between ibuprofen use and an increase in kidney dialysis. It is also not safe to take this med if you have asthma, kidney and or liver disease, stomach diseases, a history of heart problems and stroke, blood clots, congestive heart failure or if you smoke.

If your Doctor has you taking this med on a longer term basis, once again, blood and urine tests are a must.

Topamax: The real name being Topiramate, Topamax is the trade name and is produced by Ortho-McNeil Neuologics and Noramco. These are both divisions of Johnson and Johnson (You know, the company that also makes Band-aids, Baby products, Listerine and Splenda).

Topamax is a seizure medication (originally produced to treat children with epilepsy) and is used off label for migraines, nerve pain among other symptoms. Off label means not being originally developed for these conditions.On May 21, 2010, Ortho-McNeil plead guilty and was fined 14 million dollars by the FDA for promoting Topamax to treat psychiatric disorders, without applying for any approval and there was no data from any well-controlled clinical trial to demonstrate that Topamax was safe and effective to treat any psychiatric conditions.

Side effects of Topamax include:

  • sudden vision loss, pain around or behind your eyes;
  • dry mouth, increased thirst, drowsiness, decreased sweating, increased body temperature, and hot, dry skin;

  • slowed thinking, memory problems, trouble concentrating, problems with speech or balance;
  • confusion, mood changes, unusual behavior, thoughts of suicide or hurting yourself;
  • vomiting, loss of appetite, tired feeling, irregular heartbeats, feeling like you might pass out; or
  • severe pain in your side or lower back, painful or difficult urination.
  • mild dizziness, feeling nervous;
  • numbness or tingly feeling;
  • diarrhea,

  • change in your sense of taste; or
  • cold symptoms such as stuffy nose, sneezing, sore throat.

Before taking Topamax, tell your doctor if you have a history of kidney disease or kidneys stones, asthma, glaucoma, osteoporosis, a history of depression and or suicidal thoughts. Topamax should not be used if you are pregnant as it has shown to lead to birth defects. You must also not use this medication if you are breastfeeding.

Lastly, Topamax side effects can cause increase in Fibromyalgia symptoms like difficulty thinking (fog), so this is another case of taking one med for Fibromyalgia which might make Fibromyalgia worse. Another example of damned if you do and damned if you don’t. sometimes it seems you just can’t win!

Monday: Odds and Ends that might interest you. Also I editorialize a bit.

6 thoughts on “Fibromyalgia Drugs Part 3

  1. Iam taking 300 mg or Tramadol for over a month now and fail to see ANY relief whatsoever. I have tried all the others, Lyrica, gabapentin, and they seem to work mildly for a few days then NOTHING!! It is expensive, exhaustive and excruciatingly disppointing. I hve recently heard there is a morphine patch but don’t know if we have it in Canada or if MY doc would have the compassion to prescribe it. Why can’t I just wave a magic wand and make it all go away, for good?

  2. I wish there was an easy answer for you, it is very frustrating and can be quite disheartening at times. You should probably speak to your Doc about stopping the Tamadol as you should have seen a reaction much sooner.

  3. Ugg, I take tramadol and was told it was not an opiod. I don’t understand why my rheumy, phsych and neuro would let me take tramadol, topamax, prozac, clonazapam, buproprion xl, ambien, flexeril, adderall and one vicodin at bedtime all at the same time. Now my rheumy is adding plaquinil to the mix to try to help the “inflammation” in my body (My C-Reactive Protien tests high, went from 24 to 21 now at 9.6), I can’t take anti-inflammatories due to high creatinine levels and a 57 on kidney function test. I’ve had pseudotumor cerebri, I get so nervous but am in pain every single day and have to work so what am I to do, nobody seems to be listening.

  4. Debbie. Have him check his PDR (Physician desk reference), Tramadol most certainly is. No surprise your C-reactive are high, with everything you’re taking. Lastly I would start by finding a new doc who can manage you properly. You are on too many meds, how old are you, If I might ask?

    • Hi I am on Morphine slow release tablets for fibro and I can’t take anti-inflammatories and the nerve pain meds, I have read that Topamax is helping some people but I don’t know if I can get it in the Uk, I would really like to give it a try, but I also don’t think my Doctor is very understanding.
      I had a spinal reconstruction that took 9 hours and I have been in constant pain since then.
      I wish you lots of luck.

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