Dr. Harold Sheldon Laski M.D.

What is an over-the-counter pill similar to Tramadol?

Tramadol is a synthetic opioid analgesic medication used to treat pain. It is sold under the brand names ConZip, FusePaq Synapryn, Rybix, Ryzolt, and Ultram. The U.S. Drug Enforcement Administration listed Tramadol as a schedule IV controlled substance in August 2014 due to the risk of addiction and overdose. In order to look for a drug that can be used for pain that is similar to Tramadol, you need to understand shat a synthetic opioid analgesic medication is. By definition, an analgesic is in the class of painkillers used for relief from pain. Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia Synthetic opioids mimic the naturally occurring opioids such as codeine and morphine. They include drugs like tramadol, fentanyl and methadone. The problem in answering your question is the word in your question "SIMILAR." What do you mean by similar? There are many prescription medications that are, in many ways similar to Tramadol for chronic pain. However, you are asking about non-prescription medications that are SIMILAR. If you mean non-prescription pills that also treat chronic pain, then you of course have the NSAIDS, or non-steroidal anti-inflammatory drugs, such as Ibuprofen and naproxyn among others. There is also aspirin that has been used for years for headaches and muscle aches and arthritis for many a year, although not so much lately due to it's possible long term side effects. There are also other treatments for chronic pain that use no medications. These include TENS Units, Acupuncture, Massage Therapy, Physical Therapy, Hypnosis, and Mindfulness training, to name a few. As two of the lines from the song "The Gambler," sung by Kenny Rogers say: "Cause every hand's a winner/And every hand's a loser." The same holds for pain medications. Every drug's a winner, and every drug's a loser. In other words, the medications may help with the pain, but they also have side effects and other consequences when you take them. Whenever there is chronic pain, meaning pain for more than 3 months, you need to see a physician to find the cause. Some causes are easy to treat, while others may not be so easy. As far as natural remedies then, here are a few that are supposed to help with pain. I am not recommending any of the following, only listing some that have been purported to help with pain. Turmeric is a root that’s part of the ginger family. It curbs inflammation, says Eva Selhub, MD, a clinical associate at Massachusetts General Hospital and author of Your Health Destiny. You can cook with this dark yellow spice or make tea with it. Or take it in capsule form. Devil’s claw root is an herb that may ease low back pain and common arthritis discomfort. Studies have used 30-100 milligrams of the active compound, harpagoside, per day. If you have a sensitive stomach, stick with a low dose or you might get a mild stomachache. Capsicum/capsaicin comes from chili peppers. A skin cream with 0.025%-0.075% capsaicin may soothe your back pain. Apply it directly to the area that hurts. Supplement pills may also help with diarrhea and cramps. Comfrey. If you have lower or upper back pain, you could try a skin cream made with comfrey extract. Use it three times a day. Make sure that you have seen a doctor first to diagnose your pain. Back pain can have many causes, and some can be life-threatening. Comfrey can harm your liver if you take it by mouth, so don’t drink comfrey tea. Glucosamine may help with joint pain, but the research is conflicting. Chondroitin, which is often sold with glucosamine, may ease pain and give you better joint movement. They are part of what makes up the cartilage in your body. Many people who take glucosamine and chondroitin combine it with aspirin or other treatments. So, it’s hard to say which is effective. Give it time. It may take up to 4 months to see an improvement. White willow bark. “White willow is nature’s aspirin,” Selhub says. It has salicin, which tames inflammation. It’s good for headaches and may ease low back pain. You can take it as tea or as a capsule. In research studies, people took 120-240 milligrams per day as a capsule. Avoid high doses if you have a sensitive stomach. Willow bark should not be used in anyone under 18 because of a higher risk of a serious condition called Reye’s syndrome. Boswellia comes from the boswellia tree. It’s also known as Indian frankincense. In one study, people who often get cluster headaches had milder, less frequent headaches when they took boswellia. Caffeine. Combining acetaminophen, ibuprofen, or other pain relievers with caffeine may work better than taking them alone for migraine headaches and tension headaches. But caffeine withdrawal is a known cause of headaches as well. Feverfew and butterbur. These herbs may help prevent and treat migraine pain. There is some research that shows they might work, but more studies are needed. Omega-3 fatty acids. These “good fats” lower inflammation. That can help with joint pain and stiffness, back pain, and pain from menstrual cramps. Experts recommend foods high in omega-3 fatty acids: fatty fish, canola oil, Brussels sprouts, spinach, and foods with added omega-3s like eggs. Or you can take up to 3 grams of fish oil per day as supplements, with your doctor’s permission. Probiotics. These bacteria live in your gut and help keep you healthy. Probiotics may lessen inflammation. It may also help with irritable bowel syndrome, especially pain and bloating. Try foods high in probiotics, like some yogurts (look for “live active cultures” on the label), kimchi, kefir, and sauerkraut. You can also take a probiotic supplement. Tramadol Is Not an NSAID Tramadol belongs to the class of drugs known as opiate agonists. What that means is tramadol binds to opioid receptors in the brain and provides pain relief. Some people mistakenly believe that tramadol is an NSAID (nonsteroidal anti-inflammatory drug), but it is not. Just as it works differently, Tramadol also carries with it different potential side effects that must be weighed (see below). Some People Cannot Take Tramadol Tramadol is not FDA-approved for children under 18 years of age, as children are at greater risk of experiencing drug-induced breathing problems and death compared to adults. It is also not recommended for breastfeeding mothers, as the drug can be passed on through breast milk, possibly causing harm to infants. Because the safety of Tramadol use during pregnancy has not been established, the medication should not be used during pregnancy. The Drug Comes in Two Forms Tramadol may be prescribed as an immediate-release 50 mg tablet or as an extended-release 100, 200, or 300 mg tablet. The extended-release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment. As with all Schedule IV controlled substances in the U.S., after a prescription is first written, you can get a maximum of five refills in a six-month period. After you hit that limit or reach the six-month mark (regardless of the number refills), a new prescription is required from your healthcare provider. Always follow your doctor's instructions regarding dosage and how often to take the medication. It Must Be Swallowed As Is It is important to swallow tramadol pills whole and especially important not to split, chew, or crush extended-release tablets. Breaking the pill may cause too much of the drug to be released into your system at one time. Take your medication exactly as directed and follow prescribing instructions to stay as safe as possible. Side Effects Can Be Serious Tramadol is usually well-tolerated when taken properly, and side effects are usually temporary. That said, there are cases when they can be deadly. Common side effects may include: -Nausea -Constipation -Dizziness -Headache -Drowsiness -Vomiting Less common side effects include: -Itching -Sweating -Diarrhea -Rash -Dry mouth -Vertigo Serious side effects include: -Seizures -Serotonin syndrome, characterized by symptoms such as muscle rigidity, confusion, and rapid heart rate -Slowed breathing -Life-threatening allergic or skin reactions -Angioedema (fluid swelling under the skin) -Orthostatic hypotension (low blood pressure when you stand up) -Suicidal thoughts or actions Always report side effects to your doctor. Get immediate help if a serious side effect occurs. Dangerous Drug Interactions Are Possible Tramadol interacts with many other medications, which can lead to life-threatening interactions including breathing problems, sedation, and coma. Of special concern are interactions with benzodiazepines, such as Ativan (lorazepam) and Klonopin (clonazepam), and monoamine oxidase inhibitors (MAOIs), such as Nardil (phenelzine) and Parnate (tranylcypromine). If taken with recreational or controlled substances, like alcohol, narcotics, anesthetics, tranquilizers, and sedatives, tramadol can affect breathing — even causing breathing to stop. Discuss all medications and supplements you take, plan to take, or plan to stop taking with your doctor so these can be adjusted to prevent a dangerous interaction. People Process It Differently Tramadol is broken down in the liver and excreted mostly by the kidneys in the urine. The half-life of Tramadol in the blood is between five and nine hours, and even longer for people who have been taking multiple doses. That is the time it takes half of a dose to be inactivated by the body. Complete elimination takes about five to six times as long as the half-life. However, about 7 percent of people are "poor metabolizers" of Tramadol, and it takes them longer to break it down. As a result, they have more active drug in their bloodstream for a longer time. These people are especially at risk if taking other medications that further reduce the actions of the enzymes that break down Tramadol. Tramadol Can Be Habit Forming A 2015 government report showed a steep rise in emergency room visits due to Tramadol abuse between 2005 and 2011. Even at prescribed doses, the drug can be addictive. If you suspect you are becoming dependent on Tramadol or taking more than you're supposed to get the desired effect, talk to your doctor or a social worker about how you can wean yourself off the medication and seek alternatives for pain relief. Likewise, do not share your Tramadol or store it in a place that is easily accessible to others. Stopping the Drug Suddenly Can Cause Withdrawal Symptoms Do not stop taking this medicine suddenly without talking to your doctor first. Gradually reducing the amount over time will prevent withdrawal symptoms such as anxiety, diarrhea, headache, nausea, shivering, sweating, tremors, or insomnia. READ MORE