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Taking medicine for fibromyalgia. What dose of tramadol is to be taken daily?

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Practicing since : 1999
Answered : 547 Questions
I was diagnosed with Fibromyalgia a few years ago. Recently, I was prescribed Nortriptyline (25 MG per day), and also a prescription for Flexeril that I can refill as needed. I also take Aleve as needed. This combination works quite well, and has vastly improved my quality of life. I have requested and been given a prescription for breakthrough pain that cannot be eradicated with any of these medicines—Tramadol, 50 MG; however, it has no refills. I must request another refill each time I want to have it filled. I am currently experiencing an exacerbation (I often flare when exposed to viral illnesses; I think that is what has caused this instance but am not sure). I have to option to increase my Nortriptyline to 50 MG per day, and tried this, but found that it actually made my symptoms worse, where it definitely helps at the 25-MG level. My issue is that the Tramadol is very effective at knocking the pain back to levels where I can function well enough to move around and get rid of most of the muscle stiffness (which also decreases the pain). I would like to ask my doctor (a general practitioner) for an ongoing prescription, so that I can take a dose without worrying about not having any when the pain increases to intolerable levels. I am hesitant to ask him for this, however, since I am never given any extra refills when I request the prescription. I have been given 20 pills at a time. I am wondering if I should be worried about taking one per day during this flare--if that would be considered too high a dose and would make me appear to be drug-seeking. Now, I take one only when nothing else works, but can't help thinking I would get better results if I didn't have to wait until that point. Thanks in advance for your time!
Posted Tue, 26 Feb 2013 in Bones, Muscles and Joints
Answered by Dr. Divya Agarwal 28 minutes later

It is good that your symptoms are mostly controlled on nortryptiline.

Tramadol if taken on a sos basis (as and when required) is ok. In fact, you could take it up to 2 to 3 times a day, but that should not be a regular feature because that would mean that your baseline medication is not working well.

Hope this helps. Get well soon. Let me know if you have more concerns.
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