Spondylitis Association of America Forums General Discussion General Message Board for Ankylosing Spondylitis and Related Diseases Clonazepam and tramadol

I just wanted to share my nervousness with the new meds I've been prescribed for sleep and pain. Does anyone else get really scared when they try new meds?

As per my earlier post, I recently ended up with acute hypertension after several sleep deprived weeks due to pain from my broken arm, which paracetamol (tylenol) wasn't controlling. I had stopped my meloxicam, because it was contributing to the hypertension and apparently nsaids slow fracture healing. I am allergic to codeine.The hospital prescribed zopliclone sleeping tablets, which did help me sleep better, but the pain still woke me in the early hours of the morning.

At my follow-up visit to my own doctor on Wednesday, he said I have to manage the pain better and get enough sleep. He prescribed clonazepam for sleep (and the restless legs I get when overtired). He said it lasts longer than the zopiclone. I had half a tablet (so 0.25mg) the last two nights - they do help me sleep, but I still wake up during the night with pain. I'm not sure about taking a full tablet as even half a tablet seems to make my stomach churn a bit, triggers what seems like reflux and I also feel quite groggy in the morning.

My doctor also prescribed tramadol and I'm thinking of trying that today. I can tolerate morphine, even though I'm allergic to codeine, so they think it will probably be ok, but I'm a bit scared. Added to the mix is that it comes in a capsule that I can't swallow, so I'll have to open the capsule and mix the contents with something...

I'm kinda used to the idea of taking biologics and methotrexate now as I know they help, but I think I was scared at the time I started them. But the meds for sleep and pain are new ground for me...

Has anyone else taken clonazepam and tramadol the same evening?

I survived my first tramadol capsule last night - broken open and mixed with dairy food. I decided to not have the clonazepam at the same time so I could be sure that any side effects were from the tramadol, but will try both tonight in addition to the paracetamol.

I didn't notice any difference to my pain and sleeplesness with the tramadol compared to just taking paracetamol. Asleep about 11.30, arm still woke me up at 1am, took dose of paracetamol, awake for an hour or so for pain to settle, woke again sore at 4am and just dozed a bit after that.

Dear Shirley,

I am sorry to read about your painful sleepless nights. I am brand new to the forum, so bear with me. Here in Connecticut, our local pharmacist is really very helpful regarding med questions and allaying fears. Also, I am followed by a pain specialist as well as a rheumatologist. I take pain med and muscle relaxers at dinner time to help with sleep and avoid next day grogginess. It's helpful, although not always totally effective. Warm bath before bed, no caffeine after 12 noon helps me too. Good luck.

Merry (Mary)

Thanks Mary. And welcome to the forum! It looks like you've dealt with alot of pain yourself looking at your signature.

I think it would be a good idea to take the clonazepam with dinner, since it's what makes me groggy in the morning and also upsets my stomach a bit. And maybe take the tramadol just before I go to bed since it didn't cause the same problems. Coffee doesn't like me, so my main source of caffeine is in chocolate and I'm trying not to eat too much of that. Unfortunately I can't get in and out of the bath at the moment as I have a broken arm, but my main problem at the moment is that my broken arm gets sore when I am in bed, so I don't sleep for long.

I'm glad you've got a good pharmacist. Ours isn't very forthcoming - he didn't even advise me on whether I could open up the tramadol capsule. He just looked up the data sheet and said it didn't say either way, which I could do myself. I do miss the pharmacy we used to go to before shifting house - they were more helpful and friendly. I am considering trying a different one that is also nearby.

Wishing you the best, Shirley.
When I had shoulder surgery, the surgeon told me to sleep in a chair recliner. I sometimes have trouble swallowing capsules . Taking the capsule in thick pudding or applesauce works for me. Then, there is no need to open capsule. I hope you find a very knowledgeable, informative, supportive pharmacist. Thanks for the warm welcome.

Mary (Merry)

I got told a method for taking capsules or big pills - place on tongue lined up with the length of your tongue, then take a mouthful of a slightly thicker liquid than water - milk was what I was recommended. As you take the mouthful you kind of do a slurp to whoosh the pill or capsule down your throat. Then take another couple of mouthfuls normally as a chaser. Also, don't tip your neck back - if anything keep your head just a fraction tilted down. Most folk throw their head back to swallow a pill but that doesn't keep your gullet open well to get the pill down.

I'd echo what MerryC said about finding a different place to sleep, or a completely different sleeping position. You want to be able to keep that arm in the best possible position and lying down probably isn't it. Don't know if you share a bed or not, but now is definitely the time to have a bed to yourself. If you think bed is the best place though, then experiment with pillows around your body to keep your arm in the right place and support your body so you don't move too much. If you can't figure out what you need to get your body comfortable, see if you can see an OT - they have helped a few folk I know with things like long beanbag pillows or foam wedges to keep them comfortable sleeping.

I know a lot of doctors don't like prescribing diazepam, but thats my drug of choice for relaxing me enough to sleep. I get it as a syrup and that makes it easy to titrate the dose to what I need - I'm allowed anything from 2-5 mg and because I don't use it very often, that is usually more than enough, and doesn't seem to give any morning effects for me.

Thanks cemc. My problem isn't with the actual swallowing process, capsules get stuck just below the swallowing point and sit there until they dissolve. Even with tiny prednisone-sized tablets, I have to eat something afterwards to push it down. I used to be fine with any sized tablets, this is something that developed in the 1990's. A barium swallow suggested an irregularity in that area, too high to see properly with gastroscopy, would need to go to ENT to get it checked out.

The sleeping position thing is tricky. I do share a bed, but my husband does sometimes (often lately) move to the spare room after a bit when one or both of us is restless. But whether he's there or not, I can't find a position that is comfortable for long. The fracture is at the top of my left humerus, so no plaster. I sleep on my right side and the best position I have found involves kind of wrapping my left arm around a pillow, but it's not ideal. The orthopaedic surgeon suggested some people lie on their back with a pillow under their left shoulder but that doesn't work for me for long. We don't have any reclining chairs, but I might look into a second hand one if this is going to go on much longer. I see the orthopaedic surgeon tomorrow so will see what he says. He has previously said things like "yes fractures hurt" and "you'll sleep when you get tired enough", but I'll be telling him how the pain and tiredness has been risking my health and triggered a visit to ED.

A syrup sounds good. My doctor prescribed clomazapam because it helps with the restless legs I get when overtired (like now).

Taking the clonazepam with dinner and tramadol before bed worked well. I was asleep by 11pm,woke once briefly to top up the paracetamol then slept until 6am and feel half human this morning yay!

So glad you got a half decent sleep!

That's great, Shirley!