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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Tramadol And Fentanyl Transdermal Be Taken Together?

My 75 year old father has stage IV metastatic prostate cancer to the bones diffuse throughout nearly all bone systems bilaterally. He has been using tramadol 50mg QID for the last year but it is no longer working. He has been started on 25mcg transdermal fentanyl and I just wondered if the tramadol counts towards considering him non-naïve to opiates.
Tue, 10 Jul 2018
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General & Family Physician,  's  Response
Detailed Answer:
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Both tramadol and fentanyl are drugs that belong to the opioid family and if you take them simultaneously you risk overdose and toxicity so it is important to talk to your doctor if the symptoms are not well controlled and consider use of one of them and in which dose. It seems that if he has been using tramadol for a while it might not help with time and changing to a stronger opioid (fentanyl) might be reasonable but there is no reason to take them both. Using opioids for a while might cause tolerance (the patient needs higher dose to achieve the effect) and this might be the case with prolonged use of tramadol in the case of your father. Fentanyl has the same risk of developing tolerance but switching him from tramadol to fentanyl will make him feel some improvement because fentanyl is a stronger opioid.

Hope I have answered your query.
Let me know if I can assist you further.

Kind regards,
Antoneta Zotaj, MD
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Can Tramadol And Fentanyl Transdermal Be Taken Together?

Detailed Answer: Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Both tramadol and fentanyl are drugs that belong to the opioid family and if you take them simultaneously you risk overdose and toxicity so it is important to talk to your doctor if the symptoms are not well controlled and consider use of one of them and in which dose. It seems that if he has been using tramadol for a while it might not help with time and changing to a stronger opioid (fentanyl) might be reasonable but there is no reason to take them both. Using opioids for a while might cause tolerance (the patient needs higher dose to achieve the effect) and this might be the case with prolonged use of tramadol in the case of your father. Fentanyl has the same risk of developing tolerance but switching him from tramadol to fentanyl will make him feel some improvement because fentanyl is a stronger opioid. Hope I have answered your query. Let me know if I can assist you further. Kind regards, Antoneta Zotaj, MD