Tramadol

[Chris.B]

What are the local equivalents of Tramadol please?

 

I have a frozen shoulder and I need a pain killer better than paracetamol which I have been taking.

[BenDeCosta]

You can buy Tramadol here, I've bought it many times. Some pharmacies get antsy about it though.

[Pilotman]

OP, yes, you can get Tram here, but also Ultracet, which is,  I think, 30% Tram and 70% Paracetamol.  It maybe a better bet and easier to get, although it is a controlled medicine, it is also less addictive. For both you may have to ask a few pharmacies before you find one that will give it to you without a prescription.  

[clivebaxter]

28 minutes ago, Pilotman said:

OP, yes, you can get Tram here, but also Ultracet, which is,  I think, 30% Tram and 70% Paracetamol.  It maybe a better bet and easier to get, although it is a controlled medicine, it is also less addictive. For both you may have to ask a few pharmacies before you find one that will give it to you without a prescription.  

 

it's 37.5 mg tramadol and 325 mg paracetamol, so you can safely take 3, eying the box up now! 160 baht for 10, can't find anywhere in bkk that sells pure tramadol now

Edited June 2, 2021 by clivebaxter

[TimBKK]

Recommendation for pure tramadol in Pattaya (if even available)?  Will try the pharmacy next to Tim’s on 2nd road, but if anyone has another suggestion please share.

[Chris.B]

What about Tindol ? Is it available in pharmacies and is it the same as Tramadol ?

[TooBigToFit]

It was easier to get tramadol at pharmacies but that changed a couple years ago. a few years ago, I think kids were mixing it with something for a high so they cracked down on it. Still, it may well be available at some shops, especially the Chinese ones that have piles of stuff to the ceiling in tourist areas. Another option is Etoricoxib.  This works for me too. It's still everywhere from what I have seen. I guess there are different names for it. It's not as strong as Ultracet.

[Sheryl]

Tramadol is the generic name.

 

There are more than a dozen locally made brands of plain tramadol and any "real" pharmacist will recognize the name. Pharmacies that don't have have an actual pharmacist always on duty (which is more of them than you might expect) usually won't usually sell it.

 

There are also a few brands that combine tramadol with paracetemol: Ultracet, Utraphen

 

While tramadol does not require a prescription, it can only be sold if there is a grade 1 pharmacist in the premises and requires special record keeping. Many pharmacies can't meet these requirements or don't want to bother hence it is usually only found in large pharmacies.

 

In addition, because it has become a favorite "recreational" drug for teenagers, some pharmacies will only carry the combined form with paracetemol (less possibility of taking mega doses to get high). For the same reason many pharmacies limit how much they will sell at a time.

 

Actually for musculoskeletal pain, NSAIDs are often better since they address the underlying inflammation - provided you don't have any contraindications (gastritis, being on anticoagulants, kidney disease), I would try this first.

 

Steroid injections can also be helpful with frozen shoulder, and appropriate exercises are important.

 

 

 

 

 

[drtreelove]

27 minutes ago, Sheryl said:

 

 

Actually for musculoskeletal pain, NSAIDs are often better since they address the underlying inflammation - provided you don't have any contraindications (gastritis, being on anticoagulants, kidney disease), I would try this first.

 

Steroid injections can also be helpful with frozen shoulder, and appropriate exercises are important.

 

 

 

 

 

This is really good advise in my opinion. Tramadol and opiods will drag you down and weaken your body's self healing.

Plus consider TCM and acupuncture, Tui Na, Thai or Shiatsu massage, and chi kung exercise, and a chiropractor who does extremities manipulations/adjustments, which have all helped me tremendously over the years.

 

As a veteran of 12 orthopedic surgeries, due to beating my body to a pulp for over 30 years in a highly athletic profession (tree worker, high-climber, technical rigger) plus mountain biking and martial arts training, I have relied on TCM as much as on modern orthopedic medicine. At the height of my tree work career, I have walked into my Chinese doctor's office with a frozen shoulder, and walked out after acupuncture with my arm floating up feeling weightless. Similarly, I have gone into a chiropractor's office on crutches with a locked knee, and walked out carrying the crutches.  My current TCM doc is on staff as an acupuncturist at a Kaiser Permanente hospital orthopedic clinic where they value the possibilities of alternatives for some cases, to heavy meds and surgeries . 

[faraday]

@Chris.B

 

I had a frozen shoulder over 20 years ago, & even now I can remember the pain.

 

After having painful physio, & finally a Steroid injection, it was fixed.

 

Don't mess about with analgesia only, do as DrTreelove suggests, & see an Acupuncture therapist.

 

Get some recommendations for a good Acupuncturist, as there are some charlatans about.

 

 

[Sheryl]

https://www.bumrungrad.com/en/doctors/Mason-Porramatikul

 

Top shoulder specialist in Thailand. Harvard-trained.

 

indeed, phytsio and steroid injection (if NSAID doesn't suffice) will usually do the trick.

[Chris.B]

18 hours ago, Sheryl said:

Tramadol is the generic name.

 

There are more than a dozen locally made brands of plain tramadol and any "real" pharmacist will recognize the name. Pharmacies that don't have have an actual pharmacist always on duty (which is more of them than you might expect) usually won't usually sell it.

 

There are also a few brands that combine tramadol with paracetemol: Ultracet, Utraphen

 

While tramadol does not require a prescription, it can only be sold if there is a grade 1 pharmacist in the premises and requires special record keeping. Many pharmacies can't meet these requirements or don't want to bother hence it is usually only found in large pharmacies.

 

In addition, because it has become a favorite "recreational" drug for teenagers, some pharmacies will only carry the combined form with paracetemol (less possibility of taking mega doses to get high). For the same reason many pharmacies limit how much they will sell at a time.

 

Actually for musculoskeletal pain, NSAIDs are often better since they address the underlying inflammation - provided you don't have any contraindications (gastritis, being on anticoagulants, kidney disease), I would try this first.

 

Steroid injections can also be helpful with frozen shoulder, and appropriate exercises are important.

 

 

 

 

 

Thanks Sheryl, your depth of knowledge on health matters is impressive. ????

 

I have managed to get some Umafen-200 (Ibuprofen 200mg) and will try these.

 

As for Tramadol, the pharmacies in our nearest country town don't stock them. Last time I got some, I had to go to the local government hospital and explain to a doctor why I wanted them. He let me have them no problem (1 baht a pill). I wanted the Tramadol previously for back problems, the young doctor said the hospital could look at my back if I wanted. I declined. ????

 

 

 

[Pattaya Spotter]

On 6/2/2021 at 11:54 AM, clivebaxter said:

 

it's 37.5 mg tramadol and 325 mg paracetamol, so you can safely take 3, eying the box up now! 160 baht for 10, can't find anywhere in bkk that sells pure tramadol now

Try the eXta Plus pharmacies attached to 7-Eleven...just bought me a box of Tramol a few days ago for accute sciatic pain. No muss no fuss and didn't have to sign any logbook.

Edited June 5, 2021 by Pattaya Spotter

[Moonlover]

On 6/3/2021 at 12:30 PM, Sheryl said:

https://www.bumrungrad.com/en/doctors/Mason-Porramatikul

 

Top shoulder specialist in Thailand. Harvard-trained.

 

indeed, phytsio and steroid injection (if NSAID doesn't suffice) will usually do the trick.

I'll agree with that. I've had 2 frozen shoulders, brought on by swimming. both were freed up following steroid injections.

 

I am now a fan of Qi Gong, the physical branch of TCM and I instantly recognize the early warning signs of F/S and am able to do my own preventive maintenance.

[Pattaya Spotter]

What is the legal status of Tramadol in Thailand...is there any danger from the police authorities if you are found in possession of personal use amounts...especially without a prescription? It is a Class 2 opiate, which are on the schedule of controlled substances of the Thai FDA. From the Thai FDA website:

 

Control in Thailand :  Currently controlled as a dangerous drug under the Drug Act B.E. 2510 (1967)

Production and import – by a company licensed to produce or import modern drugs And must prepare a production report and bring it to the FDA.
Sales - Can be sold in modern pharmacies. and must keep an account at the store to show to the staff. [FDA staff presumably]

 

https://www.fda.moph.go.th/sites/Narcotics/SitePages/ViewAcademic.aspx?IDitem=41

 

And this too:

 

The FDA is concerned about the misuse of Tramadol. Revealing that there is a strict control measure for pharmacies to sell no more than 20 tramadol tablets at a time, and prohibiting them from selling to children under 17 years old. If violated, they face both a fine and warned of the dangers of such drugs If used for the wrong purpose.

 

http://pca.fda.moph.go.th/public_media_detail.php?id=2&cat=50&content_id=817

 

 

[clivebaxter]

1 hour ago, Pattaya Spotter said:

Try the eXta Plus pharmacies attached to 7-Eleven...just bought me a box of Tramol a few days ago for accute sciatic pain. No muss no fuss and didn't have to sign any logbook.

where? very few pharmacies in 7/11 in Bkk 

[Sheryl]

1 hour ago, Pattaya Spotter said:

What is the legal status of Tramadol in Thailand...is there any danger from the police authorities if you are found in possession of personal use amounts...especially without a prescription? It is a Class 2 opiate, which are on the schedule of controlled substances of the Thai FDA. From the Thai FDA website:

 

Control in Thailand :  Currently controlled as a dangerous drug under the Drug Act B.E. 2510 (1967)

Production and import – by a company licensed to produce or import modern drugs And must prepare a production report and bring it to the FDA.
Sales - Can be sold in modern pharmacies. and must keep an account at the store to show to the staff. [FDA staff presumably]

 

https://www.fda.moph.go.th/sites/Narcotics/SitePages/ViewAcademic.aspx?IDitem=41

 

And this too:

 

The FDA is concerned about the misuse of Tramadol. Revealing that there is a strict control measure for pharmacies to sell no more than 20 tramadol tablets at a time, and prohibiting them from selling to children under 17 years old. If violated, they face both a fine and warned of the dangers of such drugs If used for the wrong purpose.

 

http://pca.fda.moph.go.th/public_media_detail.php?id=2&cat=50&content_id=817

 

 

As previously stated, it does nto require a prescription in Thailand.

 

It is not on the restricted narcotic list.  It is class "D" here

 

"A first grade pharmacist shall be on duty at the premises selling modern drugs, at all times, while the premises are open for operation. Daily purchase and sale record required."

 

The above rules are applied selectively to class D drugs, majority if medications sold without prescription in Thailand are Class D but only some have the Class D restrictions really enforced. Tramadol is one of them.

 

[Pattaya Spotter]

1 hour ago, clivebaxter said:

where? very few pharmacies in 7/11 in Bkk 

Maybe a Google Maps search? I bought mine in Phuket.

[Pattaya Spotter]

53 minutes ago, Sheryl said:

As previously stated, it does nto require a prescription in Thailand.

 

It is not on the restricted narcotic list.  It is class "D" here

 

"A first grade pharmacist shall be on duty at the premises selling modern drugs, at all times, while the premises are open for operation. Daily purchase and sale record required."

 

The above rules are applied selectively to class D drugs, majority if medications sold without prescription in Thailand are Class D but only some have the Class D restrictions really enforced. Tramadol is one of them.

 

What about Codamol or other codeine + NSAID combinations, are they only available by prescription, and what class do they fall under? I have had to pass kidney stones in the past and the pain was excruciating...necessitating trips to the hospital for intravenous pain relievers. Therefore my interest in having at hand very strong pain medications for short term use (also my periodic sciatic nerve attacks) if another episode should arise.

[clivebaxter]

1 hour ago, Pattaya Spotter said:

What about Codamol or other codeine + NSAID combinations, are they only available by prescription, and what class do they fall under? I have had to pass kidney stones in the past and the pain was excruciating...necessitating trips to the hospital for intravenous pain relievers. Therefore my interest in having at hand very strong pain medications for short term use (also my periodic sciatic nerve attacks) if another episode should arise.

Think that is illegal here

[jmccarty]

If you are in extreme pain, Morphine and Oxycontin are available from the hospital by prescription and work well in small doses.  Bangkok Hospital pharmacies normally have stock of it, at least in Pattaya for certain.

[Pattaya Spotter]

30 minutes ago, jmccarty said:

If you are in extreme pain, Morphine and Oxycontin are available from the hospital by prescription and work well in small doses.  Bangkok Hospital pharmacies normally have stock of it, at least in Pattaya for certain.

Yes that's where I went for my kidney stone episode. Just want to have something handy at home if I should have a reaccurance. I think the Tramol [Tramadol] I have now should do the trick. NSAIDs do nothing for kidney stones. 

[Chris.B]

6 hours ago, Pattaya Spotter said:

Try the eXta Plus pharmacies attached to 7-Eleven...just bought me a box of Tramol a few days ago for accute sciatic pain. No muss no fuss and didn't have to sign any logbook.

I haven't seen the extra Plus Pharmacies in the province I live.

 

Amazing, you can just walk in and buy so easily.

 

[kynikoi]

Try some voltaren gel.

[Pattaya Spotter]

1 hour ago, Chris.B said:

I haven't seen the extra Plus Pharmacies in the province I live.

 

Amazing, you can just walk in and buy so easily.

 

Yes very nice pharmacist at the drug annex attached to the "Seven" just down from the hotel I'm staying at in Phuket. That box of 10 50mg capsules cost 120 baht. I asked if she had Tapentadol but she said no...but that it's available in Thailand. Will ask her about co-codamol tomorrow. 

Edited June 5, 2021 by Pattaya Spotter

[Sheryl]

6 hours ago, Pattaya Spotter said:

What about Codamol or other codeine + NSAID combinations, are they only available by prescription, and what class do they fall under? I have had to pass kidney stones in the past and the pain was excruciating...necessitating trips to the hospital for intravenous pain relievers. Therefore my interest in having at hand very strong pain medications for short term use (also my periodic sciatic nerve attacks) if another episode should arise.

Anything with codeine is on the restricted narcotic list and tightly controlled, only by prescription and from a hospital.

 

The strongest pain killers you can get over the counter are tramadol and NSAIDs.

[Pattaya Spotter]

On 6/5/2021 at 8:03 PM, Sheryl said:

Anything with codeine is on the restricted narcotic list and tightly controlled, only by prescription and from a hospital.

 

The strongest pain killers you can get over the counter are tramadol and NSAIDs.

I did stop in again at the pharmacy today to purchase another box of Tramal (no problem) and inquired if opioid paracetamol combination painkillers are available without a prescription (Ultracet [Tramal + acetaminophen]). She said they were and she would order me a box. Again, this is from an eXta Plus Pharmacy attached to 7-Eleven. I figure this could be good for moderate pain, and in severe cases, use the pure Tramal. 

Edited June 9, 2021 by Pattaya Spotter

[The Hammer2021]

On 6/2/2021 at 9:19 PM, drtreelove said:

This is really good advise in my opinion. Tramadol and opiods will drag you down and weaken your body's self healing.

Plus consider TCM and acupuncture, Tui Na, Thai or Shiatsu massage, and chi kung exercise, and a chiropractor who does extremities manipulations/adjustments, which have all helped me tremendously over the years.

 

As a veteran of 12 orthopedic surgeries, due to beating my body to a pulp for over 30 years in a highly athletic profession (tree worker, high-climber, technical rigger) plus mountain biking and martial arts training, I have relied on TCM as much as on modern orthopedic medicine. At the height of my tree work career, I have walked into my Chinese doctor's office with a frozen shoulder, and walked out after acupuncture with my arm floating up feeling weightless. Similarly, I have gone into a chiropractor's office on crutches with a locked knee, and walked out carrying the crutches.  My current TCM doc is on staff as an acupuncturist at a Kaiser Permanente hospital orthopedic clinic where they value the possibilities of alternatives for some cases, to heavy meds and surgeries . 

TCM?

[The Hammer2021]

8 minutes ago, Pattaya Spotter said:

I did stop in again at the pharmacy today to purchase another box of Tramal (no problem) and inquired if codeine paracetamol combination painkillers are available without a prescription (Ultracet). She said they were and she would order me a box. Again, this is from an eXta Plus Pharmacy attached to 7-Eleven,  and not a back alley shop with a fat guy in a dirty t-shirt behind the counter.

Codeine  is illegal here.

[Pattaya Spotter]

3 minutes ago, The Hammer2021 said:

Codeine  is illegal here.

Yes I was mistaken...Ultracet is tramadol and acetaminophen. I have amended my post accordingly. I believe codeine is legal when used in a medically supervised setting.

Edited June 9, 2021 by Pattaya Spotter