How do you transition ultram ER to lortab?

DO NOT DO THIS WITH OUT THE ADVICE OF A PHARMACIST

Tramadol is significantly different then hydrocodone (lortab) even though they are both opioids.

I can't give you information on their equivalency, you need to talk to a pharmacist.

The most basic advice would be to stop taking the extended-release tramadol and start taking the lortab every 4 hours.

Some information suggests that 50mg of tramadol taken 4 times a day is equivalent to 40mg of morphine per day. That would suggest that 200mg tramadol per 24hrs is equivalent to 40mg morphine per 24hrs (roughly).

Since oral hydrocodone is considered approximately equal to oral morphine, the equivalent dose would be 40mg hydrocodone a day for each 200mg of tramadol a day.

Because of the dangers in switching and errors in conversion, you should start at half of that.

That means if you take 100 mg Ultram ER each day, you should now take 10mg hydrocodone (lortab comes as 2.5, 5, 7.5, and 10 mg hydrocodone along with 500 mg acetaminophen).

Assuming you have 5mg/500mg lortab pills, I would take a quarter of a pill every 3 hours (1.25mg hydrocodone 8 times a day).

If you take 200mg Ultram ER each day, start with 2.5mg hydrocodone (1 pill) every 3 hours (20mg a day).

If you take 300mg Ultram ER, still start with 2.5mg every 3 hours. If those dosages don't help your pain, you'll need to slowly increase your dosage.

A more advanced method would be to slowly decrease the ultram er (which may be impossible since its an ER fomulation, shouldn't be broken in half, etc.) and slowly increase the lortab

Never take these medications any other way besides oral.