Medication issues

I am currently waiting for disc replacement surgery on my neck at C2-C4 levels, I am fused from C4-T1 already and I also need a disc replacement in the low back.  I am taking methadone 5 mg tablets 3 times per day and Ultram 100 mg in the morning, 50 mg in the afternoon and 100 mg extended release in the evening.  The reason for the mixed up dosage on the ultram is I am trying to get off of the extended release due to the cost.  The problem I have is that before when I was taking 100 mg Ultram ER twice a day with the methadone as listed above my pain was controled, but since I have tried going down on it I have pain all the time again.  I was wondering if there was any other long acting medication out there that works simular to the Ultram ER?  My doctor don't want to increase the methadone due to the time frame that I am going to have to wait for the surgery to be approved by the insurance and she has offered no other solutions.

[Kalvin]

There's really nothing in Ultram's class that's extended release. You'd have to go up to a much stronger narcotic. Have you looked at generics, or Canadian pharmacy's? Can't you just use 50mg instance release until you find a solution. And not wanting to increase the Methadone is a good thing.

[snuggles61268]

I am currently working on dropping down to just using the 50 mg tabs, but that don't last through the night, so when I wake up in the morning the pain is at its worse.  That is why I liked the extended release medication.  The only down side to the 50 mg tabs that I have noticed is that the twitching that I have since I started taking ultram is getting worse, with the extended release it was almost non-existant, which was wonderful.  I felt better while taking the extended release and I am thinking on going back to doing what worked, but the cost is just outrageous and we have a high deductible, so that was the main reason for me going off of it.  I was taking Tylenol 3 and Ultram before they put me on the Methadone, I was able to get off the Tylenol, which was the one they wanted to see me get off, they don't seem to concerned about the Ultram - go figure the expensive one is the safe one!!!  I appreciate your comments and I will check with my doc to see if tramadol, which is the generic form of Ultram, comes in extended release, but I don't believe it does.