Cappy, a much better combo is Tramadol with paracetamol. And if 50mg isn't working, take 100mg. In my experience, GPs usually prescribe 1-2 tablets (capsules) every 4-6 hours. I always took 2 every 4 hours for the first several weeks. With the paracetamol, of course. It really enhances the Tramadol.