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Tramadol is a controlled substance used to treat pain. It’s safe to use tramadol under medical supervision, however this class of drugs has a high potential for abuse, addiction, and overdose if misused. These risks are heightened, and new dangers introduced if tramadol is combined with other substances.
This guide to tramadol interactions highlights how to use this medication safely and what substances to avoid when you’re using this opioid painkiller. You can also find out how to connect with compassionate care [1] if you have been abusing prescription medications like tramadol.
Tramadol is a medication used to relieve pain. It comes in two types: immediate-release, which works quickly, and extended-release, which works slowly over a longer period. Both forms help manage moderate to severe pain.
Tramadol is available as both tablets and capsules. You can get it as a generic drug or under the brand name Ultram. Generic drugs are usually less expensive but might not be available in all strengths or forms.
Because tramadol is a controlled substance, it requires a doctor’s close supervision due to its potential for misuse and dependence.
Tramadol is prescribed to manage moderate to severe pain. Sometimes, it is used alongside other medications as part of a combination therapy.
Tramadol belongs to a class of drugs known as opioid agonists [2]. These drugs work by changing how the brain senses pain. Tramadol mimics natural pain-relieving chemicals in the brain called endorphins. When endorphins bind to certain parts of cells, they reduce the pain signals sent to the brain. Tramadol works similarly, helping to lower the amount of pain you feel. The medication can also boost levels of norepinephrine and serotonin in the brain.
Like other opioids, tramadol comes with risks. Besides side effects, it can interact with other drugs. Some interactions are mild and might just need careful watching. However, others can be more serious and may require changes to your medications. You can stay safe while using tramadol by becoming aware of these interactions.
Tramadol can interact adversely with many common substances, from alcohol and OTC medications to prescription drugs and illicit substances.
Benadryl (diphenhydramine [3]) is an over-the-counter antihistamine commonly used to treat allergies, hay fever, and cold symptoms. It also serves as a sleep aid due to its sedative effects. When combined with tramadol, Benadryl can increase the risk of side effects such as severe drowsiness, dizziness, and confusion. Both medications can cause sedation and respiratory depression. This combination can be particularly dangerous for older adults or individuals with pre-existing respiratory conditions, as it can lead to severe breathing problems.
Additionally, Benadryl has anticholinergic properties, which can cause dry mouth, constipation, urinary retention, and blurred vision. When combined with tramadol, these effects can be amplified. Consult your healthcare provider before taking Benadryl with tramadol to ensure it’s safe for you. Your doctor might recommend alternative treatments for allergy relief that don’t have the same risk of interaction.
Trazodone is commonly prescribed to treat depression and anxiety. When combined with tramadol, the risk of serotonin syndrome increases. Serotonin syndrome is a potentially life-threatening condition caused by excessive levels of serotonin in the brain, and its symptoms include agitation, hallucinations, quick heart rate, high blood pressure, fever, sweating, shivering, and muscle stiffness.
Both tramadol and trazodone have sedative properties, which can lead to increased drowsiness, dizziness, and impaired motor coordination when taken together. This can affect your ability to perform tasks that require alertness, such as driving. Always consult your healthcare provider before combining these medications. They can monitor you for signs of serotonin syndrome and adjust your treatment plan as necessary to ensure your safety.
Ibuprofen is an NSAID (nonsteroidal anti-inflammatory drug [4]) that is often used to reduce inflammation, pain, and fever. It can be safely taken with tramadol, and this combination is often used to manage pain that involves inflammation, such as arthritis or muscle injuries. While tramadol works by altering pain perception in the brain, ibuprofen reduces inflammation at the site of pain, providing a complementary approach to pain management.
However, it’s imperative to follow your healthcare provider’s dosage recommendations. Ibuprofen can cause gastrointestinal issues, such as stomach ulcers and bleeding, especially when taken in high doses or for prolonged periods. Tramadol can also cause side effects like nausea and dizziness. By following your doctor’s guidance, you can minimize these risks and effectively manage your pain.
Hydroxyzine is an antihistamine that is used to treat anxiety, nausea, and allergic reactions. It also has sedative properties, making it effective for managing insomnia. When taken with tramadol, hydroxyzine can increase the risk of sedation, dizziness, and difficulty concentrating. Both medications can depress the central nervous system, leading to significant drowsiness and impaired motor function.
This combination can be particularly dangerous for anyone with pre-existing respiratory conditions, as it can worsen breathing problems. Consult your healthcare provider before combining hydroxyzine with tramadol. Your doctor can monitor for adverse effects and adjust your medication regimen as necessary to ensure your safety.
Lexapro (escitalopram) is an SSRI (selective serotonin reuptake inhibitor) used to treat depression and anxiety. When taken with tramadol, there is an increased risk of serotonin syndrome [5].
Both Lexapro and tramadol can cause drowsiness and dizziness, and their combined use can enhance these effects, leading to significant impairment in motor skills and cognitive function. It is essential to consult your healthcare provider before taking these medications together. Your doctor can monitor for signs of serotonin syndrome and adjust your treatment plan to ensure your safety.
Tizanidine is a muscle relaxant used to treat muscle spasticity. When taken with tramadol, there is an increased risk of sedation, dizziness, and impaired motor function. Both medications depress the central nervous system, leading to significant drowsiness and respiratory depression.
This combination is inadvisable for those with pre-existing respiratory conditions or those aged over 65. Consult your healthcare provider before combining tramadol with tizanidine. Your doctor can provide guidance on safe usage, monitor for adverse effects, and adjust your medication as necessary.
Oxycodone is a potent opioid pain reliever [6]. Taking it with tramadol is generally not recommended due to the increased risk of severe side effects, including profound drowsiness, respiratory depression, coma, and potentially fatal overdose. Both tramadol and oxycodone work by altering pain perception in the brain, and their combined effects can lead to a dangerous suppression of the central nervous system [7].
If you require more pain relief than one opioid can provide, your healthcare provider will need to carefully manage the dosages and monitor for any adverse effects. They may consider other pain management options or adjust your medication regimen to ensure your safety. Never take tramadol and oxycodone together without medical supervision.
Naproxen is another NSAID used to reduce inflammation and pain. It can be safely taken with tramadol to manage pain that involves inflammation.
As with ibuprofen, you should follow your healthcare provider’s dosage recommendations when taking naproxen with tramadol. Naproxen can cause gastrointestinal issues, and tramadol can also cause side effects like nausea and dizziness. By following your doctor’s guidance, you can effectively manage your pain while minimizing these risks.
Wellbutrin (bupropion) is an antidepressant also used to help with smoking cessation. Combining Wellbutrin with tramadol can increase the risk of seizures. Both medications lower the seizure threshold, making seizures more likely, especially in individuals with a history of seizures or other risk factors.
If you need to take both medications, your healthcare provider may need to adjust the doses and closely monitor for any signs of seizure activity. They might also recommend alternative treatments that do not carry the same risks. Always consult your healthcare provider before combining Wellbutrin with tramadol to ensure your safety.
Xanax (alprazolam) is a benzodiazepine used to treat anxiety and panic disorders. Taking Xanax with tramadol is generally not recommended due to the increased risk of severe drowsiness, respiratory depression, coma, and potentially fatal overdose. Both medications have sedative effects, and their combined use can significantly depress the central nervous system.
If you need both medications, your healthcare provider will need to carefully manage the dosages and monitor for any adverse effects. They may consider alternative treatments for anxiety or adjust your medication regimen to ensure your safety. Never take tramadol and Xanax together without medical supervision.
Eliquis (apixaban) is a blood thinner used to prevent blood clots and strokes. There is limited information on direct interactions between tramadol and Eliquis, but caution is advised. Tramadol can increase the risk of bleeding [8], especially when taken with other medications that affect blood clotting.
If you are taking Eliquis and need pain relief, your healthcare provider can help determine the safest options and monitor for any signs of increased bleeding. They may recommend alternative pain management strategies or adjust your medication. Always consult your healthcare provider before combining these medications.
Percocet is a combination medication that contains oxycodone and acetaminophen [9]. Both tramadol and oxycodone are opioids, making their combined use particularly risky. Taking Percocet with tramadol can lead to severe central nervous system depression, causing extreme drowsiness, difficulty breathing, and an increased risk of overdose. The addition of acetaminophen in Percocet can further complicate the situation by potentially leading to liver damage, especially if taken in high doses.
Combining tramadol with Percocet is generally not advised due to these heightened risks. If your pain is not adequately managed with one medication, your healthcare provider will need to carefully consider alternative treatment options that do not involve combining multiple opioids. Always discuss your pain management plan with your doctor, who can provide guidance on safe and effective ways to manage your pain without risking serious side effects or overdose.
Gabapentin is used to treat nerve pain and seizures. When taken with tramadol, there is an increased risk of sedation, dizziness, and respiratory depression. Both medications can intensify each other’s effects, leading to significant drowsiness and impaired coordination.
Consult your healthcare provider before combining gabapentin and tramadol. Your doctor can monitor for adverse effects and adjust your treatment plan as necessary to ensure your safety. They may also consider alternative treatments that do not carry the same risks.
Hydrocodone is a powerful opioid pain reliever often prescribed for severe pain management. Taking hydrocodone with tramadol is not recommended due to the high risk of serious side effects. Both medications are opioids, and their combined use can lead to profound sedation, severe respiratory depression, and even life-threatening overdose. Each drug affects the central nervous system by altering pain perception, and their combined effects can significantly increase the risk of dangerous side effects.
Additionally, both tramadol and hydrocodone have a high potential for misuse and dependence. Combining them can further increase these risks, leading to issues such as addiction and withdrawal symptoms. If your pain management needs are not being met by one medication, your healthcare provider might consider adjusting the dosage or exploring non-opioid alternatives. Never combine these medications without strict medical supervision and thorough evaluation by your doctor.
Tylenol (acetaminophen) is a common over-the-counter pain reliever. It can be safely taken with tramadol to help manage pain. This combination is often used for various types of pain, such as headaches, muscle aches, and arthritis. Tylenol works by reducing pain and fever, while tramadol alters pain perception in the brain.
Always follow your healthcare provider’s dosage recommendations to avoid potential side effects. Taking high doses of Tylenol can cause liver damage, and tramadol can cause side effects like nausea and dizziness. By following your doctor’s guidance, you can effectively manage your pain while reducing these risks.
Flexeril (cyclobenzaprine) is a muscle relaxant used to treat muscle spasms. When taken with tramadol, there is an increased risk of sedation, dizziness, and impaired coordination. Both medications depress the central nervous system, leading to significant drowsiness and respiratory depression.
This combination can be especially dangerous for seniors and for those with pre-existing respiratory conditions. Speak with your healthcare provider before combining tramadol with Flexeril. Your doctor can provide guidance on safe usage, monitor for adverse effects, and adjust your medication regimen as necessary to ensure your safety.
If you have been abusing prescription medications like tramadol, we can help you get back on track at Gratitude Lodge. We have inclusive luxury rehabs in Long Beach and Newport Beach, offering inpatient opioid addiction treatment covered by health insurance.
You can begin your recovery with opioid detox at one of our rehabs by the beach. During one week of detox, you will have access to medications and continuous care, moving from opioid dependence to ongoing inpatient treatment.
Since all opioid addictions are different, all our treatment programs offer personalized therapies, such as:
Call our recovery experts today at 844-576-0144.
[1] https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
[2] https://www.hca.wa.gov/assets/billers-and-providers/opioid-policy.pdf
[3] https://medlineplus.gov/druginfo/meds/a682539.html
[4] https://orthoinfo.aaos.org/en/treatment/what-are-nsaids/
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451445/
[6] https://www.ncbi.nlm.nih.gov/books/NBK482377/
[7] https://www.pediatrics.wisc.edu/education/sedation-program/sedation-education/sedation-respiratory-depression/
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705477/
[9] https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/040330s015,040341s013,040434s003lbl.pdf
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