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What Is the Interaction between Tramadol and Acetaminophen?

Erin J. Hill
Erin J. Hill

There are no known drug interactions between tramadol and acetaminophen, and the two medications are sometimes combined in one pill for patients who suffer from chronic pain. Both are pain relievers, although tramadol is generally longer lasting and is given to those who require constant relief. Acetaminophen is available over the counter in a single pill and is generally considered safe when taken as directed.

The combination of acetaminophen and tramadol is often used for arthritis sufferers and others who have a chronic illness which causes pain and stiffness. While acetaminophen is generally mild and fast-acting, tramadol is designed to last for long enough to provide all day relief. The medications also work in slightly different ways.


New warnings distributed by certain government health agencies now require that drug manufactures limit the amount of acetaminophen in certain prescription medications. Over the counter options are not a part of this new guideline since they contain smaller doses of the drug.

Even with no known side effects between tramadol and acetaminophen, it is advised that any patient thinking of taking both speak with a doctor or pharmacist. Drug interactions and side effects may be determined more by the individual patient than with statistics and past studies. This means that a severe reaction could still occur even if none have been reported previously. For this reasons, patients should discuss all potential pain treatment options with a professional to ensure safety and proper monitoring.

A bottle of acetaminophen.
A bottle of acetaminophen.

Special precautions have to be taken by those who are using a medication containing both tramadol and acetaminophen. Although the latter is considered safe during pregnancy in most cases when taken in lower amounts, tramadol is not recommended for women who are pregnant or breastfeeding. Tramadol may also cause more side effects than acetaminophen alone, including nausea, constipation, and dizziness. Additionally, tramadol cannot be cut, mashes or chewed when being taken as acetaminophen can.

Although uncommon in healthy individuals when taken in proper amounts, acetaminophen is linked to liver damage. The risk is increased when patients drink alcohol while taking the drug or in those who take higher than recommended doses. Any drug containing tramadol and acetaminophen should be taken in moderation and under a doctor’s instructions. It is not advised that patients order any version of tramadol online, since quality, potency, and purity cannot always be verified.

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