What is Tramadol-Acetaminophen: Uses, Warnings & Interactions

How to take Tramadol-Acetaminophen

• The prescriber will tell you how much medicine to use. Do not use more than directed.

• Doses should not be taken for longer than five days.

• Do not take more than eight tablets a day. Contact the prescriber if the dose does not seem to be working.

• Please read the Medication Guide that comes with the medicine.

• The tablets can be taken with or without food.

• Swallow the tablet whole with a drink of water. Do not crush, break, or chew it.

• Store the medicine at room temperature in a closed, childproof container out of the reach of children.

What to do if you miss a dose of Tramadol-Acetaminophen

• Ask the prescriber how to handle a missed dose.

• Do not take extra medicine to make up for a missed dose.

Tramadol-Acetaminophen contraindications

• This medicine is not right for everyone.

• Do not take tramadol-acetaminophen if you have:

  • Known allergies to acetaminophen, tramadol, or other narcotic pain medications

  • Stomach or bowel blockage

Tramadol-Acetaminophen warnings

• Tell other healthcare providers treating you that you are taking tramadol.

• The prescriber may need follow-up visits, particularly when it’s time to stop taking tramadol-acetaminophen. Keep all appointments.

• Tell your healthcare provider if you are pregnant or breastfeeding, or if you have:

  • Liver problems

  • Kidney problems

  • Lung or breathing problems (including sleep apnea)

  • Pancreas problems

  • Gallbladder problems

  • Thyroid problems

  • Problems urinating

  • Depression or other mental health problems

  • A history of seizures

  • Any past head injury

  • A history of substance or alcohol abuse 

• Tramadol can cause serious and life-threatening problems, including: 

  • Respiratory depression (insufficient breathing)

  • Dependence

  • Abuse

  • Opioid withdrawal

  • Opioid withdrawal in a newborn

  • Suicidal thoughts and behaviors

  • Death

• Tramadol can cause other serious side effects, including:

  • Sleep-related breathing problems (including sleep apnea and sleep-related oxygen deprivation)

  • Mood or behavior changes

  • Constipation or intestinal paralysis

  • Serotonin syndrome 

  • Adrenal gland problems

  • Severely low blood pressure

  • Low blood sugar

  • Low sodium

  • Severe allergic reactions

• Acetaminophen, too, can cause serious problems, including:

  • Overdose and acetaminophen poisoning (causing liver damage)

  • Severe and possibly life-threatening skin reactions

• Tramadol can impair your judgment, make it difficult to think, and make you drowsy, dizzy, and lightheaded. Do not drive or engage in any other risky activity until you know how this medicine affects you. 

• Constipation is a common side effect of tramadol. Ask the prescriber about using laxatives to prevent or treat constipation.

• Opioids can impair fertility. Talk to the prescriber if this is a concern.

• This medicine can be habit-forming. Do not use more than your prescribed dose. If the dose doesn’t seem to be working, talk to the prescriber.

• Tramadol is a federally controlled substance. Giving or selling this drug to anyone else is hazardous and a criminal offense.

• Children and other adults can get hurt or die from taking opioids without a prescription. Keep this medicine locked up in a secure location out of the reach of children or visitors.

Tramadol-Acetaminophen interactions

• Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.

• Do not drink alcohol when taking tramadol ER.

• Avoid taking any other drug that contains acetaminophen.

  • Acetaminophen is a common ingredient in over-the-counter combination drugs. Check the ingredients and the strength of the acetaminophen dosage.

  • It is not safe to take more than 4 grams (4,000 milligrams) of acetaminophen in one day (24 hours). 

• To avoid drug interactions, tell the prescriber about all the prescription drugs, over-the-counter medications, and supplements being taken, particularly:

  • Other opioids, including diarrhea treatments

  • Drugs or other substances that make you sleepy, such as barbiturates, sleeping pills, benzodiazepines, muscle relaxants, seizure medications, allergy medications, CBD, and alcohol 

  • Prescription medications that treat depression, anxiety, psychosis, or other mental health problems

  • Migraine drugs called triptans

  • Drugs that make you urinate (diuretics)

  • Macrolide antibiotics 

  • Azole antifungal drugs 

  • Antiviral drugs called protease inhibitors 

  • Anticholinergic drugs

  • Amiodarone, digoxin, metaxalone, Paxlovid, quinidine, rifampin, warfarin

• Do not drink alcohol when taking tramadol-acetaminophen.

• Do not start any new medications without consulting the prescriber.

• Tell other doctors who treat you that you are taking tramadol.

Find more information about tramadol interactions here.