Drug & supplement interaction

Phenibut + Tramadol

Tramadol brand names: Ultram, Zytram XL, Qdolo.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Phenibut has a moderate interaction with Tramadol. Theoretically, phenibut might increase the risk of sedation and respiratory depression when taken with CNS depressants.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Phenibut and Tramadol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CNS DEPRESSANTS

Why this applies to Tramadol

Tramadol falls under CNS DEPRESSANTS — the group Phenibut interacts with.

Theoretically, phenibut might increase the risk of sedation and respiratory depression when taken with CNS depressants.
Phenibut has been associated with sedation and respiratory depression in several case reports, especially when taken at high doses.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: both phenibut and tramadol calm down your central nervous system. Tramadol is an opioid pain reliever that already brings its own sedation, slowed breathing, and dizziness. Phenibut piles on top of that, since it's a brain depressant too. Stacking two sedating things can leave you overly drowsy, foggy, or, in the worst case, breathing too slowly and shallowly.

I'll be honest, this concern is based on how these drugs work and on case reports with phenibut, not hard clinical trials. But the stakes (slowed breathing) are high enough that I'd take it seriously, especially since we don't recommend phenibut at all. Please don't combine these without talking to your doctor or pharmacist first, and ask about safer, proven options.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Downes MA, Berling IL, Mostafa A, Grice J, Roberts MS, Isbister GK. Acute behavioural disturbance associated with phenibut purchased via an internet supplier. Clin Toxicol (Phila). 2015;53(7):636-8. PubMed
  2. O'Connell CW, Schneir AB, Hwang JQ, Cantrell FL. Phenibut, the appearance of another potentially dangerous product in the United States. Am J Med. 2014 Aug;127(8):e3-4. PubMed
  3. Sankary S, Canino P, Jackson J. Phenibut overdose. AM J Emerg Med. 2017 Mar;35(3):516.e1-516.e2.
  4. Graves JM, Dilley J, Kubsad S, Liebelt E. Notes from the field: phenibut exposures reported to poison centers - United States, 2009-2019. MMWR Morb Mortal Wkly Rep 2020;69(35):1227-8. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Phenibut Also Interacts With Other Medications

Phenibut has 247 moderate known drug interactions in our database — the Tramadol one above is one of them. If you take anything else, check it against the full list below.

Moderate 247 No known interaction 2,583 (incl. Tramadol)
Taking anything else?

Check Another of Your Medications Against Phenibut

Covers the 2,830 medications we’ve checked against Phenibut. Pick one to open its full report.

From our Q&A

Questions About Phenibut or Tramadol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Phenibut or Tramadol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Tramadol

This page covers Phenibut only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tramadol page lists 223 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 10 major · 174 moderate · 39 minor.

From our pharmacist’s overview on the Tramadol page

“Tramadol (Ultram, Qdolo) is an opioid, and its supplement interactions worry me more than most because the worst of them compound the drug's most dangerous effects. Alcohol and dozens of calming herbs deepen its sedation, sometimes to the point of slowed breathing.”

Reviewed by 2 · Jul 18, 2026

Open the Tramadol interaction page

One more smart check

Taking Phenibut as Part of a Dietary Supplement Product? Check It for Interactions

We hold 41 real supplement products containing Phenibut, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phenibut. Your product may carry other ingredients that interact with Tramadol too, on top of Phenibut — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Phenibut and Tramadol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Phenibut
Top half

#570 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tramadol
Top 25%

#311 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Phenibut

What is Phenibut?

Phenibut
  • Anxiety and stress
  • Insomnia and sleep problems
  • Stress relief
  • Mood and focus
  • Reducing alcohol withdrawal symptoms (unproven)

Phenibut is a synthetic, lab-made central nervous system depressant—not a natural herb—that some people use for anxiety and sleep, but it carries a serious risk of tolerance, dependence, and dangerous withdrawal. It is not an approved medication or dietary supplement in the United States, and we do not recommend its use. Talk to a doctor or pharmacist about safer, proven options for anxiety or sleep.

Read the full Phenibut monograph & all interactions
Medication

About Tramadol

What Is Tramadol Used For?

Brand names: Ultram, Zytram XL, Qdolo

Tramadol is used in adults for pain that is severe enough to need an opioid-strength medication and where non-opioid treatments haven't been enough. It's typically reserved for situations where milder options have failed or aren't expected to work.

It is not meant for everyday or long-term use unless the pain remains severe and alternatives continue to fall short. Prescribers carefully weigh the benefits against the real risks before starting tramadol.

See full Tramadol drug information
Keep checking

Other Drugs & Phenibut

Browse every other medication we’ve checked against Phenibut — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
247Moderate
0Minor
2,582No known interaction
247 Moderate 2,582 No interaction
Moderate

247 interactions

Showing 60 of 247 moderate interactions — see all 247 on the Phenibut page.

No interaction 2,582 drugs checked — show the list

We also checked Phenibut against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,582 medications checked with no known interaction — see the full Phenibut list.

See the full Phenibut interactions page
See every supplement checked against Tramadol, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Phenibut monograph › Uses, safety, and every drug interaction in one place Tramadol supplement interactions › Every supplement checked against Tramadol, ranked by severity Tramadol drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Phenibut and Tramadol Together: Common Questions

Can you take Phenibut with Tramadol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Phenibut and Tramadol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tramadol and Phenibut?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.