Medication interaction hub

What Supplements Interact with Tramadol?

Tramadol brand names: Ultram, Zytram XL, Qdolo. Every interaction below applies to the brands too.

223 Interactions 10 Major 174 Moderate 39 Minor
Curated & coded by · Clinical Pharmacist · Updated September 22, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Tramadol? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Tramadol against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

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. Another large group changes how the liver handles the drug, so grapefruit can push levels up while St. John's wort can drag them down and weaken pain relief. A third cluster raises serotonin, as tramadol itself does, risking serotonin syndrome, an overload marked by agitation, fever, and a racing heart.

If you drink, be upfront with your pharmacist; beer and wine carry two of the highest ratings on this page. Charcoal and some bulking fibers can also block absorption, so keep them well apart from doses. Of the 223 flagged ingredients, ten rate major, 174 moderate, and 39 minor, and those ten are where I would start reading.

— , Clinical Pharmacist · July 18, 2026

Major 10 Moderate 174 Minor 39 No known interaction 1,229

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Top Ingredient Interactions

Tramadol: Top Interactions at a Glance

The most significant Tramadol supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 223 interacting ingredients — plus 1,229 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Tramadol + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Likely Beer + Tramadoli

Concomitant use may increase sedative and other adverse effects.

Read the full interaction Major Likelihood Likely Grapefruit + Tramadoli

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Major Likelihood Likely Wine + Tramadoli

Concomitant use may increase sedative and other adverse effects.

Read the full interaction Major Likelihood Probable 1,4-butanediol + Tramadoli

Theoretically, concomitant use of 1,4-butanediol with CNS depressants may potentiate respiratory and CNS depression.

Read the full interaction Major Likelihood Probable Activated Charcoal + Tramadoli

Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the route of administration.

Read the full interaction Major Likelihood Probable Gamma-hydroxybutyrate (ghb) + Tramadoli

GHB may increase the risk of serious CNS and respiratory depression.

Read the full interaction
The complete list

Every Supplement Checked Against Tramadol

All 1,452 ingredients in our database, ranked by severity — 223 with a Tramadol interaction on file and 1,229 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Tramadol?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Clove with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use of clove may increase levels of drugs metabolized by CYP2D6.

Full Clove + Tramadol answer

Can you take Delta-9-tetrahydrocannabinol (thc) with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, THC might have additive effects if used with other CNS depressants.

Full Delta-9-tetrahydrocannabinol (thc) + Tramadol answer

Can you take Lithium with Tramadol?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Theoretically, taking lithium supplements with serotonergic drugs might both mask and increase the risk of serotonin syndrome.

Full Lithium + Tramadol answer

Can you take German Chamomile with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, German chamomile might have additive effects when used with CNS depressants.

Full German Chamomile + Tramadol answer

Can you take Ginger with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Ginger might increase or decrease the levels of CYP3A4 substrates.

Full Ginger + Tramadol answer

Can you take Ginkgo with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.

Full Ginkgo + Tramadol answer

Can you take Goji with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, goji berry might inhibit CYP2D6 and reduce metabolism of CYP2D6 substrates.

Full Goji + Tramadol answer

Can you take Goldthread with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. There's very preliminary evidence that berberine, a constituent of goldthread, might inhibit cytochrome P450 3A4 (CYP3A4) enzyme.

Full Goldthread + Tramadol answer

Can you take Gotu Kola with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.

Full Gotu Kola + Tramadol answer

Can you take Grape with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.

Full Grape + Tramadol answer

Can you take Greater Celandine with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Research in vitro shows that chelidonine, a constituent of greater celandine, inhibits cytochrome P450 2D6 (CYP2D6) enzyme activity.

Full Greater Celandine + Tramadol answer

Can you take Griffonia Simplicifolia with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking Griffonia simplicifolia seed extract with CNS depressants might increase the risk of additive CNS depression.

Full Griffonia Simplicifolia + Tramadol answer

Can you take Guar Gum with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Guar gum might reduce the absorption of some oral drugs, potentially decreasing their effectiveness.

Full Guar Gum + Tramadol answer

Can you take Guarumo with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In an animal study, an aqueous extract of guarumo depressed the central nervous system, inducing significant motor incoordination and muscle...

Full Guarumo + Tramadol answer

Can you take Gum Arabic with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.

Full Gum Arabic + Tramadol answer

Can you take Hawaiian Baby Woodrose with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use may increase the risk for serotonergic adverse effects.

Full Hawaiian Baby Woodrose + Tramadol answer

Can you take Hesperidin with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use with CNS depressants may cause additive sedative effects.

Full Hesperidin + Tramadol answer

Can you take Higenamine with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, higenamine might increase the levels and clinical effects of drugs metabolized by CYP2D6.

Full Higenamine + Tramadol answer

Can you take Hops with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.

Full Hops + Tramadol answer

Can you take Horny Goat Weed with Tramadol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.

Full Horny Goat Weed + Tramadol answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Tramadol is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Tramadol, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Tramadol sits in 8 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Tramadol through this category.

Cns Depressants 78 ingredients

Central-nervous-system depressants. Sedating supplements can intensify drowsiness and slowed reactions when combined.

78 of the supplement ingredients on this page reach Tramadol through this category.

Cytochrome P450 2D6 (Cyp2D6) Substrates 60 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

60 of the supplement ingredients on this page reach Tramadol through this category.

Serotonergic Drugs 20 ingredients

Medications that raise serotonin activity. Combining them with serotonin-active supplements can, in rare cases, push serotonin too high.

20 of the supplement ingredients on this page reach Tramadol through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Tramadol through this category.

Seizure Threshold Lowering Drugs 6 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

6 of the supplement ingredients on this page reach Tramadol through this category.

Tramadol (Ultram) 3 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

3 of the supplement ingredients on this page reach Tramadol through this category.

Serotonergic Drugs 1 ingredient

Medications that raise serotonin activity. Combining them with serotonin-active supplements can, in rare cases, push serotonin too high.

1 of the supplement ingredient on this page reaches Tramadol through this category.

About Tramadol

Tramadol is an opiate pain reliever used to treat moderate to moderately severe pain in adults and children 12 and older.

Generic name: Tramadol  ·  Brand names: Ultram, Zytram XL, Qdolo.

See the full Tramadol drug information
Check a real product

Take a Supplement Product? Check the Whole Bottle Against Tramadol

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Tramadol.

Search a supplement product

Type a product name, brand, or UPC — smart search across our full catalog.

Grounded search over our product catalog — every verdict comes from our interaction database, never AI guesswork. How we use AI

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Prefer typing? The interaction checker looks up products by name too.

Products that contain Tramadol-interacting ingredients

Real supplements from the NIH label database that contain the top interacting ingredients on this page — each one is worth a full label check before combining with Tramadol.

Yeast-Cleanse by Solaray contains Grapefruit Ultimate GCB by M3 Supplement Company contains Grapefruit Neuro Health by Nature’s Craft contains Grapefruit NDF Happy Peach by Bioray Kids contains Grapefruit
Pharmacist Counseling Corner

Tramadol & Supplements: Common Questions

What supplements interact with Tramadol?
Our database currently documents 223 ingredients with a known Tramadol interaction (10 major, 174 moderate, 39 minor). The practical move: scan the major group first, then look up the exact supplements you take rather than reading all 223. The highest-ranked right now: Beer, Grapefruit, Wine.
Which Tramadol supplement interactions are the most serious?
Focus on the major group: Beer, Grapefruit, Wine, 1,4-butanediol and Activated Charcoal, among others. A major rating means the combination can be clinically significant, not that harm is guaranteed — but it's exactly the kind of thing to run past your pharmacist before your next dose, not after. Jump to the ranked list.
Can I take vitamins or supplements while on Tramadol?
Plenty of supplements coexist fine with Tramadol; a shorter list does not. Rather than memorizing it, check the specific ingredients on your labels — the ranked list above covers every one we've checked, and multi-ingredient products can be checked label-by-label with our scanner. Try the label scanner or the interaction checker.
Do brands like Ultram have the same supplement interactions as Tramadol?
Yes — Ultram, Zytram XL, Qdolo all contain Tramadol, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
What about Tramadol and my other medications?
This page covers Tramadol against supplements and herbal ingredients. Checking Tramadol against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Tramadol drug information.

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

Where next

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 22, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.