Medication interaction hub

What Supplements Interact with Tramadol, Acetaminophen?

Tramadol, Acetaminophen brand name: Tramacet. Every interaction below applies to the brands too.

280 Interactions 12 Major 224 Moderate 44 Minor
Curated & coded by · Clinical Pharmacist · Updated September 15, 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, Acetaminophen? 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, Acetaminophen 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.

The combinations I worry about most with tramadol and acetaminophen (Tramacet) involve anything that deepens drowsiness or strains the liver. Tramadol is an opioid, so sedating supplements like kava, along with alcohol in any form, can slow breathing on top of adding sleepiness, which is why this list deserves genuine care rather than a skim. The acetaminophen half brings its own worry, since dozens of these ingredients can stress the liver, and stacking them compounds the load.

Many other entries change how the body handles one or both drugs; grapefruit can raise levels while St. John's wort can lower them, and a smaller group adds serotonin activity that can, rarely, become dangerous. Read the twelve major-rated pairings first, since they carry the real weight, and treat the remaining 224 moderate and 44 minor entries (280 in all) as items to check rather than fear.

— , Clinical Pharmacist · July 18, 2026

Major 12 Moderate 224 Minor 44 No known interaction 1,172

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 ↓

Most Viewed Ingredient Interactions

Tramadol, Acetaminophen: Top Interactions at a Glance

The Tramadol, Acetaminophen supplement & herbal interactions people checked most in the last 24 hours, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 280 interacting ingredients — plus 1,172 more checked with no known interaction. See the complete ranked list.

Start here

The Most-Checked Tramadol, Acetaminophen Combinations Today

The Tramadol, Acetaminophen + supplement pages people viewed most in the last 24 hours (resets at midnight). Open any card for the full report.

Minor Likelihood Possible Vitamin D + Tramadol, Acetaminopheni

Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.

Read the full interaction Moderate Likelihood Possible Turmeric + Tramadol, Acetaminopheni

Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.

Read the full interaction Major Likelihood Likely Grapefruit + Tramadol, Acetaminopheni

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Moderate Likelihood Possible American Elder + Tramadol, Acetaminopheni

Theoretically, taking American elder might increase levels of CYP3A4 substrates.

Read the full interaction Minor Likelihood Possible Rhodiola + Tramadol, Acetaminopheni

Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.

Read the full interaction Minor Likelihood Possible Blond Psyllium + Tramadol, Acetaminopheni

Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.

Read the full interaction
The complete list

Every Supplement Checked Against Tramadol, Acetaminophen

All 1,452 ingredients in our database, ranked by severity — 280 with a Tramadol, Acetaminophen interaction on file and 1,172 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, Acetaminophen?

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 Vitamin D with Tramadol, Acetaminophen?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.

Full Vitamin D + Tramadol, Acetaminophen answer

Can you take Turmeric with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.

Full Turmeric + Tramadol, Acetaminophen answer

Can you take Grapefruit with Tramadol, Acetaminophen?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Full Grapefruit + Tramadol, Acetaminophen answer

Can you take American Elder with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking American elder might increase levels of CYP3A4 substrates.

Full American Elder + Tramadol, Acetaminophen answer

Can you take Rhodiola with Tramadol, Acetaminophen?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.

Full Rhodiola + Tramadol, Acetaminophen answer

Can you take Gamma-hydroxybutyrate (ghb) with Tramadol, Acetaminophen?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. GHB may increase the risk of serious CNS and respiratory depression.

Full Gamma-hydroxybutyrate (ghb) + Tramadol, Acetaminophen answer

Can you take Kava with Tramadol, Acetaminophen?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Combining kava with CNS depressants can have additive sedative effects.

Full Kava + Tramadol, Acetaminophen answer

Can you take L-tryptophan with Tramadol, Acetaminophen?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.

Full L-tryptophan + Tramadol, Acetaminophen answer

Can you take Lithium with Tramadol, Acetaminophen?

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, Acetaminophen answer

Can you take St. John's Wort with Tramadol, Acetaminophen?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. St.

Full St. John's Wort + Tramadol, Acetaminophen answer

Can you take Asarabacca with Tramadol, Acetaminophen?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Asarabacca, a herbaceous plant, is often contaminated with aristolochic acid, a compound known for its nephrotoxic effects.

Full Asarabacca + Tramadol, Acetaminophen answer

Can you take Ayahuasca with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, ayahuasca might increase plasma concentrations of CYP2D6 substrates.

Full Ayahuasca + Tramadol, Acetaminophen answer

Can you take Brussels Sprout with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation.

Full Brussels Sprout + Tramadol, Acetaminophen answer

Can you take Cabbage with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.

Full Cabbage + Tramadol, Acetaminophen answer

Can you take Cannabidiol (cbd) with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Cannabidiol may increase levels of drugs metabolized by CYP1A2.

Full Cannabidiol (cbd) + Tramadol, Acetaminophen answer

Can you take Coffee Charcoal with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Coffee charcoal can reduce the absorption of orally administered drugs and should be separated from oral drug administration by at least two...

Full Coffee Charcoal + Tramadol, Acetaminophen answer

Can you take European Mandrake with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European...

Full European Mandrake + Tramadol, Acetaminophen answer

Can you take Evodia with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Evodia might reduce the levels and clinical effects of CYP1A2 substrates through induction of CYP1A2.

Full Evodia + Tramadol, Acetaminophen answer

Can you take Garlic with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Garlic might increase levels of drugs metabolized by CYP2E1.

Full Garlic + Tramadol, Acetaminophen answer

Can you take Glucomannan with Tramadol, Acetaminophen?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, glucomannan may decrease absorption of drugs taken orally.

Full Glucomannan + Tramadol, Acetaminophen 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, Acetaminophen is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Tramadol, Acetaminophen, 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, Acetaminophen sits in 15 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, Acetaminophen through this category.

Cytochrome P450 1A2 (Cyp1A2) Substrates 79 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.

79 of the supplement ingredients on this page reach Tramadol, Acetaminophen 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, Acetaminophen 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, Acetaminophen through this category.

Hepatotoxic Drugs 38 ingredients

Medications with known liver considerations. Supplements that can stress the liver add to the load.

38 of the supplement ingredients on this page reach Tramadol, Acetaminophen through this category.

Cytochrome P450 2E1 (Cyp2E1) Substrates 24 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.

24 of the supplement ingredients on this page reach Tramadol, Acetaminophen 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, Acetaminophen 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, Acetaminophen through this category.

Glucuronidated Drugs 12 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.

12 of the supplement ingredients on this page reach Tramadol, Acetaminophen through this category.

Acetaminophen (Tylenol, Others) 8 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.

8 of the supplement ingredients on this page reach Tramadol, Acetaminophen through this category.

Nephrotoxic 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, Acetaminophen 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, Acetaminophen 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, Acetaminophen through this category.

Cytochrome P450 1A2 (Cyp1A2) Substrates 1 ingredient

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.

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

Related: does Tramadol, Acetaminophen deplete any nutrients?

Tramadol, Acetaminophen has 1 reported nutrient association in the research literature — see the Tramadol, Acetaminophen nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Tramadol, Acetaminophen

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, Acetaminophen.

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

Or scan the bottle

Photograph any Supplement Facts panel — we read the ingredients and check each one against your medications. Free, in seconds.

Open the label scanner

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

Pharmacist Counseling Corner

Tramadol, Acetaminophen & Supplements: Common Questions

What supplements interact with Tramadol, Acetaminophen?
In our interaction database, 280 supplement and herbal ingredients have an interaction with Tramadol, Acetaminophen on file — 12 rated major, 224 moderate, and 44 minor. That number sounds scarier than it is: severity matters far more than the count, which is why the list on this page is ranked instead of alphabetical. Start at the top. The highest-ranked right now: Beer, Grapefruit, Siberian Cocklebur.
Which Tramadol, Acetaminophen supplement interactions are the most serious?
Focus on the major group: Beer, Grapefruit, Siberian Cocklebur, Wine and 1,4-butanediol, 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, Acetaminophen?
That depends entirely on which supplement. The honest answer for Tramadol, Acetaminophen is in the ranked list above — and if what you take is a combination product with a dozen ingredients, don't check them one by one: photograph the label with our scanner and we'll check the whole thing at once. Try the label scanner or the interaction checker.
Do brands like Tramacet have the same supplement interactions as Tramadol, Acetaminophen?
Yes — Tramacet all contain Tramadol, Acetaminophen, 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.
Does Tramadol, Acetaminophen deplete any vitamins or nutrients?
It might — Tramadol, Acetaminophen has 1 reported nutrient-depletion association in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Tramadol, Acetaminophen nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Tramadol, Acetaminophen and my other medications?
This page covers Tramadol, Acetaminophen against supplements and herbal ingredients. Checking Tramadol, Acetaminophen 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.

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

Where next

More Free Pharmacist Tools

Supplement interaction checker Check any supplement or product against your medications Supplement label scanner Photograph a Supplement Facts panel; we check every ingredient Browse medications A–Z Every drug we’ve checked against herbs & supplements Ingredient directory Every vitamin, herb & mineral we track, with interaction data Product directory Look up any bottle by name, brand, or barcode Ask a pharmacist Free, personal answer from our licensed team
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 15, 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.