Can You Take Tylenol With Tramadol?
In our latest question and answer, the pharmacist discusses if Tylenol (acetaminophen) can safely be taken with tramadol.
I was prescribed tramadol for back pain. I only take it rarely. Usually, I just take Tylenol. I want to know if I take Tylenol first, but it doesn't seem to be working well enough, can I take tramadol then too?
Nov 04, 2022- Tylenol and tramadol can be safely taken together because there is no drug interaction between them, and they are actually available combined in a single medication called Ultracet.
- Taking both drugs together may provide better pain relief than either drug alone because they work through different mechanisms and have complementary effects.
- You can start with Tylenol alone and add tramadol only when you need additional pain relief.
Answer
Tylenol (acetaminophen) can safely be taken with tramadol as there is no known drug interaction between them. In fact, acetaminophen and tramadol are available in combination in a single product, Ultracet (tramadol; acetaminophen).
The Combination May Be More Effective Than Either Drug Alone
Several studies have concluded that the combination of tramadol and acetaminophen can provide more effective pain relief than either drug can on their own.
One such study reported that the combination's benefits include their different mechanisms of action, onset of action and duration of action:
Tramadol/acetaminophen combination is a new preparation that is effective in acute or chronic moderate-to-moderately severe pain. It benefits from the complementary actions of the constituent analgesics, having the rapid onset of acetaminophen and the sustained effect of tramadol.
Another study reported better pain relief (i.e. supra-analgesic effects) when both drugs are used together compared to either drug alone:
Our study provides first results on interactions of tramadol and acetaminophen on experimental pain and hyperalgesia in humans. Pharmacodynamic modeling combined with the isobolographic technique showed supra-additive effects of the combination of acetaminophen and tramadol concerning both, analgesia and antihyperalgesia. The results might act as a rationale for combining both analgesics.
How Do Tramadol And Tylenol Work?
Tylenol is an analgesic (i.e., pain-reliever) and antipyretic (i.e., fever reducer). It works by changing how we sense pain. Specifically, it increases the pain threshold by inhibiting cyclooxygenase enzymes.
Tramadol works via several different mechanisms. Namely, it is an opioid agonist and serotonin-norepinephrine reuptake inhibitor.
These differing mechanisms of action are thought to be complementary for treating several different types of pain, which is likely why studies have shown that they work well in combination with one another.
You can find out more information on these drugs on drug detail pages:
Additional Information
Although I talk about acetaminophen and tramadol being available as a single pill, it makes sense in your case to have them as separate drugs.
Tramadol is an opioid and should only be taken if necessary to help control your pain. If you get effective relief in most situations from Tylenol alone, it makes sense to continue taking that primarily for your pain, and only add tramadol on when needed.
So, yes, you can take Tylenol first, and if you need additional pain relief, tramadol is safe to add on.
Final Words
I appreciate you reaching out to us! Feel free to do so again in the future.
References & sources
- Tramadol/acetaminophen combination tablets for the treatment of chronic lower back pain: a multicenter, randomized, double-blind, placebo-controlled outpatient study — PubMed
- Tramadol/acetaminophen combination tablets for the treatment of pain associated with osteoarthritis flare in an elderly patient population — PubMed
- Efficacy and safety of tramadol/acetaminophen tablets (Ultracet) as add-on therapy for osteoarthritis pain in subjects receiving a COX-2 nonsteroidal antiinflammatory drug: a multicenter, randomized, double-blind, placebo-controlled trial — PubMed
- [Tramadol/acetaminophen combination tablets] — PubMed
- Tramadol and acetaminophen combination for chronic non-cancer pain — PubMed
- The new analgesic combination tramadol/acetaminophen — PubMed
- Supra-additive effects of tramadol and acetaminophen in a human pain model — PubMed
- Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study — PubMed
Glossary — Terms in This Answer
- Drug interaction
- A reaction that occurs when two medicines affect each other's effectiveness or safety when taken together.
- Analgesic
- A medication that relieves pain.
- Antipyretic
- A medication that reduces fever.
- Cyclooxygenase enzymes
- Proteins in the body that produce substances responsible for pain and inflammation.
- Opioid agonist
- A substance that binds to opioid receptors in the brain and body to reduce pain.
- Serotonin-norepinephrine reuptake inhibitor
- A medication that increases levels of brain chemicals involved in pain regulation and mood.
- Supra-additive effects
- When two drugs work together to produce a greater effect than the sum of their individual effects.
- Mechanisms of action
- The specific ways that a drug works in the body to produce its effects.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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