When To Take Tramadol After Hydrocodone
In our latest question and answer, the pharmacist discusses whether or not it is safe to take tramadol after hydrocodone.
If I took a Norco 2 hours ago with no relief. Is it okay to take 50mg of tramadol?
Oct 08, 2022- It generally isn't recommended to take tramadol and hydrocodone within 4 to 6 hours of each other because both are opioids that can cause additive side effects like sedation, constipation, and shallow breathing.
- Taking tramadol with hydrocodone may increase seizure risk, so if both medications are needed together, the lowest possible dose of each should be used.
- You should wait at least 4 to 6 hours between taking hydrocodone and tramadol, though it takes much longer for both drugs to be completely eliminated from your body.
It generally isn't recommended to take tramadol and Norco (hydrocodone/acetaminophen) within 4 to 6 hours of each other. Tramadol and hydrocodone are opioid agonists and taking both around the same time can cause additive side effects, such as:
- Sedation
- Constipation
- Shallow breathing
In addition, there are reports that the use of tramadol increases the seizure risk in patients taking other opiate agonists, such as hydrocodone.
If tramadol and hydrocodone are used together, caution is needed and it is recommended to start on the lowest possible dose of each to assess tolerance.
How Long To Wait Between Doses Of Hydrocodone And Tramadol
The duration of action of tramadol and hydrocodone are both around 4 to 6 hours. It is therefore recommended to wait at least 4 to 6 hours to take tramadol after taking hydrocodone.
The caveat to this, however, is that although the analgesic effects of tramadol and hydrocodone last 4 to 6 hours, they both take considerably longer to be completely eliminated from the body.
Tramadol has a half-life of 6 to 7 hours while hydrocodone has a half-life of 3 to 4 hours. It will therefore take about 30-35 hours for tramadol to be completely eliminated from the body and around 24 hours for hydrocodone to be eliminated. If you want to be sure neither drug is in your system before taking the other, be sure to wait the appropriate amount of time.
Final Words
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References & sources
- Tramadol Monograph — PubChem
- Hydrocodone Monograph — PubChem
- Tramadol and Seizures: A Surveillance Study in a Managed Care Population — ACCP Journal
Glossary — Terms in This Answer
- Opioid agonists
- Medications that bind to and activate opioid receptors in the body to relieve pain.
- Additive side effects
- Unwanted effects that become stronger when two drugs are combined because their effects add together.
- Sedation
- A state of drowsiness or reduced alertness caused by medication.
- Constipation
- Difficulty or infrequency in bowel movements, often a side effect of opioid medications.
- Shallow breathing
- Slow or weak breathing that doesn't fully expand the lungs, a serious potential side effect of opioids.
- Seizure risk
- The increased likelihood of experiencing an uncontrolled electrical disturbance in the brain causing convulsions.
- Duration of action
- The length of time a medication remains effective in the body.
- Half-life
- The time it takes for the body to eliminate half of a medication's dose.
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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