Can You Take Tramadol and Ibuprofen Together to Control Pain and Inflammation?

Tramadol is an opioid analgesic that acts on the central nervous system to relieve moderate to severe acute pain. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat mild to moderate acute pain. It can be bought over the counter or prescribed by a healthcare professional.

Sometimes people combine ibuprofen and opioid medications in order to enhance pain relief while also reducing swelling and inflammation, studies have proven this to be effective. The reduction of swelling and inflammation is thanks to ibuprofen. It is safe to combine tramadol with most over-the-counter NSAIDs, like ibuprofen, acetaminophen, and aspirin. 

However, some over-the-counter medications sold in pharmacies contain codeine, in various forms, which is similar to Tramadol, and the two should not be combined. This combination is likely to enhance adverse reactions.  

When You Combine These Drugs…

When ibuprofen and opioids are combined they can effectively relieve severe pain and swelling in most cases, according to several studies. Ibuprofen works by blocking the release of chemical messengers that lead to discomfort and inflammation. Tramadol works by blocking the transmission of pain signals to the brain, lowering the perception of pain. 

These medications are safe to take together, as there is no known drug interaction between the two. However, you should only use them as directed by your physician. Your health care provider knows your medical history, conditions, and other medicines, making them the best person to determine whether or not these medications will be safe for you.

Although both tramadol and ibuprofen work to relieve discomfort, they are different classes of pain medicine because they work differently. The fact that they have different mechanisms of action while also providing synergistic effects makes them effective when used in combination with each other for the treatment of moderate to severe symptoms, helping you to continue with your normal life functions.

It is commonly suggested to use them together by taking ibuprofen to treat mild to moderate symptoms while reserving the tramadol for any breakthrough pain symptoms. This is because while it is more effective in treating acute pain than ibuprofen is, tramadol is classified as an opioid and a controlled substance, so it is often reserved and used conservatively as it has a high risk of dependence.

Common Side Effects (Other Than Pain Relief)

Studies show that taking opioids and ibuprofen taken in combination with each other won’t necessarily increase the risk or severity of you having reactions, and won’t typically have a negative impact on your overall health. However, they are both known to cause gastrointestinal issues. When taking this combination in any form, you may experience any of the following side effects:

  • Nausea
  • Vomiting
  • Constipation
  • Stomach discomfort and cramping
  • Indigestion
  • Weakness
  • Dizziness
  • Sleepiness
  • Dry mouth 
  • Respiratory Depression


Currently, there are no known interactions between ibuprofen and opioids. However, tramadol does have known interactions with other substances, such as alcohol. Alcohol increases the risk of any reactions related to your nervous system. Like drowsiness, dizziness, difficulty breathing, and impaired judgment. It is always recommended that alcohol is avoided while taking tramadol. 

Tramadol has the ability to affect serotonin, therefore there has been some concern that it could cause thinning of the blood, especially when combined with other drugs that can thin the blood, like ibuprofen. However, most studies show that tramadol is not actually associated with having any effect on the blood.

There are several medications that can affect the way that tramadol works for you, these medications can also increase the risk of you experiencing any adverse reactions. Any medications used to treat the following conditions may be a cause for concern if combined with an opioid; depression, anxiety, other mental health issues, and trouble sleeping. 

Be sure to notify your doctor or pharmacist of all other medications that you’re taking if you are prescribed tramadol. This includes other prescriptions, over-the-counter medications, herbal remedies, vitamins, supplements, and any other medicinal products. There isn’t an abundance of research to tell us whether or not it is safe to take herbal remedies and other complementary medicines in combination with Tramadol. These types of medications are not regularly tested in the same manner that prescription medications are tested. Typically, they’re not tested for the way that they interact with other medications. 

What One Study Says About Using Tramadol and Ibuprofen Together After a Pediatric Tonsillectomy

A study was conducted in order to get a better look into the interaction between tramadol, acetaminophen, and ibuprofen. This clinical trial also investigated their effect when given to manage pediatric pain during the post-tonsillectomy recovery period of healthy volunteers.

During this study, children were given an oral dose of ibuprofen and acetaminophen around the time of the operation. Following the procedure, oral tramadol was given to the children by their adult caregivers, but only if the ibuprofen wasn’t effective enough and the child was experiencing an unacceptable amount of postoperative discomfort. Throughout the study, the child’s symptoms were measured by a scale that was provided to the parents or responsible party, and they were instructed to measure the child’s symptoms every two hours on the first day after the operation. 

Upon study completion, researchers were able to conclude that the combination of acetaminophen and ibuprofen given in commonly used doses has the ability to reduce post-operative pain by up to 65%.  They also learned that increasing the dose of ibuprofen and acetaminophen only added very little additional benefit. Finally, this clinical trial was able to confirm that adding oral tramadol into the treatment of postoperative pain was able to prolong the duration of the analgesic effects. Another study discovered a similar outcome.

Research-Based Evidence on the Anti-Inflammatory Effects of This Combination

Recently, several studies have been conducted to prove that the combination of tramadol with a Non-Steroidal Anti-Inflammatory Drug, such as ibuprofen, can provide an effect that is better than each drug has when taken alone. One study investigated the anti-inflammatory effects of these two medications by measuring C-reactive protein concentrations in healthy adult patients after the removal of an impacted tooth by surgical intervention. The patients participating in this study were categorized into 3 equal groups based on postoperative analgesic medication. 

  • The first group received 100 mg of tramadol every 8 hours. 
  • The second group received 400 mg of ibuprofen every 8 hours. 
  • The third group received a combination of the two; 50 mg of tramadol and 200 mg of ibuprofen every 8 hours. 

The first phase of this study was conducted before the operation. C-reactive proteins were measured in order to exclude any preexisting inflammation that could interfere with the outcome of the study. It was also measured immediately after the procedure and 72 hours into the postoperative period as well. 

The results of the C-reactive protein measurement 72 hours after surgery are as follows.

  • The first group experienced an increase in the c-reactive protein by 123% over the post-surgery baseline. 
  • The second group experienced an increase in the c-reactive protein by 84% over the post-surgery baseline.
  • The third group experienced an increase in the c-reactive protein by 37% over the post-surgery baseline. 

The patients that participated in this study were all healthy adults, including 21 men and 24 women. None of them had any pre-existing inflammatory conditions that would affect the outcome of this clinical trial. Additionally, there were no other significant differences or biological distinctions between any of the adult patients participating in this study. 

The results of this study revealed that while ibuprofen was significantly more effective at treating inflammation than tramadol was by itself; the combination of the two was by far the most effective way to treat post-operative inflammation, and improve your quality of life while recovering from the procedure. 

Risk of Addiction

The potential for abuse and the risk of opioid addiction are high. Although Tramadol has a lower risk than most opioids, it is no exception. When abused, the risk of addiction is still present and associated with an even greater risk of overdose and death. 

The Substance Abuse and Mental Health Services Administration (SAMHSA) sponsored an observational study that told us that the misuse of tramadol was seen in 8.1% of people that took the drug. Anyone abusing this substance is putting themselves at risk of overdose and possibly even death in severe cases. 

The Centers for Disease Control and Prevention report that 51.5% of deaths caused by drug overdose in 2019 in the United States involved a synthetic opioid, including tramadol. That’s more than half of overdose deaths caused by tramadol or other drugs similar to it. 

In order to avoid addiction and overdose, it is important for you to only take an opioid as prescribed by your healthcare provider. It is also important that you do not share your prescription medication with anyone else. 

Frequently Asked Questions

No, it is not a muscle relaxer or an anti-inflammatory medication. Tramadol is a synthetic opioid that effectively relieves severe pain. But it will not reduce any swelling that you have when you take it alone. Ibuprofen has the capability of reducing swelling, which is why this combination is effective in treating severe pain and swelling.
Always consult with a medical professional regarding the proper doses before taking or combining any medications. There are no known medication interactions between ibuprofen and opioids, however, that doesn’t mean that none exist.
As with other opioids, tramadol can have adverse reactions such as fatigue, lightheadedness, and dizziness. Tramadol is also known to make you extra sleepy. Therefore, it isn’t recommended for you to drive heavy machinery immediately after taking the medication. Because of this, taking this substance can hinder your ability to perform normal life functions.

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