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Tramadol and Tylenol: How Patients Are Achieving Acute Pain Relief

Reviewed by Dr. Kamemba

  • October 10, 2022

Reviewed by Dr. Tulman

  • October 10, 2022

The combination of acetaminophen (Tylenol) and tramadol is typically prescribed to treat moderate pain to severe pain or discomfort. The tramadol component of this medication is a synthetic opioid analgesic and has the potential to be habit-forming. 

Because tramadol is an opioid, it is not typically prescribed unless other non-opioid pain relievers were unsuccessful. This combination provides pain relief more effectively than either tramadol or acetaminophen would by themselves. However, it should not be prescribed for long periods because tramadol is considered a narcotic and has a high risk of addiction when abused or misused. Acetaminophen, on the other hand, is not habit-forming but long-term use may lead to other negative side effects like liver damage. 

How To Properly Use This Pain Medication

This acetaminophen combination tablet should only be used as instructed and prescribed by a medical professional. You should not take a higher dose than prescribed, take it more frequently than prescribed, or take it for a longer period than prescribed. Taking too much of this medication can lead to an overdose or liver damage if taken for excessive periods. 

It is very important to follow the instruction of a healthcare professional to prevent and avoid addiction, abuse, and misuse of the acetaminophen/tramadol combination. If you ever have questions about the proper use of this medication, you should contact your treating physician or refer to the Medication Guide that should have come with the medication when you picked it up from the pharmacy. 

The physical form of this medication should not be changed or altered in any way. It typically comes in pill or tablet form and should be ingested this way. Breaking, crushing, or chewing can result in your body receiving the entire dose of medicine at once, potentially causing an overdose.  

You should not take tramadol and acetaminophen in combination with any other medications that contain acetaminophen. It is not safe to exceed 4,000 milligrams of acetaminophen within 24 hours. Doing so could potentially lead to severe liver problems. For this reason, you must read the labels on any other medication that you are taking. 

This medication should be stored in a closed container at room temperature. You should avoid storing it anywhere that it would be exposed to excessive heat, moisture, or direct light. Do not freeze this medication and always keep it out of reach from children. If you are unsure of how to properly dispose of any unused narcotic you should contact your healthcare provider or pharmacist, they will be able to direct you to the nearest drug take-back location. 

Proper Drug Dosage & Potential Risks Associated With Incorrect Dosing

The prescribed dose of tramadol will be different for every patient, and you should not change it unless instructed to do so by the prescribing healthcare professional. The amount of the medicine that you take depends on several factors including; the strength of the medicine, the number of doses that you take each day, the time in-between doses, and the length of time that you will be on the tramadol. The length of time that you take the medication will depend on your medical diagnosis that is causing your pain & discomfort. 

Tramadol should not be used by anyone under the age of 12 years old. The dosage for children over the age of 12 years will be determined by the prescribing physician. Typically when prescribed to an adult, the average instructions will direct the patient to take two tablets every 4-6 hours as needed for no more than 5 days, being sure not to exceed 8 tablets per day. However, this might change due to your current state of health, as well as your personal medical history and diagnosis; always be sure to review the instructions on your prescription. 

If you think that you may have missed a dose, you must maintain your regular dosing schedule. Taking another dose, or double dosing could lead to an accidental overdose. Because this medicine is used to treat moderate to severe pain, it is unlikely that you will miss a dose. 

If you do take a double dose you should seek medical attention immediately or contact the Poison Control Helpline at 1-800-222-1222. The symptoms of an overdose can include pinpoint pupils, severe drowsiness, and breathing issues such as; slowed breathing, noisy breathing, shallow breathing, or no breathing. An overdose has the potential to be fatal, especially in children or anyone misusing this drug in a way other than prescribed by a medical professional. 

Side Effects of Tramadol

Along with the positive and intended effects of the drug, most opioids also cause some adverse effects as well. Some of the more common side effects may include drowsiness, dizziness, abdominal pain, loss of appetite, nausea, diarrhea, constipation, and sweating. There are also some more rare and more dangerous side effects associated with this combination drug, if you experience any of them it is recommended that you contact your physician immediately. These rare side effects include the following. 

  • Abnormal thinking/depression
  • Changes in vision/blurred vision
  • Clumsiness, unsteadiness, or difficulty controlling muscles/lack of coordination
  • Chest Pain
  • Trembling
  • Cold sweats
  • ringing, buzzing, or other unexplained noise in ears

A Few Things You Should Know… 

Before taking tramadol and acetaminophen, there are a few things that you should be aware of. When starting a new medication like a prescription opioid, you must talk with your doctor and weigh the risks against the benefits to be sure that this is the right treatment option for you. 

Before taking this medication you should notify your physician if you are allergic to acetaminophen or tramadol to avoid any life-threatening allergic reactions, or if you have any of the following conditions: severe asthma or breathing issues, a severe blockage in your stomach or intestines, or if you have taken any MAO inhibitor in the last 14 days. MAO inhibitors include drugs such as isocarboxazid, linezolid, phenelzine, rasagiline, and selegiline. 

You should always keep all of your treating physicians up to date with any medications that you are taking to avoid possible drug interactions. However, it is especially important if you happen to be taking any of the medications listed below. Combining tramadol and acetaminophen with any of the following drugs is not recommended. 

  • Iproniazid
  • Isocarboxazid
  • Furazolidone
  • Linezolid
  • Methylene Blue

Some other less severe interactions may occur when taken in combination with certain types of foods or other substances. In particular, you should use caution when taking this tramadol and acetaminophen in combination with ethanol, grapefruit juice, or tobacco. And as always, taking any medication in combination with alcohol is not recommended. 

Frequently Asked Questions

Can you take tramadol and acetaminophen together?
Tramadol and acetaminophen combination is prescribed to relieve acute pain severe enough to require an opioid treatment or when other non-opioid pain medicines were not effective or could not be tolerated. When used together, they provide better pain relief than either medicine used alone.
What is tramadol with acetaminophen called?
The combination of tramadol and acetaminophen is more commonly referred to or known as Ultracet.
Is tramadol an anti-inflammatory?
Tramadol has been shown to relieve pain in most inflammatory conditions, by inhibiting the development of experimental inflammation, and reducing prostaglandin E2 (PGE2)concentrations in the inflammatory exudate.

Additional Information

Gabapentin and Tramadol: Effects & Safety Concerns

Using Prescription Opioids for Chronic Pain: Risks & Effects

Tramadol vs. Percocet: Differences, Risks and Treatment

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Dr. Andre Waismann

Dr. Waismann identified the biological roots of opioid dependency, Since then he has successfully treated more than 25,000 patients worldwide that are struggling with opioid addiction.


Throughout his career, he has lectured and educated health professionals in dozens of countries around the world to this day.

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