Sunday March 29th 2015

Mixing Tramadol with alcohol

Mixing Tramadol with alcohol

Thinking about mixing Tramadol with alcohol? Know what can happen.

How much Tramadol can you take at once? It depends on your opioid or opiate tolerance, but doctors start opioid naive patients on 25 mg no more than 4 times a day (100 mg total per day).  But the main danger of mixing Tramadol (an opioid medication) with alcohol is their unpredictable depressant effects. Learn what happens in your body when you mix Tramadol with alcohol and what can go wrong. Plus, we invite you to ask questions about mixing Tramadol and alcohol in the comments, at the end.

Tramadol and alcohol effects

Tramadol is a pain relieving medication that can also cause feelings of euphoria and sedation. Some people like to enhance these euphoric effects (the feeling of getting high) by mixing Tramadol with alcohol. From self-reported experiences people have reported some of these Tramadol and alcohol effects:

  • drowsiness
  • euphoria
  • hallucinations
  • numbness
  • relaxation

Is Tramadol addictive? Yes.   But this isn’t the main danger of drinking while on Tramadol.  While alcohol can intensify the euphoric effects of Tramadol, users have also reported negative and frightening side effects as well. Tramadol chemically reacts with alcohol, having an additive effect in the body and brain when combined. That means that the central nervous system depressant effects of the alcohol and Tramadol are intensified when taken together. But slowing down the central nervous system is dangerous and can cause a potential overdose.

Dangers of mixing Tramadol and alcohol

When alcohol is taken with Tramadol it can cause dangerous side effects to occur. This is mainly because mixing alcohol and Tramadol can intensify the depressant effects of both alcohol and Tramadol on the central nervous system. Some potentially dangerous effects of mixing Tramadol with alcohol include:

  • dizziness
  • drowsiness
  • impaired coordination
  • loss of consciousness
  • nausea
  • overdose
  • shallow breathing
  • slowed heart rate
  • vomiting

Note here that this additive effect goes both ways – the Tramadol you’re taking also enhances the effects of the alcohol itself. Alcohol makes you sleepy, drowsy, and lightheaded. This is why drinking and using Tramadol can cause trouble concentrating, difficulty with coordination, and a slowed reaction time, all of which can cause accidents. Tramadol also heightens the intoxication you experience from alcohol, which can be potentially deadly or at least increase your risk of alcohol poisoning. In fact, you won’t be able to tolerate the same amount of alcohol you normally drink safely while simultaneously taking Tramadol.

Tramadol and alcohol overdose

It’s probably a good idea to avoid taking Tramadol and alcohol together on the same day. Why? Your risk of overdose on Tramadol directly increases when combined with alcohol. The effects of both drugs are much stronger together than they are separately. This is the reason why doctors recommend never mixing Tramadol and alcohol.  And although Tramadol overdose amount depends on your exposure to opiates, doctors start opiate naive people on doses of 25 mg of Tramadol no more than 4 times daily.

Tramadol and alcohol deaths

Alcohol is one of the most common substances people abuse in combination with Tramadol, and it can cause death. Even normal doses of Tramadol combined with alcohol can cause breathing problems or other serious issues. And if you abuse Tramadol (chew/crush Tramadol, snort Tramadol, inject Tramadol, etc.) or take more than a normal prescription dose, you might overdose. The only way to avoid these risks is to decide not to drink at all while on Tramadol.

Is it safe to drink on Tramadol?

No. The FDA warns against mixing the two at all. Mixing Tramadol and alcohol enhances the most dangerous effects of both drugs. If you’re not sure how far apart to space a prescribed dose of Tramadol and a drink, ask your doctor for more information on taking Tramadol and drinking safely.

Mixing Tramadol alcohol questions

Do you still have questions about mixing Tramadol with alcohol or other substances? Do you want more information on avoiding problems while drinking and taking prescription drugs? Please leave us your Tramadol use questions here. We try our best to answer all legitimate questions personally, and promptly. And if we don’t know the answer, we will refer you to someone who can help. Your experiences with mixing Tramadol and alcohol are also welcome.

Reference Sources: NIAAA pamphlet: Harmful Interactions, Mixing Alcohol with Medicines
DailyMed: Ultracet (tramadol hydrochloride and acetaminophen)
PubMed Health: Tramadol

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12 Responses to “Mixing Tramadol with alcohol
n. graytock
1:34 am October 14th, 2013

How soon after having a drink (alcohol) can you take 50 mg. of Tramadol?

7:36 am October 14th, 2013

Hello N. Graytock. Thanks for your question. While it’s best to consult with a pharmacist for clearance and authorization for drinking and using tramadol, it seems to me (a layman’s researcher) that as long as the drink is metabolized (best to wait for 2 hours after alcohol consumption per unit of alcohol), the alcohol would be out of your system, making it a non-issue for taking tramadol. The problem usually occurs when people want to drink after taking tramadol…and then it’s best to wait at least the 4-6 hours until tramadol effects wear off…or longer, given the extended half life of the opioid.

7:19 am January 2nd, 2014


2:47 pm September 12th, 2014

A family member has been taking Tramadol for a few years now to help her with severe pain in her back. While she’s been taking this drug she also drinks a fair amount of alcohol in the evenings. She recently has started to shake which is getting worse all the time. She also has lapses in memory and short blackouts where she doesn’t know where she is. She’s having problems with walking and even writing. She went in for a Cat Scan and an MRI which didn’t show signs of serious issues and we’re wondering if these effects may be caused by her use of Tramadol and perhaps mixing it with a few drinks from time to time.
Any feedback you could provide would be greatly appreciated.
Thank you,

9:02 am September 17th, 2014

Hi Regis. As you already know, taking Tramadol and drinking alcohol is not recommended. Most people experience the side effects you described, as a result of taking tramadol in conjunction with alcohol.

2:10 am September 20th, 2014

Will it hurt me to take one 50MG Tramadol and have one scotch and soda two or three hours later?

11:34 pm February 1st, 2015

I take 50mg Tramadol twice daily. is it ok to have 3 or 4 beers, if you skip your Tramadol altogether that day?

4:58 pm February 26th, 2015

Can mixing antidepressants alcohol and taking more than ur prescribed dosage of tramadol make you violent. Can you mix codeine with tramadol

1:07 pm March 2nd, 2015

Hi Terry. Different people react differently under the influence of alcohol and drugs, especially when they are mixed together. Actually, mixing any prescription medication with alcohol is not recommended, but can also be dangerous.

8:02 pm March 6th, 2015

I drink wine and beer. One or the other. I do not drink until the evening. I take Tramadol 200 mg once a day. Is this dangerous?

1:43 am March 12th, 2015

Hello Dianna. It’s risky behavior mixing alcohol and tramadol and can be potentially dangerous. Doctors don’t recommend drinking alcohol for at least 10 hours after digesting any medication.

Dr Feel Goode
4:50 pm March 17th, 2015

I must have a constitution like an ox. I’ve had very unpleasant neck pain from musculo-ligamentous strain over the past week and took 200mg of tramadol tonight (kindly and unwittingly offered by a friend who suffers from chronic back pain). I then drank at least 7 glasses of wine and I’m writing about it right now. The tramadol did bugger-all for my neck pain and I feel exactly the way one would expect to feel after 7 glasses of wine. Mildly pissed. I often suspect the potential repercussions of mixing drugs with alcohol are grossly overstated to stop idiots from abusing them. However, the medical advice should clearly be adhered to, unless of course you have the constitution of an ox. Goodnight. I’m confident I will wake up in the morning and function as I normally do.

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