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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.

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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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27 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.

5:02 pm April 23rd, 2015

Started taking 400mg tramadol 15 april took my last dose midday 23 april will it be okay to drink alcohol on 24 april at 6-30pm

6:22 am May 3rd, 2015

Hello, I just had a single glass of wine (mixed with ice cubes and fruit punch) and my arthritis started bothering me. I generally take 100mg, but was wondering -very hopefully- if it would be acceptable to take 50mg instead.

12:51 am May 16th, 2015

Hi. I have had 2 points of meth and two hours after I consumed two 50mg Tramadol capsules plus two 50 mg Tramadol SR (Slow Release) also marijuana. So 200mg all up. Are there any documented opinions out there as to whether this gets you high??

3:47 pm May 17th, 2015

Is it safe to take TRAMADOL HCL 50mg TAB MYLAN after having one glass of wine four hours prior?

2:30 pm May 22nd, 2015

Hi Ralph. You shouldn’t be taking any tramadol when you have had a drink. The medication may not be that strong, but different organisms react differently. Mixing painkillers and alcohol is not a wise idea.

6:02 pm June 15th, 2015

Hello, I was in severe pain this weekend and was already drinking quite heavily. I took a few tramadol to try and rid my pain. I was fine until a couple hours later when I blacked out and had no recollection of anything for about an 8 hour span. It’s now two days later and I still am unable to keep food down, and I have the shakes pretty badly. I now know how stupid my actions were, but obviously Cannot take them back. Any advice on how to feel better?

5:16 pm June 18th, 2015

Hi Gabby. I’d suggest you seek doctor’s help since you are facing great chances for dehydration after not being able to keep anything down for a few days. Ask your doctor and/or pharmacist to recommend medications or herbal remedies that can calm your upset stomach.

9:59 pm August 9th, 2015

after taking 50g of tramadol i had 3 glasses of wine miced with lemonade,,afterwards i was freezing cold and i couldnt get warm, through the night i was up 4 times for a drink as i had a very dry tongue and this morning when i woke up i was sweating anf had a severe headache,n i was sent home from work due to feeling ill,,,is this down to the alcohol or have i picked up a bug????

2:40 pm October 1st, 2015

If mistaken taken alcohol n taramadol together .. What will I do? And if more than a week and 2weeks nothing happen to me .. Do I need to be still worry? If mistaken taken Alcohol n taramadol together .. Did cause damages already or do I need to see doctor for it?

1:12 pm October 4th, 2015

Am taking tramadol tablets. Can a I a few bottle of alcohol for today only.

4:38 pm October 9th, 2015

Hi Ben. If I understood you correctly, you accidentally mixed tramadol and alcohol more than 2 weeks ago? If you are feeling no side effects or problems, you are OK. Just be careful not to take different substances together again.

9:06 pm October 11th, 2015

my partner is 44, has been on DELUXOTEEN and TREMADOL for back pain and depression, she also drink a lot every day, I don’t know how to help her, if its at all possible. She is such a nice person but needs to know what she is doing will kill her

9:40 pm October 21st, 2015

My husband is 53 years old has dual additictions main one alcohol he has been in two rehab in two years he was in the last stage of alcohol meaning if he would of not got help they only give him a year to two months to live so he went into this last rehab this time last year this rehab seam to work he almost made it 9 months then a Dr prescribe him ultram I have smelled alcohol on him a few times my question is could the ultram have woke up the side of the brain that craved the alcohol and if he hadn’t taken the ultram would he have not drank what are the possiblety of that

4:22 pm November 4th, 2015

Hi Steve. You are right, mixing those medications with larger amounts of alcohol is causing harm slowly but surely. You can try to talk to her and tell her you will support her to stop drinking while taking the prescribed meds. Also, counseling and psychotherapy sessions may help get to the bottom of what it is that is causing her to drink every day.

7:10 pm November 9th, 2015

Hi Cindy. Ultram use does not cause people to crave or go back to drinking. I do not agree with the doctors prescribing him medications while he should be sober and completely substance-free. See if you can talk with him about this and suggest he gets some support group or psychotherapy help before he goes back to drinking regularly again.

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