Mixing Tramadol with alcohol

Effects of mixing Tramadol and alcohol include drowsiness and relaxation. But mixing Tramadol and alcohol can calso cause shallow breathing and slowed heart rate. Or you can die from Tramadol overdose. More here on harms and warnings for mixing Tramadol with alcohol.

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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.


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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
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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