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Can you take tramadol and hydrocodone together and what is the effect?

20 Answers

Official Answer Medically reviewed by Drugs.com. Last updated on Sep 8, 2020.

Tramadol and hydrocodone are two types of potent pain relievers. They are used to treat moderate to severe pain.
They should not be taken together unless recommended by your doctor.
Caution is required as the combination can lead to serious side effects including seizures, respiratory distress, coma, and even death.

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Votes: +1
Inactive 14 May 2010

Since tramadol is not really an opioid and it's not as powerful or strong as hydrocodone I should say so yes why not other people have taken worse with the hydrocodone.

Votes: +5
queenbee2cj 19 Oct 2017

Bad advice... unless you have a Dr tell g you to take them at the same time and knows your med history... people with heart conditions can die from combining these 2 drug in the wrong doses..

timm25 1 Mar 2018

Many people are prescribed tramadol and hydrocodone..But you should first check with your doctor..

belinda_pitcock12 29 Aug 2011

is tramadol and hydrocodone the same

Votes: +0
JulzieBaby10 12 Apr 2012

they are not the same. they work the smae in your body, however, to get rid of moderate to severe pain. Both working with your central nervous system. tramadol is a non narcotic pain reliever and hydrocodone is a narcotic pain reliever. they both can be very addicting so use with caution.

creatineforever 24 Oct 2012

Negative, ghostrider! They are not the same. Hydrcodone is a true opiate based from opium,semisynthetic,aka dihydrocodeinone.it is a scheduled controlled substance.
Ultram,besides being garbage,is now called an opiod becauuse it acts on opiate receptors inthe brain,like hydro, butis totally fake.its not a controlled substance, but the literature flaunts it as"not to be snifed or injected". If it was so bad theyd schedule it.ITS A MARKETING GIMMICK for scary candyacs doctors that are shaking in their boots about prescribing opiates to people that hurt.and every opiate in USA is controlled.except ultram. I started out in florida in a car wreck,then given oxy and hydrocodone,etc,then progressed to 6-8mg of Dilaudid,morphine,etc and still functioning. At no point was ultram an option.theytried me once and i threw it away. GARBAGE.seizures are a possibility.worse side effects than any opiate.understand i rate "feel good"with kills pain.but ultram feels BAD and kills pain.its garbage bs scam.

Larrybaty66 6 Mar 2013

Tramadol is now Scheduled as a class 2. I have been taking it for two years and without it I can't walk. It replaced the fentanyl patches for me.

ceeagee 19 Jun 2013

and tramadol works just fine unless you are just looking for a high.

hillallen 31 Jan 2014

Well, it certainly is a controlled substance here in Canada.

Reneboston 10 Sep 2016

About 2 years ago, even though Tramadol is not a true opioid, they chose to put it in the category of a controlled, countable substance. As an RN, myself and others are outraged, as this is being prescribed more and more... with little effect... and people in moderate to severe pain are stuck with this product.
Pharmacies need to now label them as such, and nurses have to keep them on strict count, as with other controlled countable substances.
Sad but true.

Reneboston 10 Sep 2016

Ultra has been re-scheduled as a controlled, countable substance for well over 3 years now, and is treated as such... RN

suesinger71 17 Oct 2016

You are looking for a high. I have been taking tramadol for my neck and it work well. So to tell people its garbage probably because you want the high not to help with the pain. Just my opinion.

suesinger71 30 Oct 2016

You know creativrpaste. Maybe tramadol is crap to you probably because u can't get high off it. But to throw that out there like that is totally untrue. Get your facts straight before you put s### out there. Not everyone is looking for that high which is what you are probably looking for. Just my opinion. Peace

wings1969 12 Dec 2016

Sorry to skin your teeth but IT IS A CONTROLLED SUBSTANCE because I have to sign for it when I take it for my back pain! So that is where YOU are wrong! I don't care how much you think you know - get your facts right!

queenbee2cj 19 Oct 2017

Creatineforever... great answer...

JulzieBaby10 12 Apr 2012

in smaller doses tramadol and hydrocodone should be alright to take together. tramadol is a non narcotic pain reliever while hydrocodone is a narcotic. Both used to treat moderate to severe pain. Both these medications have the same response to your body. they both work with your central nervous system to get rid of pain. However, taking any SSRI's with tramadol i strongly do not recommend. tramadol is classified as an SSRI, i believe, and taking any SSRI's with tramadol could result in a serotonin over dose and you could develope serotonin syndrome which could be life threatening. remember these are just my opinions. so if you want a more accurate response i would suggest to call your local pharmacist or contact your primary health care provider. ive been on many medications so my response is from my personal experience and the initial knowledge i have on these two drugs. i hope it helps!!

Votes: +4
hillallen 31 Jan 2014

I have taken wellbutrin and celexa for many years, and have also on occasion taken tramadol at the same time with no adverse effects. My doctor and my pharmacist have never advised otherwise... they HAVE, however, indicated that the properties of tramadol are such that they should NEVER be taken with any other opiod at the same time or within a 24 hour period. I did it once and, like I'd been warned by my doctor, I went into narcotic withdrawal and it was absolutely awful. I can only relate my own experiences, but please check with a trusted physician or better, a psycho-pharmacologist.

Reneboston 10 Sep 2016

Tramadol has been re- classified as a controlled countable substance for well over 3 ys. It is counted with all controlled substances, and must be labeled as such by pharmacies... Although sadly, it not REALLY a narcotic, and is not a very good reliever of pain... RN

AnneCCRN 3 Jan 2017

Contacting your pharmacist or PCP is always the best advice.

Badboy69 29 Jun 2018

NO pain meds work WITH your Central Nervous System they just increase CNS depression which CAN cause breathing problems with all you lightweights. Opiates work on your opioid receptors in your brain which in turn CAN but not always cause CNS depression.
And NO tramadol is not an SSRI.
"Selective Serotonin Reuptake Inhibitor"
A selective serotonin reuptake inhibitor (SSRI) is one of the commonly prescribed drugs for treating depression. SSRIs affect the chemicals that nerves in the brain use to send messages to one another.
Anti-depressants are NEVER prescribed for pain although sometimes written for depression caused by pain.
I know everyone will read this so...
Why do so many people post like they know what they are talking about but cannot spell, type or even punctuate.
All of these errors make EVERYONE who does so look like they haven't even made it through middle school! DO you people not even care what you post?

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Obviously Not!
So why even post? Just to make you sound smart? It does not work. I am sorry but all the posters on Facebook and all over the web do this. But remember everything you type on the web is there forever. So if you want to keep looking like you have the IQ of a turnip forever and ever keep posting like you have the IQ of a turnip!
Big fat Lol!
And by the way while I am at it my IQ is 164... Which I am told is genius level.
Not to brag... just making a statement.
So I will not list all my degrees and licenses but I will say I NEVER...
EVER... post anything PERIOD unless I know 100% exactly what I am talking about!
Being a chronic pain patient opioid user for over 45yrs I have not yet spoken to anyone other than chemists that know more than me about controlled substances.
You also cannot believe everything a Dr.
Tells you either. I had one tell me 10yrs ago that my opioid receptors were so fried from all my heroin use (self medicating for pain) that no amount of any opioid pain meds will ever even touch my pain. WRONG! After kicking 4yrs ago and kicking 160mg of methadone a day, 2 norco 10/325 every 6hrs works... although sometimes 2 tramadol 50mg are needed also but I have to take with food or my stomach hurts for 24hrs too. I still have a very high tolerance for opiates though. Actually a lot of drugs. I had Emergency gallbladder removal surgery 2 weeks ago and got 4mg IV morphine and 2mg IV Ativan every 4 hours for 6 days and never slept a wink. All I did was watch tv and the clock to see when 4hrs was up so I could call my nurse and get my meds. NO! I never got high or felt any different other than no pain. My drug tolerance is so high my anesthesiologist said it took 2 vials of propofol (drug that killed Michael Jackson) to knock me out for an hour. That is insane! It was general surgery not the robotics. I read the surgical report in extreme detail of every surgical tool and how they inflated my stomach. I thought I would have a 1 to 2 inch incision but ended up with 9! I even had brain surgery when my skull was busted wide open with a pool of blood around my head. I came out of that babbling nonsense for a bit then came back 100%. The Dr's were so amazed and told me they had NEVER seen anyone come back 100% from that type of surgery. I had tubes drilled into my skull to drain out all the blood clots. Whomever posted they switched from fentanyl (fen-ten-ill NOT fen-ten-all) to ultram is crazy. Go from the strongest pain med to the weakest and it works better? Jeez Oh Peets!
I want some of what he is smoking!
No my medical marijuana works just fine and helps as a pain med booster. It will help all of you in pain. My neighbor turned me on to it he had for cancer and it worked well for him. But he had 10/325 Norco's too. 2 every 4 hrs. Then he passed away 6 weeks later. What a bummer!
So I know everyone who reads this will learn something. So I have done my job once again today.

adamscat 24 Apr 2014

NO!!! A couple of hours ago, I took a tramadol (50 mg.). Less than an hour later, I popped a hydrocodone (5/325) because the tramadol wasn't helping much. "Hydro" by itself usually makes me feel really, really good (almost too good), and tramadol by itself usually puts me in a good mood. But now I feel like crap. My chest feels heavy, I have a headache, my mouth is dry, I'm dizzy, and my legs hurt. I don't know what is going on, but it isn't good. Curiously, I also feel very alert. I just checked the web for interactions between the two drugs (I know, I should have done that first!), and the best info I found indicates that the two should not be taken together. I wanted to go to bed, but now I'm going to be up until these effects start wearing off. Whatever is the opposite of synergy is what these two give you. My stomach hurts too. Ug. I feel awful. Lesson learned.

Votes: +2
TattedTammii20 12 Aug 2016

I am a Type 1 Diabetic and has chronic neck and back pain plus neuropathy and excessive foot pain and im 20 years old! Sad, unfortunately, but i just took a hydro and 2 tramadol making the tramadol 100mg (50mg=1), all at the same time! Makes my stomach hurt but makes me lightheaded like a drowsy, high feeling! Crazy thing is,it always helps my feet but still not for my back or neck, hate it!! But totally had to comment on this because it sounds just like my situation lol!

Steve Thompson 19 Oct 2016

Been taking tram (100mg) for 4-5 years for my neuro pain. Works great. NO probs. Just had cervical diskectomy and fusion on c4-5 and c6-7. Prescribed norco 10-325 for the surgical pain. I think you guys are getting bad reactions because you need to eat more and drink more water. Had 2 thumb surgeries in 2014 back to back. Took a couple months but I ended up in the ER because I didn't eat enough or drink enough water. Lots of coffee tho. Developed a peptic ulcer and a case of extreme gastritis. Please eat and drink to metabolize pain unless you r taking them to get high. If that's the case you r the bad apple who spoils it for the rest of us.

Steve Thompson 19 Oct 2016

Me again. The ER Issues were from Percocet. Just be careful

mooki 29 Dec 2016

i was reading your post and i was curious if you are still alive?

chawk928 8 Nov 2017

This was the best answer. I am currently in a lot of pain with an erupted cyst in my bladder due to a disease called Interstitial Cystitis and I took Hydro earlier with not much relief. .was thinking about taking both. .but have now reconsidered. Thanks!

Badboy69 29 Jun 2018

You have to take tramadol with food so you DON'T feel like crap and have stomach pain.

Klparkid 5 May 2014

OMG don't do it. I made the mistake of taking a 100mg tramadol and a 7.5/325 hydrocodone about an hour later yesterday (I had a headache that would not subside) and I have NEVER been sicker in my life. Cold sweats, an intense headache, vomiting, nausea, dizziness; I almost felt drunk or on some type of heavy drug. It was absolutely awful and I will never take either again. Still feel under the weather today... DO NOT TAKE HYDROCODONE WITH TRAMADOL! :) #lessonlearned

Votes: +1
AnneCCRN 3 Jan 2017

That sounds like the drug withdrawal symptoms reported earlier.

EMS85 9 May 2014

No you may not take these two medications together. As a health care professional in a PCP office I deal with medications on a day to day basis. Typically the doctor I work for usually starts a patient out with tramadol for pain before using a narcotic(norco/percocet) it's easier to prescribe and it's scheduled class makes it easier for us to send electronically through our computer system. It is dangerous to mix the 2 medications most pharmacys here would alert the dr office before filling the medications to be sure the patient is to be getting both. If your narcotic medication is not helping with pain we would usually have you add an additional 1000mg of Tylenol to your norco __/325mg every 6 hrs as needed. the recommended max dose for acetaminophen per day is 3000-4000mg for an adult. Or you can rotate ibuprofen 800mg every 6-8 hrs while taking your narcotic pain med as prescribed.

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Another option would be to add a muscle relaxant ie: flexeril, zanaflex, robaxin all are safe to take with tramadol or a hydrocodone medication. Let's face it hydrocodone honestly shouldn't be used as a long term medication eventually like many other things your body just adapts to it and you end up needing more and more to even feel relief! I've been to a pain management conference and learned a few interesting things but really for those of you taking tramadol and a hydrocodone med to see what might happen that's just stupid! And you might end up in the ER and depending on your physician office policy you may not be getting refills on your narcotic pain pills in the future I know my office I work for has a strict no tolerance contract my patients sign.

Votes: +2
Theresem2 5 Nov 2016

As a "health care professional" you should be aware of the rules regarding prescribing medications without a license which is basically what you are doing in your comment, saying to take an additional 1000mg of acetaminophen (Tylenol) is just irresponsible as the lower dose is often the reason Norco may be prescribed as opposed to violin, due to possible liver disease or other processes with the patient.

Theresem2 5 Nov 2016

Vicodin not violin

Djdamro 14 Dec 2016

You must not being a degreed health care professional... You cant spell pharmacies.

townsenderika24 6 Aug 2017

My doctor prescribed both to me and I would take Hydrocodone during the the day then trams at night, they would make me extremely nervous, I'd have to take a Valium. Both taken separately, I'm fine. I'm about to see what taking them together feels like.

A1234b56 17 Oct 2016

Yes if you take them 4 hours apart

Votes: +0
DenAnn1 21 Mar 2017

I have been taking 7.5/500 Hydrocodone and 50 mg tabs of ultram for 20 years. I am prescribed 4 hydrocodone and 8 tramadol a day for pain. I do take them together, 1 hydrocodone and 3 tramadol.

Votes: +1
Jackie green 28 Mar 2018

I have been taking 50 mg tramadol for 5 years I take 2 at a time I recently came down with a severe case of shingles my Dr gave me 7.5/325 Norco for added pain relief I also take lyrica 100 mg I take all 3 meds together an never have a problem and for my shingles believe me it takes all 3 to release the pain ..

Raychul2415 20 Jun 2017

I just got out of the hospital about a week ago. I left with a script for tramadol 50mg and hydro 5/325. They said if I take a tramadol wait at least 2 hours before taking a hydro. They said it can cause an overdose but not like I am gonna die overdose a different kind of overdose. The nurse had a difficult time explaining it to me. I think she was trying to dumb it down for me bc I was still pretty out of it from the iv pain meds.

Votes: +0
fibropatient 19 Oct 2017

I have been taking Vicodin and Ultram together since 2013 for fibromyalgia and other chronic illnesses. Vicodin helps my joint pain but doesn’t touch the constant burning pain in my legs, Ultram helps with this pain. I know there is a danger of seizures but since I didn’t have them, I don’t see the harm. I’ve had pharmacists argue with me that they work the same way but why then doesn’t one address my two types of pain? I went to a new rheumatologist because mine retired and he told me I can’t take two “narcotic” medications at the same time. First, I didn’t think Ultram was a narcotic and second, he offered no alternative?

Votes: +1
rikiwillkillyou 2 Nov 2017

Yes you can! I am prescribed BOTH tramadol and hydrocodone for chronic back pain. Tramadol rocks!!! Whoever says that tramadol doesn't work is either a liar or a damn junkie with a huge tolerance. Hydrocodone and Tramadol together is WAY BETTER than just Hydros for pain! Don't knock it til you try it. PEOPLE HERE ARE GIVING FALSE AND INACCURATE ANSWERS! DO THE RESEARCH YOURSELF. DONT TRUST MORONS ON THE INTERNET!!!

Votes: +1
Christy3112 29 May 2018

Yes I love tramadol! I’ve had legs problems since I was pregnant 8 yrs ago and doc prescribed me tramadol six years ago and it’s the only thing that gets me going with my kids and I do hair stand on my feet all day, I couldn’t do those things if I didn’t have tram Its the one and only thing that works on my legs. I hope one day they can figure out why my legs hurt this bad

Beakshire65 11 Jan 2019

You are the moron for thinking just because you take them at the same time means everyone should. They can cause a bad interaction and you are giving out dangerous advice you fool. And saying do the research yourself is moronic. Ask your doctor, they have done the real research. You don’t know what you’re talking about and this advice could hurt someone or even make them die.

Karen 1966 6 Nov 2017

I had Norco 4 hours ago can I take my tramadol now

Votes: +0
Billy twister57 4 Jan 2018

I need to know

Votes: +0
Pookie Edward 24 Feb 2018

Answer my question

Votes: +0
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