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Drug Interactions With Tramadol/Acetaminophen

Other Narcotics or Opiates
Use extreme caution when combining tramadol/acetaminophen with narcotics or opiates, as serious side effects could occur. You should only use these medications together with your healthcare provider's approval and supervision.
 
Other Products With Acetaminophen
When taking tramadol/acetaminophen, you should limit your total daily dose of acetaminophen (from all sources combined) to no more than 4 grams (4000 mg) per day. The acetaminophen content of tramadol/acetaminophen is 325 mg per tablet. Taking too much acetaminophen could lead to serious liver damage or even death.
 
Watch for any other sources of acetaminophen, including other prescription pain relievers and many over-the-counter products, such as Tylenol. To be safe, all other acetaminophen products should be avoided while you are taking tramadol/acetaminophen, unless you are extremely careful to limit your total acetaminophen use to 4 grams per day.
 
Sibutramine (Meridia)
Taking tramadol/acetaminophen with sibutramine can cause seizures or a group of dangerous symptoms called serotonin syndrome. Talk to your healthcare provider before taking these medications together.
 
Sleep Medications
Tramadol/acetaminophen can cause significant drowsiness, and combining it with a sleep medication could lead to dangerous effects. In general, tramadol/acetaminophen should not be used in combination with sleep medications, unless your healthcare provider specifically recommends that you do so.
 
SSRI or SNRI Antidepressants
Taking tramadol/acetaminophen with an SSRI or SNRI antidepressant can cause seizures or a group of dangerous symptoms called serotonin syndrome. Talk to your healthcare provider before taking these medications together.
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