Can You Take Tramadol And Oxycodone Together?

The pharmacist discusses whether or not two opioid medications, tramadol and oxycodone, can be taken together.

Question

Can I take tramadol and oxycodone in the same day?

Asked by Delia On May 31, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jun 04, 2018

White Tablets Out Of BottleTramadol and oxycodone are pain medications known as opioids. Both are generally prescribed for acute pain and are not typically prescribed together. Taking these together can lead to increased sedation, altered mental status, and respiratory distress. Taking tramadol with opioids can also increase the risk of seizures in some patients.


In order to avoid untoward effects like addiction, constipation, and respiratory depression, the lowest dose for the shortest duration is generally recommended when taking opioids such as tramadol and oxycodone. If the pain is mild, nonopioids like acetaminophen and ibuprofen may be a good option instead of taking a dose of tramadol or oxycodone.


In situations where your doctor has prescribed both tramadol and oxycodone to you, they shouldn't be taken at the same time but could be taken the same day, as they are both relatively short acting. You should separate each by at least 6 hours. However, this will not completely eliminate the risk of additive side effects, as discussed below.


Information About Tramadol

Tramadol (Ultram) is a unique type of pain medication that has multiple modes of action. It is similar to other opioids in that it lessens pain by binding to the mu-opiate receptor, but it is not as potent as other opioids. Tramadol also has effects on the neurotransmitters norepinephrine and serotonin.


Tramadol starts working in about 1 hour and takes about 2 hours to reach peak concentration. The maximum dose recommended is 400 mg for the immediate release formulation. The half-life is approximately 6 to 7 hours.


The DEA recently decided to classify tramadol as a Schedule IV controlled substance. This means that it is classified as having less risk of abuse than other opioids. Prior to the DEA’s classification, tramadol was not considered to be a controlled substance. 

 

Information About Oxycodone

Oxycodone (Roxicodone) is a controlled substance pain medication that is available as a single ingredient or as a combination tablet with acetaminophen (Percocet).


Opioids, such as oxycodone, work by binding to the mu-opiate receptor. This works in the central nervous system to decrease perception of pain and the person’s emotional response to pain.


Oxycodone should start working in about 15 minutes and should reach peak effect in about 1 to 2 hours. Overall, oxycodone treats pain for about 3-4 hours. The half-life is about 3 to 5 hours.


The DEA classifies oxycodone as a Schedule II controlled substance. This is the highest risk category that can be prescribed based on abuse potential.

 

Summary

Taking tramadol with oxycodone is generally not recommended because of the duplication of action on the opiate receptors. Taking both together can lead to an increased risk of sedation, altered mental status, and respiratory depression. Due to the elimination half-life for each drug, it would take about 24-36 hours to completely clear tramadol and about 12 to 24 hours to completely clear oxycodone.

About the Pharmacist

Dr. Kevin Davis Pharm.D

Dr. Kevin Davis is a licensed pharmacist with experience in retail and hospital pharmacy. He graduated from the University of Florida with a Doctor of Pharmacy degree in 2015 and a Master of Healthcare Administration degree from Adventist University in 2017. He is also a Board Certified Pharmacotherapy Specialist since 2016.

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