Is it Safe To Take Tramadol And Ibuprofen The Same Day?

In our latest question and answer, the pharmacist discusses the use of tramadol and ibuprofen together.

Mar 31, 2019

Klauy asked

I was just wondering if I can take 600 mg ibuprofen and tramadol 50 mg in one day for pain.

At a glance

  • Tramadol and ibuprofen can safely be taken the same day as there is no known drug interaction between them. Be sure to only use them as directed by your doctor however.


Tramadol Ibuprofen Title Card

Yes, for most individuals, it is safe to take tramadol and ibuprofen the same day. There is no known interaction between the two medications.[1]

While they are both used for pain, they are in different medication classes.

Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug) while tramadol is an opioid agonist (and also has a weak effect on norepinephrine and serotonin).

Since they have different mechanisms of action, they can have synergistic effects and some studies have even used both (or similar drugs) in combination for the treatment of moderate to severe pain/inflammation.[2]

One common method for using tramadol and ibuprofen together is to use ibuprofen for mild pain/inflammation and reserve tramadol for any breakthrough pain symptoms.[3]

Tramadol may provide more effective pain relief for some individuals but is generally reserved for use since it is an opioid (like codeine), a controlled substance and has a risk of dependence and abuse.

Side Effect Concerns

Using both together shouldn't significantly increase your risk of side effects but they are both known to cause gastrointestinal problems, including:

  • Nausea
  • Diarrhea
  • Constipation
  • Abdominal pain
  • Stomach cramping

Since tramadol can affect serotonin, there was some concern that it could thin the blood, especially when used in combination with other drugs that thin the blood (like ibuprofen). Most studies, however, report that tramadol is not associated with an increased risk of bleeding.[4]

Lastly, it is important to note that tramadol is not known to have anti-inflammatory properties so if what you are treating involves inflammation, ibuprofen will likely be more effective in reducing it.[5]

  1. ^ Elsevier ClinicalKey Drug-Drug Interactions. ClinicalKey (Subscription Required)
  2. ^ Pain Treatment in Arthritis-Related Pain: Beyond NSAIDs PubMed
  3. ^ Tramadol Prescribing Information
  4. ^ Risk of upper gastrointestinal bleeding associated with non-aspirin cardiovascular drugs, analgesics and nonsteroidal anti-inflammatory drugs. PubMed
  5. ^ Low-Dose Tramadol and Non-Steroidal Anti-Inflammatory Drug Combination Therapy Prevents the Transition to Chronic Low Back Pain. PubMed

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