NutriStack
Alcohol and Tramadol, contraindicated.
Alcohol can add to tramadol's opioid sedation and respiratory depression while also worsening judgment and coordination. Tramadol also lowers the seizure threshold, and alcohol intoxication or withdrawal can make seizure risk more concerning. The combination can result in overdose, falls, accidents, coma, or death.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Pair type
- Contraindicated
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −25 to your Stack Score (per scored contraindication row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Contraindicated · Moderate evidence
Contraindicated
What is happening. Alcohol can add to tramadol's opioid sedation and respiratory depression while also worsening judgment and coordination. Tramadol also lowers the seizure threshold, and alcohol intoxication or withdrawal can make seizure risk more concerning. The combination can result in overdose, falls, accidents, coma, or death.
Mechanism. Tramadol produces mu-opioid agonism and inhibits serotonin and norepinephrine reuptake. Alcohol adds central nervous system depression and impaired arousal, increasing sedation and respiratory risk; both substances can also contribute to impaired seizure control in susceptible people.
Recommendation. Do not drink alcohol while taking tramadol. Avoid extra doses if alcohol was used, and do not combine tramadol with sleep aids or other sedatives. Seek emergency care for slow breathing, fainting, seizure, or inability to wake.
Sources (2)
- Jones CM, Paulozzi LJ, Mack KA; Centers for Disease Control and Prevention. Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths - United States, 2010. MMWR Morb Mortal Wkly Rep. 2014;63(40):881-885. PMID 25299603
- Beakley BD, Kaye AM, Kaye AD. Tramadol, Pharmacology, Side Effects, and Serotonin Syndrome: A Review. Pain Physician. 2015;18(4):395-400. PMID 26218943
Stack Score
How this pair moves the number.
Effect on the composite score
If both Alcohol and Tramadol are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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