Tramadol, an opioid, should be avoided with alcohol due to an increased risk of side effects, including the risk of a deadly overdose on either substance.

If your doctor has prescribed you tramadol, you may wonder if it is safe to drink while taking the medication. Because tramadol is an opioid, it is important to be cautious when taking it with other central nervous system depressants, including alcohol.

Article at a Glance:

  • Tramadol is an opioid that is frequently prescribed for moderate to severe pain.
  • Mixing tramadol and alcohol can increase the chances of overdosing on either substance.
  • Both substances are central nervous system depressants, which means they can slow down brain function when combined.

Mixing Tramadol and Alcohol

Drinking while taking tramadol can be dangerous. Both substances are central nervous system depressants, so they can interact and lead to increased side effects. These include:

  • Dizziness
  • Drowsiness
  • Confusion
  • Problems concentrating
  • Cognitive impairment 
  • Problems with judgment
  • Coordination difficulties

What Is Tramadol?

Tramadol is a synthetic opioid that is prescribed to treat moderate to severe pain. It was introduced in the U.S. in the mid-90s and became the 25th most-prescribed drug in the United States as of 2018, the most recent year for which data is available. 

Like other opioids, tramadol can be addictive and is a Schedule IV controlled substance. With that in mind, it’s important to take this medication only as directed by a licensed medical professional.

Brand NameUltram, ConZip, Qdolo
Conditions it can treatModerate to severe pain
Drug typeOpioid
Controlled substance statusSchedule IV
Side effectsConstipation, nausea, vomiting, dizziness, vertigo, headache, dry mouth, indigestion
How long it takes to start workingWithin one hour
How long it takes to have its peak effectFast-acting tramadol: Within 2–3 hours
Long-acting tramadol: Within 4–12 hours
Duration of effectFast-acting tramadol: 4–6 hours
Long-acting tramadol: 24 hours

Tramadol and Alcohol Side Effects

Because both tramadol and alcohol are central nervous system depressants, they have a drug interaction that can lead to additive side effects.

What Is the Risk of Drinking While on Tramadol?

The primary risk of drinking while taking tramadol is worsened central nervous system depressant side effects, including excessive sedation and slowed breathing. In severe cases, this can lead to coma and death. For this reason, the FDA has a Black Box Warning about the risks of taking tramadol while using other central nervous system depressants like alcohol.

How Long After Taking Tramadol Can I Drink Alcohol?

If you have taken a dose of tramadol, it is safest to wait until the tramadol is completely out of your system before having a drink. Short-acting tramadol has a half-life of around 6.3 hours, meaning that it takes that long for your body to clear half the drug from your system. Because it generally takes five half-lives to fully remove a drug from your body, a dose of short-acting tramadol should be out of your system within 32 hours. Long-acting tramadol has a half-life of around ten hours, meaning it takes about 50 hours to fully leave your body.

Waiting until tramadol is cleared from your system can help avoid worsened side effects and lower your risk of overdose.

Can You Overdose on Alcohol & Tramadol?

It is possible to overdose on both alcohol and tramadol. Alcohol poisoning alone is responsible for more than 95,000 deaths annually in the United States. Tramadol on its own can also cause an overdose. Unfortunately, tramadol overdose is one of the only opioid overdoses that is not completely reversible by naloxone (Narcan).

Because both agents are central nervous system depressants with additive side effects, the FDA has a Black Box Warning about increased overdose risk if they are combined. For this reason, it is safest to avoid taking tramadol and alcohol together.

If you suspect someone is overdosing on tramadol or alcohol, it is important to seek emergency medical treatment immediately. If you or a loved one is struggling with an addiction to alcohol, opioids or both, help is available. Contact The Recovery Village to discuss treatment options that can address both substances and any co-occurring mental health conditions. The start of a healthier, happier, substance-free life can begin with just one call. 

Melissa Carmona
Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
Jessica Pyhtila
Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

Hallare, Jericho; Gerriets, Valerie. “Half Life.” StatPearls, October 6, 2020. Accessed July 5, 2021. “Tramadol.” August 17, 2020. Accessed July 5, 2021. “Drug Interaction Report.” Accessed July 5, 2021.

Centers for Disease Control and Prevention. “Commonly Used Terms.” January 26, 2021. Accessed July 5, 2021.

ClinCalc. “Tramadol Hydrochloride.” Accessed July 5, 2021.

Pothiawala, Sohil; Ponampalam, R. “Tramadol Overdose: A Case Report.” Proceedings of Singapore Healthcare, 2011. Accessed July 5, 2021.

Centers for Disease Control and Prevention. “Deaths from Excessive Alcohol Use in the U.S.” January, 2021. Accessed July 5, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.