Can I take Naproxen and Tramadol together?

You can take naproxen and tramadol together if both have been prescribed by your doctor, but use the lowest dose for the shortest time, as taking them together can increase the risk of serious side effects, especially to your stomach and kidneys.

If you have a history of epilepsy, kidney problems, or stomach ulcers, talk to your pharmacist or doctor before combining them.

Always take them with food to protect your stomach.

Why this happens

Naproxen is an anti-inflammatory (NSAID) and tramadol is an opioid-like painkiller. Both can irritate the stomach lining, increasing the risk of ulcers or bleeding.

Both drugs also affect how the kidneys filter blood. Additionally, tramadol can lower the 'seizure threshold' (making a fit more likely), and while naproxen doesn't directly cause this, the combination of pain and multiple medications can increase overall physical stress.

How to know if you're having a drug interaction

You may be experiencing an interaction between naproxen and tramadol if you have:

• Severe stomach pain.

• Black or bloody poo (stools).

• Swelling in the legs.

• Severe drowsiness or confusion.

• Difficulty breathing.

• Are vomiting blood.

• Are peeing (urinating) less.

Seek medical attention urgently (ring 999 or go to A&E) if these symptoms occur.

How to take naproxen and tramadol safely

• Only take both if prescribed or recommended by your doctor.

• Use the lowest effective dose for the shortest possible time.

• Take naproxen with food to reduce stomach irritation.

• Avoid alcohol, as it can increase drowsiness and stomach bleeding risk.

• Do not take other anti-inflammatory painkillers (such as ibuprofen) at the same time unless advised.

Important precautions

Asthma and breathing difficulties

Do not take naproxen if you have asthma that is sensitive to aspirin or other NSAIDs, as it can trigger a life-threatening asthma attack or severe breathing difficulties.

Tramadol can cause dangerous breathing difficulties, especially if you have existing lung conditions or asthma. Seek immediate medical help if you experience slow or shallow breathing.

Stomach ulcers or bleeding

Naproxen can cause serious stomach ulcers and internal bleeding. This risk is higher if you have had ulcers before, are over 65, or take other blood-thinning medicines. Stop taking it and see a doctor immediately if you have black, tarry stools or vomit blood.

Serotonin syndrome

Tramadol increases serotonin levels. Taking it alongside other serotonergic medicines (such as SSRI or SNRI antidepressants) can cause serotonin syndrome, a potentially life-threatening condition involving confusion, sweating, and muscle rigidity.

Epilepsy or history of seizures

Tramadol can increase the risk of having a fit (seizure), even at normal doses. This risk is higher if you have a history of epilepsy or are taking other medicines that lower the seizure threshold.

Pregnancy (third trimester)

Do not take naproxen if you are more than 20 weeks pregnant. It can cause serious kidney or heart problems in the unborn baby and may lead to complications during delivery.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Combining alcohol with naproxen increases the risk of stomach irritation and bleeding. Combining alcohol with tramadol significantly increases the risk of dangerous side effects, such as extreme sleepiness, breathing difficulties, and loss of consciousness. Both medicines, when combined with alcohol, increase the risk of liver damage.

Food (General)

You should take naproxen with or just after a meal or a snack. This helps to protect your stomach lining and reduces the risk of indigestion or stomach pain.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.