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Can I take Pregabalin and Tramadol together?

Drug interaction guide

Taking pregabalin and tramadol together can significantly increase the risk of serious side effects. Both medications slow down the central nervous system, which can lead to extreme sleepiness, dizziness, and confusion. Most importantly, this combination can cause dangerous breathing problems (respiratory depression) where your breathing becomes too shallow or slow, which can be life-threatening. There is also an increased risk of having a seizure or feeling very uncoordinated.

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Why this happens

Both drugs work by depressing the central nervous system (CNS), but in different ways. Tramadol is an opioid-like painkiller, and pregabalin is an anti-convulsant used for nerve pain. When used together, their sedative effects add up (an additive effect), making the impact on your brain and breathing much stronger than if you took either drug alone.

What you should do

You should only take these two medicines together if they have been specifically prescribed by your doctor with full knowledge of your current medications. If you are prescribed both, your doctor should start you on the lowest possible doses and monitor you closely. Seek immediate medical help if you experience extreme sleepiness, difficulty waking up, or slow, shallow breathing. Avoid driving or operating machinery until you know how this combination affects you.

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Important precautions

Respiratory depression and CNS depression

Taking these medicines together significantly increases the risk of dangerous breathing difficulties, severe drowsiness, and coma. Avoid alcohol and other sedatives while taking this combination.

Seizure disorders (Epilepsy)

This medicine can trigger seizures or fits, even in patients without a history of epilepsy. The risk is higher if you take certain antidepressants or have a known seizure disorder.

Pregnancy

Pregnancy must be avoided. Use of this medicine during the first trimester is linked to an increased risk of major birth defects in the baby. Effective contraception must be used during treatment.

Food and drink warnings

Alcohol

You must avoid drinking alcohol while taking these medicines. Both tramadol and pregabalin cause drowsiness and dizziness; alcohol significantly increases these effects. Combining alcohol with these medications can also lead to dangerous breathing problems (respiratory depression) and severe impairment of coordination.

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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.

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Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 24 Jan 2026 | Originally published
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