A synthetic opioid analgesic, tramadol is used to treat moderate pain and can be considered a medium-strength opioid. Tramadol also has the unusual effect of being a serotonin releasing agent and a serotonin reuptake inhibitor, and as a consequence should not be taken in excess due to the risk of serotonin syndrome. Risk of seizures above 300mg doses.
⚠️ Tramadol has a ceiling dose, where recreational effects are not increased. Risk of seizure at doses over 300mg. Tramadol decreases the seizure threshold, use extreme caution. Dosing insufflated is ineffective.
These combinations are considered extremely harmful and should always be avoided.
alcohol: Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.
amphetamines: Tramadol and stimulants both increase the risk of seizures.
benzodiazepines: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration is a risk when passed out, lay down in recovery position if ingested.
cocaine: Tramadol and stimulants both increase the risk of seizures.
ghb/gbl: The sedative effects of this combination can lead to dangerous respiratory depression.
lithium: Tramadol and Lithium both increase the risk of seizures and serotonin syndrome.
mdma: Tramadol and stimulants both increase the risk of seizures.
opioids: Concomitant use of tramadol increases the seizure risk in individuals taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present
There is considerable risk of physical harm when taking these combinations, they should be avoided where possible.
2c-x: Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.
dmt: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
dox: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
lsd: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
mescaline: This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.
mushrooms: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
nbomes: Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures
These combinations are not usually physically harmful, but may produce undesirable effects.
nitrous: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.