From the FDA Drug Label
Mixed Agonist/Antagonist and Partial Agonist Opioid Analgesics: Avoid use with tramadol hydrochloride extended-release tablets because they may reduce analgesic effect of tramadol hydrochloride extended-release tablets or precipitate withdrawal symptoms. (5.16,7) The use of tramadol with Suboxone (buprenorphine and naloxone), a partial agonist opioid analgesic, is to be avoided as it may reduce the analgesic effect of tramadol or precipitate withdrawal symptoms 1.
From the Research
Yes, you can take tramadol with Suboxone (buprenorphine and naloxone), as evidenced by a case report where a patient on buprenorphine/naloxone for opioid use disorder was started on tramadol for acute pain and reported an additive analgesic effect without side effects or withdrawal symptoms 2.
Key Considerations
- The combination of tramadol and buprenorphine may be effective for pain management in patients on Suboxone therapy, as shown in a case report where the patient experienced improved pain control and greater daily functioning 2.
- However, it is essential to note that the evidence is limited, and more research is needed to fully understand the effects of this combination.
- The patient in the case report was started on tramadol 50 mg 3 times a day (TID) for acute pain, and the combination of buprenorphine and tramadol demonstrated an additive analgesic effect 2.
- Other studies have highlighted the potential risks of combining opioids, including respiratory depression, sedation, and overdose 3, 4, 5.
Important Factors to Consider
- The patient's individual response to the combination of tramadol and buprenorphine, as well as their medical history and current health status, should be carefully evaluated.
- The potential benefits of the combination, including improved pain control and reduced opioid use, should be weighed against the potential risks.
- Close monitoring and regular follow-up with a healthcare provider are crucial to ensure safe and effective use of the combination.
Recommendations
- If you're on Suboxone for opioid use disorder treatment and experiencing pain, consult your healthcare provider immediately about appropriate pain management options.
- Your healthcare provider may consider adjusting your Suboxone dosage or recommending non-opioid pain relievers like acetaminophen or NSAIDs, which are safer to use with Suboxone.
- However, based on the available evidence, the combination of tramadol and buprenorphine may be a viable option for pain management in some patients, and further research is needed to fully understand its effects 2.