Drugs used for pain management come in multiple forms and types. Most of these drugs work on your brain or the central nervous system (CNS) to numb discomforts like pains or spasms. Especially, drugs such as amitriptyline and tramadol are widely used to bring relief from different kind of pains. Amitriptyline is mostly used for the treatment of headaches, fibromyalgia as well as neuropathic discomforts. On the other hand, tramadol is widely used for various types of chronic as well as acute pains including conditions like fibromyalgia. But, what happens when you take these two painkillers together?

Amitriptyline finds its use in treating tension headaches as well as migraines. It is also commonly administered to treat fibromyalgia and nerve-related discomforts. The drug is known for its analgesic effects and it can boost your sleep cycles. Tramadol belongs to a genre of drugs known as opioid-based analgesics. It works on your brain and numbs painful feelings. The safe dosage of these two drugs – to a larger extent – depends on your clinical condition as well as how well your system responds to the initial doses.

As these two drugs may lead to dizziness, the initial doses are always kept at a lower level. As your body gets used to the active ingredients, the doses are steadily increased. Among these two drugs, tramadol works on your central nervous system to bring relief from pains. This drug is also available in an extended version; this extended form provides relief for a longer time. It may cause side effects like convulsions, seizures and fits. Intake of tramadol in sizable doses is often linked to many such adverse side effects. Children may turn very sensitive to the active ingredients of tramadol. Owing to its undesired side effects, it is generally not administered to younger adults (i.e., those aged  18 years). Also, if you have had a recent surgery, it is not recommended to take tramadol.

What happens when you take amitriptyline with tramadol?

Drowsiness and sleepiness are common side effects of taking amitriptyline. So, when you take pain killing meds like tramadol along with amitriptyline, you may experience acute spells of sleepiness. You are advised not to engage in activities that may require a high level of mental focus and concentration. For example, it is a good practice to stay away from activities like driving or operating heavy machinery.

As a safety precaution, it is recommended to make a list of drugs that you are currently taking. You may also need to include all the treatment plans you are presently pursuing. While compiling the list of meds presently taken, care to add over the counter drugs, prescription drugs, herbal supplements, vitamins, dietary aids as well as nutraceuticals, if any. Once you have shared such a list, your doctor will assess the likely risks of interactions triggered by taking meds like amitriptyline. Hence, it is unsafe to change the dosages or discontinue the intake of some of these drugs in your list after sharing it with your medial team.


Other side effects caused due to tramadol with other painkillers

Intake of tramadol can also lead to a few other discomforts; these include tremors, shakes, abdominal discomforts such as vomiting, nausea, etc. You may also notice mental health problems like anxieties, being in a restless state of mind, excessive levels of agitation, etc. In some people, tramadol has caused discomforts like difficulties to pass stools – i.e., constipation, bad dreams, weird thoughts and indigestion.

If you are taking tramadol along with amitriptyline when these drugs are not necessary – i.e., when you do not experience pains – it can lead to addiction or habit formation. Tramadol may lead to dependencies as well as risks of substance abuse. The risks of addiction loom at large. Hence, it also becomes very important to stop taking these drugs once your doctor tells you to discontinue them. You are not advised to take these drugs while you are pregnant. The chances of fetal damages are very high. Babies may be born with physical deformities and other congenital issues. Your treating doctor may advise you to use contraceptives or other forms of birth control measures (such as pills, rings or patches) while taking tramadol along with amitriptyline.


It is also not recommended to take these drugs while you are breastfeeding or nursing a baby. Some of the active ingredients of these drugs may pass through mother’s milk. Babies consuming such milk may develop sleeping problems, persistent spells of crying, etc. Always consult a qualified medical practitioner prior to the start of the medication plan if you are pregnant / planning to become pregnant and if you are nursing a baby.

Consumption of alcohol

If you have lifestyle habits like drinking alcohol, you are advised not to take such intoxicants while taking these drugs. Those who took alcohol experienced acute forms of dizziness and drowsiness. Your treating doctor may advise limiting the intake of intoxicants or completely stop taking alcohol during the duration of your treatment / medication plans.

Toxicity or excessive levels of serotonin

In some remote cases, an excessive use of these drugs may lead to a build-up of brain chemicals such as serotonin. Increased presence of serotonin may lead to other discomforts such as erratic heartbeats, increase in pressure levels (also, termed as hypertension), fever and dilation of eyeballs. A few people have also noticed acute spells of increased sweating, softening of stools or diarrhea.

Upon noticing any of these side effects, you are advised to talk to your treating physician without any delay. Those living in the US are advised to call 911 or the emergency helpline contacts of the food and drug administration (FDA). Residents of Canada can call a local poison control center as soon as possible or establish quicker contact with Health Canada. Some of these effects may lead to near-fatal or fatal outcomes. So, taking timely medical help is extremely important upon experiencing toxicity or other serious side effects.

Above all, you also need to remember that amitriptyline is used for treating depression and a few other mental conditions. It belongs to a class of meds known as tricyclic antidepressants. It is taken in higher dosage forms to limit episodes of anxieties and depression. In case of pain management, the dosages are kept at a bare minimal level. This drug can lead to adverse side effects when taken along with codeine or other painkillers. It may also lead to lethargy and sluggishness when taken with a few types of nonsteroidal anti-inflammatory steroids such as naproxen, ibuprofen or aspirin. However, intake of aspirin may be prescribed if you are living with cardiac conditions such as heart arrests, cardiac failure, etc. In such cases, you may be recommended to take aspirin – especially, in smaller dosage forms – along with painkillers like amitriptyline.

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