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Does Tramadol contain acetaminophen?

No, Tramadol does not contain acetaminophen.

In fact, generic tramadol hydrochloride is one option doctors prescribe often for pain relief because it is both efficient and less addictive. We review tramadol combinations and risks of taking acetaminophen here.

Brand names that contain Tramadol

ER =  (extended release)
*    =  (contains acetaminophen)

  • Ryzolt
  • Ultracet *
  • Ultram
  • Ultram ER

BE AWARE: Ultracet (a brand name version of tramadol), combines both tramadol and acetaminophen.

Tramadol hydrochloride and acetaminophen together for pain

Tramadol/acetaminophen combination tablets are generally effective for the treatment of pain without any serious adverse effects. Tramadol efficacy depends on your general health, age, and dosing details. But if you want to avoid the combination, avoid ULTRACET.

Acetaminophen dangers

While acetaminophen is generally safe for short term use, there are some special considerations when considering this medicine for pain relief. First, you should not to exceed the FDA acetaminophen maximum total daily dose (4 grams/day). If you take acetaminophen over a long period of time or take it in higher than recommended doses, liver and kidney damage can result, as well as bleeding from the small and large intestines and the stomach. Large doses of acetaminophen are the main risk, but liver problems have been reported after small to moderate dosing of acetaminophen for long periods of time.

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Additionally, doctors warn that you avoid alcohol while taking acetaminophen-containing medications. This is because alcohol and acetaminophen can lead to a life threatening complications called “alcohol acetaminophen syndrome” which cause acute liver failure. Although there is no official threshold for alcohol and acetaminophen, experts recommend that heavy drinkers shouldn’t take more than 2 grams of acetaminophen daily.

Tramadol use questions

Do you have any questions about tramadol use or effects? Please leave them here. We enjoy reading and responding to your personalized queries, and helping where we can.

Reference sources: Acetaminophen Family Fact Sheet
12 things you should know about pain relievers from Harvard Health
Go Ask Alice! Mixing alcohol and acetaminophen — How can I reduce my risk for side effects?
Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study.

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19 Responses to “Does Tramadol contain acetaminophen?
11:05 am December 27th, 2011

I have been taking 50mgs of Tramadol hcl 3 times a day. (long term) I have no negative side affects from this medication. However I would like to know if taking this medication long term will be harmful to my health? I would also like to know if thier is any acetaminophen in tramadol?

12:23 pm January 28th, 2012

Hi Barbara. No, Tramadol does NOT contain acetaminophen.

Long term effects of tramadol for people taking between 100-400 mg daily seem relatively little. In a recent clinical study, tolerance did not develop after long term use of Tramadol LP and the percentage of patients with withdrawal symptoms after the end of treatment was low (6%). You can read more here:

Does this help?

12:15 pm September 9th, 2012

is tramadol a narcotic?

7:39 pm September 11th, 2012

Yes. And No. Check out our article here:

2:46 am October 19th, 2012

My doctor FIGHTS with me every time when it is time to refill my tramadol script. I can see his concern because I got VERY addicted to Norco after my DEFECTIVE knee replacement. (which I need to get reconstructed) and went through re-hab to get off it. But HE put me on this medicine and it works. Every time I go to refill it through him he either denies it with the pharmacy or I need to go in and see him. I am on 6 a day and he is just being so difficult. I am out of work, so paying for my medicine is a challenge sometimes, but yet every week I need to get it filled.

I really wish that some of these doctors come on this site. I am on here all the time and really get some great information.

7:44 am October 22nd, 2012

Hi Renee. I wonder if it would help if you suggest a monthly tramadol drug test to ease your doctor’s concerns. As long as you test within the expected norms, you might not need a weekly visit, but make it a monthly one.

6:39 am October 16th, 2013

I currently take tramadol with acetaminophen 325 grams! I have had the gastric bypass and not suppose to take the acetaminophen! I’ve taken this 1 tablet at night but have started spot like a cycle but do the depo shot so wondering if they blood is coming from my stomach? Do they make tramadol without the acetaminophen in it?

3:53 pm October 22nd, 2013

Hello Susan. You’ll need a clinical evaluation to determine the cause of the bleeding. Yes, generic tramadol does exist without acetaminophen. I’d suggest that you follow up with your prescribing doctor and seek medical counsel.

3:55 pm October 22nd, 2013

My tramadol bottle say tramadol 37.5 and acetaminophen 325. Can you clear that up for me!

4:40 pm October 22nd, 2013

Hello Susan. It seems that the numbers you refer to are the amount of mg of each of the ingredients in your medication. Consult with a pharmacist for confirmation.

11:35 pm December 26th, 2014

I have been prescribed Tramadol-Dol HCL 50mg.for severe back pain I have cirrhosis of the liver and am Terrified to take Anything,how will this further affect my liver? Thank You for response.

12:57 pm December 29th, 2014

Hi Nancy. Have you talked about this with your doctor? Metabolism of tramadol is reduced in patients with advanced cirrhosis. You can check out this link to read about the potential hazard: I’d suggest you contact your local Citizens Advice center to discuss the details around your treatment, or contact a solicitor.

6:13 am September 22nd, 2015

Hello, I just started taking tramadol/acet 37.5mg/325mg acet, should you get your blood work done for liver and kidney function after taking it for 30days?Also taking 15 mg zopiclone for sleep, do you think both drugs would be ok to take at the same time.? Or would they interact with each other? Thank-you.

4:53 pm December 3rd, 2015

I have shingles and pretty severe pain almost all the time. My Dr. prescribed Tramadol; I am currently taking Flecanide (200 mg/day) & 25 mg a day Metoprolol for A-Fib. I also take 1 mg of Alprazolam at night and occassionally Ambien to help me sleep. Wondering about the interation of taking Tramadol with any or all of these medications? Obviously I cannot stop taking the Flecanide and Meoprolol, but the others I could if necessary.

Lydia @ Addiction Blog
12:54 pm December 11th, 2015

Hello, Colleen. Does your doctor know about all medication that you take? I suggest you consult him/her on this matter, or just ask your pharmacist. If your doctor prescribed all these medications, then they are all safe to combine.

10:43 am March 31st, 2016

I just started taking Tramadol 30 mg 2 caps 3/day am wondering if there are any interactions between that and zopiclon 7.5mg for sleep or clonazipam 0.5 x4/day as I am a curious kitten? Thx… P.S. How many Tylenol 3’s can I take with the just plain Tramadol?

Lydia @ Addiction Blog
4:31 pm April 7th, 2016

Hi Jen. Have you talked with your doctor about your concerns? Also, you may speak with a pharmacist about all interactions that your medications may cause to your health.

10:47 pm April 24th, 2016

it seems to me that the tramadol makes me sleepy; but doesn’t do much for the pain

12:47 am June 22nd, 2018

Hello my message is my husband is takin tramadol 50mg does this medication makes piss dirty cause my husband goes to a drug problems n they take he’s piss everyday to make sure that he’s clean from takin drugs

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