Can Tramadol and Naltrexone be taken together?

Posted on Wed, 8 Nov 2017 in Lupus
Question: I am taking tramadol for pain management re arthiritis and spondylitis. The Rheumatologist just ordered Naltrexone to take 1.5 mg at night. My first night, I was up with diarrhea all night. Why am I taking a pain med with a opiod blocker? Is there some basis for this?
Answered by Dr. Ornela Ademovi 2 hours later
Brief Answer:
Drug interaction

Detailed Answer:

I understand your concern. There is a known interaction between Tramadol and Naltrexone and their combination is not recommended for prescription. Tramadol is an opioid, whether Naltrexone is an opioid blocker, so taking them together would defy the purpose.
I recommend you stop taking the drugs immediately and find another rheumatologist.

I hope this helps. Let me know if you have further questions.
Wishing you good health and all the best.

Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Ornela Ademovi 18 minutes later
Thank you for your answer.

I think the theory here is that the nax will free up receptors which will make the same tramadol dosage more effective. For this to be true, we would have to alternate between the drugs. She is reluctant to give any more tramadol. As it is, I do 300 mg/day. So, she just wants to make 300mg more effective instead of extending the tramadol dosage. Taking them simultaneously is just alternating them at a very fast pace......?

Answered by Dr. Ornela Ademovi 16 hours later
Brief Answer:
Alternating makes sense

Detailed Answer:

Yes, alternating them makes sense. Taking them at the same time, does not. Alternating these drugs every 12 hours seems very fast paced, I agree. So I'm not sure about how effective this combination will be. Personally, I would try to taper Tramadol to a lower dosage.

Tramadol is an opioid, and although not as potent as other opiates, it still has the potential to become addictive, so it is understandable that your doctor wants to restrict the drug by making the most out of a fixed dosage.

This remains a trial and error matter, until you find the dosage and combination that works for you.

I hope this answers your question. I wish I could be of more help to you.

Wishing you good luck and all the best.
Above answer was peer-reviewed by : Dr. Raju A.T
Answered by
Dr. Ornela Ademovi

General & Family Physician

Practicing since :2004

Answered : 738 Questions


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