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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is There Interaction Between Oxycodone, Tramadol And Tylenol?

I have been taking oxycodone and tramadol for pain for the past month after a very severe shoulder and arm injury. Lately I have not been able to sleep. Right now I am going on three days with no sleep and I am starting to get a very big headache. Is it OK to take a Tylenol p.m. with either of these pain meds?
Sat, 3 Sep 2016
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Internal Medicine Specialist,  's  Response
Thanks for your question. It is always a good idea to check before using new medications together.

Tylenol PM with Tramadol both increase sedation, so they should be used with caution if taken together. The Benadryl component of Tylenol PM also lowers the effect of Tramadol by affecting liver enzymes, so it might not be as effective for pain.

Tylenol PM with Oxycodone also increased sedation, so again, use with caution. The Benadryl component also lowers the effectiveness of Oxycodone, through the same metabolic mechanism as above.

There is no contraindication to using these together, but maybe start with a very small dose of Tylenol PM and then see how you feel.
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Is There Interaction Between Oxycodone, Tramadol And Tylenol?

Thanks for your question. It is always a good idea to check before using new medications together. Tylenol PM with Tramadol both increase sedation, so they should be used with caution if taken together. The Benadryl component of Tylenol PM also lowers the effect of Tramadol by affecting liver enzymes, so it might not be as effective for pain. Tylenol PM with Oxycodone also increased sedation, so again, use with caution. The Benadryl component also lowers the effectiveness of Oxycodone, through the same metabolic mechanism as above. There is no contraindication to using these together, but maybe start with a very small dose of Tylenol PM and then see how you feel.