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Can I take naproxen and tramadol together?

by Alivia Nyhan
Published: Last Updated on

The consumption of analgesic and anti-inflammatory drugs worldwide has spread indiscriminately; some are sold without a doctor’s prescription. Although they benefit from reducing or eliminating pain, these are drugs that do not always behave harmlessly, and some combinations of these could have adverse effects. This is the case with the everyday use of naproxen and tramadol.

Do a general search on the Internet. Many articles support the combination, and others that say it is dangerous. Still, the vast majority do not show scientific support for such affirmations in favor or against.

In this FastlyHealarticle, we will answer on a strictly scientific basis the question of whether or not you can take naproxen and tramadol together.

Naproxen: what is it for, contraindications and side effects

Naproxen is a drug that pharmacologically belongs to the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) family.

Mechanism of action

Like the rest of the NSAIDs, it allows the synthesis of prostaglandins at the peripheral level. It inhibits the migration of leukocytes to the site of inflammation so that it is not perpetuated. Its anti-inflammatory action is peripheral.

It has antipyretic action at the central level, acting directly on the temperature-regulating center of the hypothalamus.


Depending on its mechanism of action and its potency, naproxen is used to treat:

  • ankylosing spondylitis
  • Aseptic necrosis
  • Fever
  • Headache
  • Muscle or joint pain of any kind
  • Bursitis
  • Frozen shoulder
  • Herniated disc
  • Chronic myofascial pain
  • Costochondritis
  • Diffuse idiopathic skeletal hyperostosis
  • Dysautonomia
  • Gout (painful crisis)
  • Adult or juvenile rheumatoid arthritis
  • Menstrual pain
  • Radiculopathy
  • Sciatica
  • Spondylolisthesis
  • Tendinitis
  • Myelitis transversa


It would be contraindicated in cases of:

  • Hypersensitivity to naproxen.
  • History of severe allergic reactions to aspirin or other NSAIDs.
  • History of or patient with asthma attacks, rhinitis, hives, nasal polyps, angioedema, or ulcerative colitis.
  • In case of severe liver or kidney impairment.
  • Children under two years of age (except for cancer cases).
  • Patients with a history of gastrointestinal bleeding or perforation related to previous NSAID treatments.
  • Patients with active or recurrent peptic ulcer and gastrointestinal bleeding.
  • Patients with severe heart failure.
  • Pregnant in the third trimester of pregnancy.

Side effects

The adverse reactions of its use are confined almost exclusively to the gastrointestinal system. It can cause peptic ulcers, gastrointestinal perforation or bleeding, epigastric or abdominal pain, nausea, vomiting, diarrhea, flatulence, constipation, and dyspepsia, among others.


Its presentations include: 500 mg scored tablets, 275 and 500 mg coated tablets, 200 mg capsules, 50, 137, and 275 mg suppositories of Naproxen Sodium, and granules in 200 and 500 mg sachets.

You can expand this information by consulting the article Naproxen: uses and side effects.

Tramadol: what is it for, contraindications and side effects

Tramadol is a drug that pharmacologically belongs to the family of narcotic analgesics. Specifically, it is an opioid derivative (of opium).

Mechanism of action

Due to its chemical conformation, it has a dual-action mechanism. It has an agonist activity on opiate receptors and, in this way, modulates the release of nociceptive substances (neurotransmitters that allow pain to be perceived); in the end, its effect is the inhibition of the nociceptive stimulus at the central level.

It is considered a synthetic analog of codeine but without the potential of other opiates to produce dependency or respiratory depression.


Tramadol is used to treat:

  • Anxiety
  • Back pain
  • Chronic pain
  • Depression
  • Fibromyalgia
  • Obsessive-compulsive disorder
  • Pain
  • Restless Leg Syndrome
  • Syringomyelia
  • Vulvodynia


It would be contraindicated in cases of:

  • Hypersensitivity to tramadol.
  • Acute poisoning or overdose with CNS depressant substances (alcohol, hypnotics, or other opioid analgesics).
  • People consume monoamine oxidase inhibitors (MAOIs) or have been treated with them during the previous two weeks.
  • People who take linezolid.
  • In case of severe liver or kidney impairment.
  • In patients with epilepsy not adequately controlled.
  • In severe respiratory failure.
  • During lactation, long-term treatment (more than 2 or 3 days) is necessary.
  • For the treatment of opioid withdrawal syndrome.

Side effects

The most common adverse reactions are dizziness and vertigo, nausea/vomiting, constipation, headaches, lethargy, itching, and asthenia, among others.

Nervousness, anxiety, agitation, tremors, spasticity, euphoria, and hallucinations may be observed more rarely.


It is available in 50 mg capsules, 100, 150, and 200 mg retard tablets, 100 mg suspension, 100 mg/ml drops, and 100 mg injectable solution.

You can expand this information by consulting the article Tramadol: uses and side effects .

What is drug synergy?

Pharmacological synergy is defined as the process in which two drugs with different mechanisms of action mutually enhance their efforts. Their effects are not added, but they are improved, the result being much greater than the sum of its impact individually.

This implies that when we take two drugs that synergize, their actions will be more powerful and, therefore, you will need to take less of each one.

Similarly, it is essential to monitor that this enhancement of effects does not lead to also enhancement of the adverse effects of both.

Can I take naproxen and tramadol together? – the answer

Finally, let’s see what the answer is to whether naproxen and tramadol can be taken together or not.

We saw that naproxen acts at the peripheral level as an analgesic-anti-inflammatory, while tramadol acts at the main level. Clinical studies in which both drugs have been used confirm their synergy in their anti-inflammatory and analgesic action. However, all conclude that its adverse effects are not potentiated.

In this way, we can conclude that, apart from the contraindications that each of them has individually, there is no contraindication to taking naproxen and tramadol together in case of severe pain.

Of course, the indication must be made by your doctor, who knows the particularities of your body and the response that you may have to each of them or their combination, in addition to having the ability to establish whether it is essential for you to do this combination.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Can I take naproxen and tramadol together? We recommend that you enter our category of Medication and medical tests .

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