Medically Reviewed

The Dangers of Mixing Tramadol and Xanax

- 10 sections

Medically Reviewed: September 25, 2019

Medical Reviewer

Chief Editor


All of the information on this page has been reviewed and verified by a certified addiction professional.

Prescription medications are a useful part of life as they can help you manage nearly any physical or mental health condition. However, taking any prescription drug requires caution, especially if you are taking more than one of them. Certain drug combinations can be dangerous, addictive, and even life-threatening.

One potentially dangerous drug combination is tramadol and alprazolam (Xanax). Unless explicitly directed to do so by your healthcare provider, you should never mix tramadol and Xanax.

What is Tramadol (Ultram, Conzip)?

Tramadol, sold under brand names like Ultram and Conzip, is a potent prescription medication used primarily to manage moderate to severe pain. In 2021, 30.5 million prescriptions were written for tramadol.

The drug falls under the category of opioid analgesics, and it operates by changing the way the brain perceives pain signals. However, unlike traditional opioids, tramadol has a dual mechanism of action. In addition to binding to opioid receptors, it also inhibits the reuptake of serotonin in the brain. Serotonin is a neurotransmitter that plays a crucial role in regulating mood, anxiety, and other psychological functions. This serotonin reuptake inhibition contributes to Tramadol’s analgesic (pain-relieving) effects.

Tramadol is available in various formulations, including immediate-release and extended-release tablets and capsules, providing flexible treatment options for people needing pain management.

Tramadol is primarily prescribed to alleviate pain, making it valuable for conditions like post-operative pain, chronic pain, and injury-related discomfort. It may be used to treat cancer, fibromyalgia, sciatica, bone fractures, and post-surgery discomfort. Tramadol can induce a sense of euphoria and relaxation, which can make it appealing to those seeking emotional relief.

Tramadol can have side effects, including:

  • Dizziness
  • Nausea
  • Constipation
  • Respiratory depression
  • Sedation
  • Fatigue
  • Tight muscles
  • Mood swings
  • Headache
  • Nervousness
  • Sleep problems
  • Heartburn

Like other opioids, tramadol can be addictive. However, it is thought to have a lower risk of abuse and dependence than traditional opioids like hydrocodone or oxycodone.

What is Alprazolam (Xanax)?

Alprazolam, widely known by its brand name Xanax, belongs to a class of drugs called benzodiazepines. Xanax is commonly prescribed to treat anxiety and panic disorders due to its ability to modulate brain activity and produce a calming effect. This medication works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which inhibits brain activity, reducing anxiety and promoting relaxation.

Xanax can cause drowsiness and a sense of calm, which can be beneficial for individuals experiencing acute anxiety. However, its relaxing, sedative effects can also be appealing to people who are trying to self-medicate emotional symptoms or get high. Because of its potential for abuse, Xanax is a controlled substance, and long-term use or misuse can lead to physical and psychological dependence.

Common side effects of Xanax include:

  • Drowsiness
  • Sedation
  • Dizziness
  • Lightheadedness
  • Fatigue
  • Depression
  • Headache
  • Confusion
  • Fainting
  • Impaired coordination
  • Irritability
  • Memory problems
  • Muscle twitching
  • Constipation
  • Chest pain
  • Blurred vision
  • Low blood pressure

More than 16 million prescriptions were written for Xanax in 2020, and it is one of the most widely prescribed benzodiazepine medications.

Can You Take Tramadol and Xanax Together?

It’s generally not recommended to take tramadol and Xanax together without explicit instructions from your healthcare provider. Both of these medications can have powerful effects on the central nervous system, and combining them can lead to various risks and complications such as respiratory depression or overdose. If you believe your doctor has prescribed tramadol and Xanax by mistake, please contact them with your concerns. When it comes to prescription medications, it is always best to err on the side of caution.

The Dangers of Mixing Tramadol and Xanax

Mixing tramadol and alprazolam is potentially dangerous. Some of the risks include:

Respiratory Depression

One of the most significant dangers of mixing Tramadol and Xanax is the potential for severe respiratory depression. Both drugs are central nervous system (CNS) depressants that can slow down breathing, and when taken together, this effect can become more pronounced.

In extreme cases, it can lead to life-threatening situations like respiratory depression, particularly in individuals with preexisting respiratory conditions. Respiratory depression can result in low oxygen levels and high carbon dioxide levels, causing people to feel lightheaded, weak, sleepy, and confused. Respiratory depression can be life-threatening.

Extreme Sedation and Drowsiness

Both Tramadol and Xanax can cause drowsiness and sedation. When taken together, these effects can intensify, impairing cognitive function, coordination, and the ability to perform everyday tasks safely, such as driving. People may experience extreme blurry vision and drowsiness, preventing them from being able to stay awake.

Increased Risk of Drug Overdose

Combining tramadol and Xanax also increases the risk of overdose. In fact, the majority of benzodiazepine overdoses also involve opioids.

While these medications have different mechanisms of action, their combined effects can make it challenging for the body to metabolize and eliminate them effectively, leading to the accumulation of toxic levels of both substances in the system. Additionally, severe respiratory depression that is caused by drugs is considered an overdose. Overdose can also result in coma, organ failure, heart attack, or death.

Increased Risk of Dependency and Addiction

Both tramadol and Xanax have a potential for dependency and addiction. When taken together, they can reinforce each other’s addictive qualities, making it more likely for individuals to develop a substance use disorder to one or both substances. People who are addicted may purposefully mix these medications to experience intensified side effects.

Potential Mental Health Complications

Mixing tramadol and Xanax can exacerbate mental health conditions like depression and anxiety, leading to unpredictable emotional swings and worsening symptoms. At the same time, developing an addiction to one or both of these drugs can also contribute to worsening mental health.

Find Addiction Help Now

Prescription medications like tramadol and Xanax can be extremely helpful when used responsibly and under medical supervision. However, the dangers of mixing these drugs are significant and should not be taken lightly.

If you or someone you know is struggling with pain management or anxiety, it is essential to seek professional medical guidance and explore alternative treatment options that can effectively address your needs without exposing you to the potential hazards of combining these medications.

At PAX Memphis, our team of experienced addiction and mental health professionals are available 24 hours a day to assess your needs and point you in the direction of the treatment you deserve. Whether you’d like to learn about your treatment options or you aren’t sure where to start, we can assist. Please call today to get started.


  1. National Library of Medicine: Tramadol, Retrieved September 2023 from
  2. Drug Enforcement Administration (DEA): Tramadol Label, Retrieved September 2023 from
  3. ClinCalc DrugStates Database: Alprazolam Drug Usage Statistics, Retrieved September 2023 from
  4. Food and Drug Administration (FDA): Xanax Alprazolam Tablets, Retrieved September 2023 from