What the FDA labels say about taking them together
Buprenorphine and tramadol
Buprenorphine's FDA label of June 5, 2026 names tramadol in its drug interactions section, and tramadol's label names buprenorphine too. The tramadol label: “May reduce the analgesic effect of tramadol hydrochloride oral solution and/or precipitate withdrawal symptoms.”
Check it at the source: the buprenorphine FDA label on DailyMed (effective June 5, 2026); the tramadol FDA label on DailyMed (effective March 5, 2026, Lupin Pharmaceuticals, Inc.).
What does the buprenorphine label say about tramadol?
Buprenorphine label, drug interactionsClinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase (MAO) inhibitors (those intended to treat psychiatric disorders and also others, such as linezolid and …
Sublocade label (Indivior Inc., July 27, 2026), drug interactionsClinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase (MAO) inhibitors (those intended to treat psychiatric disorders and also others, such as linezolid and …
Source: FDA drug label (Brixadi, NDA210136), Braeburn Inc., effective December 31, 2025 (SPL set 5d8a8fd0-8619-422a-a664-d1d2e8970f48), via openFDA
Source: FDA drug label (Butrans, NDA021306), Knoa Pharma LLC, effective May 1, 2026 (SPL set 794aa355-66de-41b8-aedf-f2c40f6bc664), via openFDA
Source: FDA drug label (Sublocade, NDA209819), Indivior Inc., effective July 27, 2026 (SPL set 6189fb21-9432-45f8-8481-0bfaf3ccde95), via openFDA
Source: FDA drug label (Buprenorphine HCl), SpecGx LLC, effective June 5, 2026 (SPL set b60d514d-a88a-4fa2-a5b0-30ac29e04973), via openFDA; the full label on DailyMed
What does the tramadol label say about buprenorphine?
Tramadol label, drug interactionsClinical Impact: May reduce the analgesic effect of tramadol hydrochloride extended-release tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants
Source: FDA drug label (Tramadol Hydrochloride Extended-Release, NDA022370), Trigen Laboratories, LLC, effective January 23, 2026 (SPL set c0bc7218-3fd0-4646-96f4-25355fc84aa9), via openFDA
Source: FDA drug label (Tramadol Hydrochloride, NDA214044), TruPharma, LLC, effective January 25, 2023 (SPL set aea56ff9-94ac-47a8-8f15-8790d538973b), via openFDA
Source: FDA drug label (TRAMADOL HYDROCHLORIDE), Lupin Pharmaceuticals, Inc., effective March 5, 2026 (SPL set 46bb9ae6-3ee8-463c-badb-c7a45a89b84b), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Which combination products and biosimilars carry the same label text?
Their labels quote the same sentences for their ingredient; each has its own page with its own label dates.
Both medicines on the record
| Buprenorphine | Tramadol | |
|---|---|---|
| Labeled for | Opioid use disorder, Pain | Pain |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.277 per tablet 2 mg tablet sl | $0.0248 per tablet 50 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once