STOP — Contraindicated
FDA Black Box Warning — same risk level as other opioid-benzodiazepine combinations.
Evidence level: STRONG
Tramadol with diazepam carries the same life-threatening respiratory depression risk as stronger opioid-benzodiazepine combinations. Do not assume tramadol is safe just because it is considered a milder opioid.
Combined CNS depression. FDA Black Box Warning on tramadol label for concurrent benzodiazepine use.
Avoid this combination. If prescribed both, ensure your doctor is aware and has considered safer alternatives.
Take Diazepam only as prescribed — benzodiazepines carry dependence risk and should not be adjusted without medical guidance. Tramadol at a separate time. Benzodiazepines cause sedation — avoid combining with other sedating substances. Never increase dose without medical guidance.
Higher risk for: elderly, opioid-naive patients, those with sleep apnea, respiratory conditions, concurrent CNS depressants (benzodiazepines, alcohol), liver impairment, or history of substance use disorder.
Severe drowsiness, slow or stopped breathing, seizures, confusion, coma
Ask about acetaminophen or NSAIDs for pain instead of tramadol. Discuss non-benzodiazepine options for anxiety or muscle relaxation.
Opioid combinations carry serious risks including respiratory depression. Talk to your pain management specialist about non-opioid alternatives: physical therapy, NSAIDs (if appropriate), nerve blocks, or non-sedating supplements like PEA (palmitoylethanolamide) or curcumin for inflammation.
Tramadol with diazepam carries the same life-threatening respiratory depression risk as stronger opioid-benzodiazepine combinations. Do not assume tramadol is safe just because it is considered a milder opioid.
Take Diazepam only as prescribed — benzodiazepines carry dependence risk and should not be adjusted without medical guidance. Tramadol at a separate time. Benzodiazepines cause sedation — avoid combining with other sedating substances. Never increase dose without medical guidance.
Severe drowsiness, slow or stopped breathing, seizures, confusion, coma
Opioid combinations carry serious risks including respiratory depression. Talk to your pain management specialist about non-opioid alternatives: physical therapy, NSAIDs (if appropriate), nerve blocks, or non-sedating supplements like PEA (palmitoylethanolamide) or curcumin for inflammation.
Ask about acetaminophen or NSAIDs for pain instead of tramadol. Discuss non-benzodiazepine options for anxiety or muscle relaxation.
Or browse the full interaction database (121,000+ pairs).