STOP — Contraindicated
FDA Black Box Warning applies to tramadol-benzodiazepine combinations just as it does to stronger opioids.
Evidence level: STRONG
Tramadol with lorazepam (Ativan) carries the FDA Black Box Warning for life-threatening respiratory depression. Do not assume tramadol is safe because it seems milder than other opioids.
Combined CNS depression plus tramadol serotonergic and seizure-lowering effects. FDA Black Box Warning.
Do not take these together without doctor knowledge. Ask about non-opioid pain alternatives.
Take Lorazepam 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, slowed breathing, seizures, loss of consciousness
Discuss alternative pain management. If both needed, use lowest doses. Have seizure action plan.
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 lorazepam (Ativan) carries the FDA Black Box Warning for life-threatening respiratory depression. Do not assume tramadol is safe because it seems milder than other opioids.
Take Lorazepam 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, slowed breathing, seizures, loss of consciousness
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.
Discuss alternative pain management. If both needed, use lowest doses. Have seizure action plan.
Or browse the full interaction database (121,000+ pairs).