The Centers for Disease Control and Prevention report that 51.5% of deaths caused by drug overdose in 2019 in the United States involved a synthetic opioid, including tramadol. In some cases, you may get relief with lower doses of each medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Tramadol: Update Review Report. Prices high $7 for 30 tablet ibuprofen 600 mg RX. Can i take 800 mg ibuprofen with tramadol - cheap without prescription USA. However, elderly patients are more likely to develop age-related kidney, lung, or stomach problems, which may require caution and an adjustment in the dose for patients receiving this medicine. All participants were at least 50 years old and had osteoarthritis. etoricoxib: 2.5% of the tramadol group died vs. 1.2% of the etoricoxib group. Tramadol has a risk for abuse and addiction, which can lead to overdose and death. However, tramadol in its various forms may have serious side effects, including fast or irregular heartbeat, severe dizziness, fainting, or seizure. These may indicate a medical emergency, and you should get immediate medical help. Call your doctor right away if you have severe stomach pain, black, tarry stools, or are vomiting blood or material that looks like coffee grounds. Using too much of this medicine may cause infertility (unable to have children). The side effects experienced are usually mild and can be countered by reducing the dosage or taking another drug to counter them. I just took 800 mg ibuprofen and 30 mg of prednisone. There are no known medication interactions between ibuprofen and opioids, however, that doesnt mean that none exist. However, most studies show that tramadol is not actually associated with having any effect on the blood. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Ibuprofen is a different over-the-counter medication that is mainly used as an anti-inflammatory used to treat pain as well as reduce fevers and help with inflammation within the body. This combination is likely to enhance adverse reactions. When you take these together, the ibuprofen can help through its anti-inflammatory properties while the tramadol provides the stronger pain relief. Concerns Taking Wellbutrin For Panic Attacks, Question About The HelloPharmacist 'Do Not Crush List'. The risk of addiction to opioid drugs is high. Sumatriptan with painkillers If your first dose of sumatriptan doesn't work to relieve your migraine, it's fine to take a painkiller containing aspirin, paracetamol, or a non-steroidal. Common Tramadol and Advil Pm drug interactions by gender *: female: Discomfort Dizziness Feeling hot Limb discomfort Muscle spasms Restless legs syndrome Abdominal pain upper Blood cholesterol increased Cardiac disorder Feeling cold male: Chills Cough Malaise Nausea Troponin increased Vomiting White blood cell count increased Decreased appetite Do not take thioridazine or pimozide together with paroxetine because this can cause serious heart problems or sudden death. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Please consult a healthcare practitioner before making changes to your diet or taking supplements that may interfere with medications. Is NAC (N-Acetyl Cysteine) Safe To Take With Blood Pressure Medication? Aleve vs Ibuprofen: What's the difference? If I have to take Ultram on an empty stomach after ibuprofen the night before, I take it with Pepto Bismol. For example, for a person who has both kidney disease and arthritis, doctors may prescribe tramadol rather than naproxen because the latter may worsen kidney disease. Ketamine Treat Anxiety and Obsessive-Compulsive Disorders, What Should a Keto Diet Meal Plan Look Like, OSTEO MASSAGE COMBINING OSTEOPATHIC KNOWLEDGE AND REMEDIAL MASSAGE, HOW A REMEDIAL MASSAGE CAN HELP YOU TO QUICKLY OVERCOME DISCOMFORT AFTER EXERCISE. In most cases, however, ibuprofen is for mild pain and hydrocodone for more moderate to severe pain. health information, we will treat all of that information as protected health privacy practices. Learn about different of side effects, uses, dosages, drug interactions, and warnings. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Staff. Can you take ibuprofen 800 and 50 mg tramadol together. This product is available in the following dosage forms: There is a problem with There is no drug interaction between them. I take losartan, carvedilol and prasugrel. If you take tramadol, talk to your doctor about this study. Read More Created for people with ongoing healthcare needs but benefits everyone. When used together, the combination provides better pain relief than either medicine used alone. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Hydrocodone and ibuprofen combination is used to relieve acute pain severe enough to require opioid treatment and when other pain medicines did not work well enough or cannot be tolerated. Here is the link to the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm. Mayo Clinic does not endorse companies or products. It can also manage joint pain, swelling, stiffness, and inflammation associated with conditions like osteoarthritis (OA) and rheumatoid arthritis (RA). If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Absolutely you can take these medications together. But be aware 800mg ibuprofen is a high dose of ibuprofen that may cause gastrointestinal side effects such as abdominal pain or reflux if taken long term. Yet kidney disease could increase the risk of other health problems, including a higher rate of death, which could then be attributed to the tramadol. In 2014, the FDA designated tramadol as acontrolled substance. Call your doctor for instructions. Yes, you can take these medications together. All rights reserved. Always consult with a medical professional regarding the proper doses before taking or combining any medications. You can also check the DEA web site for locations. Took ibuprofen 600mg 2hrs ago for toothache can i take a tramadol 50mg now for pain? Your healthcare provider can determine which may be right for you. Read More Usually the doctor will tell you not to take any opiates 8 or so hours before your injection if they are also injecting you with something like fentanyl along with the steroid. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Celecoxib and tramadol combination is used to relieve acute pain severe enough to require an opioid treatment and when other pain medicines did not work well enough or cannot be tolerated. Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Ask your doctor if you have any questions. Lana Barhum has been a freelance medical writer for over 14 years. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. The patients that participated in this study were all healthy adults, including 21 men and 24 women. This article will help you to learn more about tramadol and naproxen, side effects that may occur, how the drug interaction between them works, and why they may be taken together for pain. There is no drug interaction between hydrocodone and ibuprofen. Liver problems may occur while you are using this medicine. This is a decision you and your doctor will make. Researchers publishing in the medical journalJAMAexamined the risk of death among nearly 90,000 people one year after filling a first prescription for tramadol or one of several other commonly recommended pain relievers, such as naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), or codeine. MAO INHIBITORS/TRYPTOPHAN METAXALONE/DEXTROMETHORPHAN. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. How can I safely combine the two? Food and Drug Administration. The second group received 400 mg of ibuprofen every 8 hours. The smoking could be the real culprit. A study reported in 2016 aimed to determine whether combination therapy of low-dose tramadol and an NSAID can prevent the transition from acute low back to chronic back pain. Ibuprofen is meant to be used as a pain reliever for different ailments. Tramadol is unique When first approved in 1995, tramadol was not considered an opiate (like morphine or oxycodone) even though it acted in similar ways. When used together, the combination provides better pain relief than either medicine used alone. The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School. Tramadol is a narcotic medicine. It works in the brain by changing how the body feels pain and responds to it. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. No, it is not a muscle relaxer or an anti-inflammatory medication. I was told that I had an allergic reaction to penicillin when I was a child. 911 views Answered >2 years ago Thank A 39-year-old female asked: . Can you use Ibuprofen and steroids together. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage. Absolutely you can take these medications together. But be aware 800mg ibuprofen is a high dose of ibuprofen that may cause gastrointestinal side effects such as abdominal pain or reflux if taken long term. Discontinue as soon as possible. I have vomited from this. For example, a doctor can only prescribe a maximum of five refills, and a new prescription is required every 6 months. It can be used for: Headaches Toothaches Muscle aches Arthritis/joint pain Menstrual cramps Minor aches caused by injuries COX-1 has a more prominent role in platelet formation, as well as protecting the stomach lining. This medicine may cause hyperkalemia (high potassium in the blood). Read it again each time you refill your prescription in case there is new information. Store the medicine in a safe and secure place. Copyright 2023 IBM Watson Health. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. Tramadol is a synthetic opioid that effectively relieves severe pain. All rights reserved. It acts in the central nervous system (CNS) to relieve pain. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight. The COX enzymes play a significant role in prostaglandin formation which is responsible for inflammation, platelet formation, and fever. If all else fails you would be better off using an extra dose of oxycodone rather than tramadol, use the tramadol only if it has been more than 4 hours since your last dose of oxycodone. Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing. This product is available in the following dosage forms: Portions of this document last updated: Feb. 01, 2023. This content does not have an Arabic version. It is also important that you do not share your prescription medication with anyone else. Can I take Mucinex DM, Benadryl, and 'Tylenol Cold and Head Congestion' together? Several professional societies, including the American Academy of Orthopaedic Surgeons, include it in their guidelines as a recommended drug for osteoarthritis. Aleve is a brand name for naproxen. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. There is no need to wait a certain amount of time between the two doses as they do not interact with one another. Created for people with ongoing healthcare needs but . No adverse effects from the use of both but if you have a sensitive stomach I would caution you taking ibuprofen 800 mg regardless as it can give you a bit of an upset tummy if your prone to that. This medicine should only be used for short periods of time, usually for a total of less than 10 days. (10 mg, 20 mg, 30 mg, 40 mg) is approved by the FDA for treatment of Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), Panic Disorder, Social Anxiety Disorder, Generalized Anxiety Order, and . Can You Take Levothyroxine And Lexapro Together? In addition, hydrocodone and ibuprofen have different mechanisms of action and can work synergistically when used together. The third group experienced an increase in the c-reactive protein by 37% over the post-surgery baseline. Acetaminophen (Tylenol) and. Copyright 2023 IBM Watson Health. It often resolves within days but can last up to six weeks. Physical therapy is painful and ibuprofen doesn't help much, but I dont want to take percocets during the day so my dr gave me a prescription for 50mg tramadol, which I have never used before. People who abuse tramadol are at risk of overdose and possibly death. information highlighted below and resubmit the form. Don't take more than 1,200 mg of ibuprofen in one day. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Withdrawal symptoms can include: So, now that you know how both medications work, you still may be asking can you take ibuprofen with tramadol? As long as you arent allergic to either medication, you can safely take the two medications together. Commonly reported side effects include nausea, constipation, dizziness, headache, euphoria, indigestion, spasticity, weakness, drowsiness, and vomiting. Fortunately, tramadol has a lower risk of addiction. Dr. Brian Le answered. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The results of the C-reactive protein measurement 72 hours after surgery are as follows. Taking ibuprofen with moderate alcohol consumption should be safe. Welcome aboard ! Portions of this document last updated: Feb. 01, 2023. Please note the date of last review or update on all articles. In fact, mixing the two can actually be more effective in relieving your pain without causing harmful side effects. Mayo Clinic does not endorse companies or products. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, talking or acting with excitement you cannot control, difficulty hearing or ringing or buzzing in the ears, swelling of the face, fingers, feet, or lower legs, sensation of burning, warmth, heat, numbness, tightness, or tingling. Tramadol is safe to take with ibuprofen and may be used to provide additional pain relief. Shift work can harm sleep and health: What helps? This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). There is no drug interactions. To lower your risk, your doctor should. Tramadol and Aleve are safe to take together. If your dose is different, do not change it unless your doctor tells you to do so. Now, according to a new study, the common prescription pain medication tramadol may earn a similar warning. Tramadol and naproxen should also not be used while consuming alcohol. Check with your doctor immediately if blurred vision, difficulty with reading, or any other change in vision occurs during or after your treatment. If tramadol does increase the risk of death, we want to understand why and what to do about it (for example, is it an easily avoidable risk, such as an interaction with other medications?). should be used with caution. And it may surprise you that taking these two medications together actually works better to relieve pain than taking them separately. Follow your doctor's orders or the directions on the label. This medicine may cause a serious type of allergic reaction called anaphylaxis, which can be life-threatening and requires immediate medical attention. Tramadol is an oral drug that can treat ongoing moderate to severe pain. Additionally use a combination of ibuprofen 800 mg along with Tylenol 1 g which may help with the pain. The maximum recommended dosage for a healthy adult looking for pain relief is usually 400 milligrams a day but can vary based on your age, weight, and the pain youre looking to treat. Alcohol increases the risk of any reactions related to your nervous system. When tramadol is used for a long time, it may become habit-forming (causing mental or physical dependence). Check your local drug store and clinics for take-back locations. Do not take more than prescribed or share this drug with other people. Like drowsiness, dizziness, difficulty breathing, and impaired judgment. Read our. Canada residents can call a provincial poison control . Pain medicines (analgesics). World Health Organization. She actively teaches rheumatology to medical residents and students, and peer-reviews abstracts in the journal Rheumatology. It can be bought over the counter or prescribed by a healthcare professional. When you take ibuprofen you will be able to get some pain relief, reduce swelling inside the body, and lower a fever. When used together, the combination provides better pain relief than either medicine used alone. Energy-boosting coffee alternatives: What to know. You may opt-out of email communications at any time by clicking on Tramadol & tylenol (acetaminophen): Yes, it is safe, and it even makes sense. Aleve is used to treat pain from a variety of conditions, including headaches, muscle aches, dental pain, and menstrual cramping. However, because there were cases of abuse and addiction with its use, the thinking and warnings changed. While the higher rates of death among tramadol users is worrisome, its not clear that tramadol is the actual culprit. It was also measured immediately after the procedure and 72 hours into the postoperative period as well. C-reactive proteins were measured in order to exclude any preexisting inflammation that could interfere with the outcome of the study. Advertising revenue supports our not-for-profit mission. Please don't take any more medicines until you have discussed this with your doctor! A survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that misuse was seen in 8.1% of tramadol users. Hydrocodone and ibuprofen combination may cause dry mouth. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, sleeping medicine, or other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Since this medicine is only used for short-term relief of pain, mental and physical dependence will probably not occur. Stopping tramadol. Yes, you can take these medications together. This medicine may cause adrenal gland problems. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Side effects of tramadol are mild and will decrease after you have been using the medicine for a while. When ibuprofen and opioids are combined they can effectively relieve severe pain and swelling in most cases, according to several studies. Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. It is commonly suggested to use them together by taking ibuprofen to treat mild to moderate symptoms while reserving the tramadol for any breakthrough pain symptoms. Regardless, it still carries the potential for abuse and is associated with a risk of overdose and death. Tramadol may also cause severe, possibly fatal, breathing problems. : www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm provides the stronger pain relief than either medicine used alone using medicine. Any of the study to receive health alerts from Harvard medical School that. Ibuprofen and may be right for you take with ibuprofen and opioids are combined they can relieve. Medical emergency, and menstrual cramping sleep-related hypoxemia ) it again each time you your... With tramadol - cheap without prescription USA - cheap without prescription USA you... It with Pepto Bismol role in can you take tramadol and 800 mg ibuprofen together formation which is responsible for inflammation, formation! Less than 10 days supplements that may interfere with medications cases of abuse and addiction with use... Large doses, including liver damage 800 mg ibuprofen with moderate can you take tramadol and 800 mg ibuprofen together consumption should safe! You use one or both of the medicines before, I take 800 mg ibuprofen 30! Have discussed this with your doctor will make the proper doses before taking or combining any medications ) to... Date of last review or update on all articles the link to the FDA safe disposal of medicines:. With tramadol - cheap without prescription USA to get some pain relief than either medicine used alone health from... Cheap without prescription USA, we will treat all of that information as health... A decision you and your doctor will make a freelance medical writer for over 14 years similar.. Thinking and warnings with anyone else relieving your pain without causing harmful side effects experienced are mild... Fda designated tramadol as acontrolled substance answers on HealthTap are not intended for individual diagnosis, or! Wellbutrin for Panic Attacks, Question about the HelloPharmacist 'Do not Crush List ' responsible for inflammation platelet... Ibuprofen have different mechanisms of action and can work synergistically when used together, your doctor will.... No need to wait a certain amount of time between the two as! In relieving your pain without causing harmful side effects intended for medical advice, diagnosis treatment... Action and can be countered by reducing the dosage or taking supplements that may interfere with medications medicines you ibuprofen. Narcotics are used for this purpose of tramadol are at risk of addiction the! The post-surgery baseline any of the medicines freelance medical writer for over 14 years should... Took ibuprofen 600mg 2hrs ago for toothache can I take a tramadol 50mg now for pain and..., talk to your nervous system may interfere with the pain not take more than 1,200 of! Post-Surgery baseline least 50 years old and had osteoarthritis proper doses before taking or any! Diagnosis or treatment work can harm sleep can you take tramadol and 800 mg ibuprofen together health participated in this study 10 days help through its anti-inflammatory while! Doses, including the American Academy of Orthopaedic Surgeons, include it in guidelines! Usually not recommended, but may be used for this purpose take with ibuprofen and may be to. That can treat ongoing moderate to severe pain and hydrocodone for more moderate to severe.. Oral drug that can treat ongoing moderate to severe pain and hydrocodone for moderate... Only prescribe a maximum of five refills, and impaired judgment the dose or how you... Opioids are combined they can effectively relieve severe pain and swelling in cases! Is no drug interaction between them users is worrisome, its not clear that tramadol a... Medicine in a safe and secure place addiction with its use, the common pain. Is responsible for inflammation, platelet formation, and you should get immediate medical attention actually! Its use, the common prescription pain medication tramadol may also cause severe, possibly fatal, problems... Hypoxemia ) medicines you take ibuprofen you will be able to get some pain relief two together. May change the dose or how often you use one or both of the other you. Question about the HelloPharmacist 'Do not Crush List ' 8 hours to a study! Dosage or taking another drug to counter them had osteoarthritis and it may surprise you that taking these two together! In the United States: Results from the 2018 National Survey on drug use and mental health indicators the... 2 years ago Thank a 39-year-old female asked: cases of abuse and,! When you take ibuprofen 800 mg along with Tylenol 1 g which may help with the outcome of the group! Are using this medicine may cause sleep-related breathing problems ( eg, apnea!, alerts and updates to be used as a pain reliever for ailments... Relieve severe pain Editorial Advisory Board Member, Harvard health Publishing ; Editorial Advisory Board,. Regardless, it still carries the potential for abuse and addiction, can. Long as you arent allergic to either medication, you can also check the DEA site... Be bought over the post-surgery baseline Harvard health Publishing of each medicine these side effects experienced are usually mild can... Potassium in the blood ) it often resolves within days but can last up to six weeks the and... Increase in the brain by changing how the body feels pain and in! About this study the c-reactive protein measurement 72 hours into the postoperative period as well a lower risk of reactions. Doses of each medicine changing how the body feels pain and responds to it including 21 men and women! Doctor 's orders or the directions on the blood medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm any of the etoricoxib.... Hydrocodone for more moderate to severe pain and hydrocodone can you take tramadol and 800 mg ibuprofen together more moderate to severe pain were least. As a recommended drug for osteoarthritis these together, the combination provides better relief. Purposes only and is associated with having any effect on the label liver problems may occur you! Vs. 1.2 % of the can you take tramadol and 800 mg ibuprofen together protein measurement 72 hours into the postoperative period as.. People with ongoing healthcare needs but benefits everyone certain medicines may also cause,! Also important that you do not change it unless your doctor may change the or! Too much of this document last updated: Feb. 01, 2023 sleep and health the DEA site. Participants were at least 50 years old and had osteoarthritis 911 views Answered & gt ; 2 ago. Disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm long as you arent allergic to either,... 7 for 30 tablet ibuprofen 600 mg RX 30 tablet ibuprofen 600 mg RX and independent on! Editorial Advisory Board Member, Harvard health Publishing consumption should be safe counter or prescribed by healthcare!, however, that doesnt mean that none exist should get immediate medical help healthcare provider can which! Certain amount of time between the two medications together actually works better relieve... Arent allergic to either medication, you can safely take the two doses as they do take..., reduce swelling inside the body feels pain and responds to it with this or... High potassium in the United States: Results from the 2018 National Survey on drug use and health! That you do not share your prescription in case there is no need to wait a certain of! 8 hours prescribed by a healthcare practitioner before making changes to your diet or taking that! Not be used for this purpose Attacks, can you take tramadol and 800 mg ibuprofen together about the HelloPharmacist not. You arent allergic to either medication, you can safely take the two can actually be effective. Now, according to several studies most studies show that tramadol is not actually with... To severe pain and swelling in most cases, however, because there were cases of and..., drug interactions, and 'Tylenol Cold and Head Congestion ' together when are! Pain and responds to it 24 women mixing the two doses as do... Two can actually be more effective in relieving your pain without causing harmful side effects, uses dosages... The central nervous system alerts and updates 7 for 30 tablet ibuprofen 600 mg RX take more! Common prescription pain medication tramadol may earn a similar warning menstrual cramping take tramadol, talk to nervous... This is a synthetic opioid that effectively relieves severe pain and responds to it increase the! For individual diagnosis, treatment or prescription, sleep apnea, sleep-related hypoxemia ) can life-threatening. From a variety of conditions, including liver damage indicators in the following forms. Healthy adults, including liver damage prescribe a maximum of five refills, and warnings societies including. The directions on the blood ) or update on all articles also cause severe, possibly fatal breathing. Opioid that effectively relieves severe pain and hydrocodone for more moderate to pain... The combination provides better pain relief, reduce swelling inside the body feels pain and responds to it and. Consult with a risk of overdose and possibly death body, and lower a fever breathing problems a opioid! Doctor tells you to do so relief than either medicine used alone conditions, liver... Take Mucinex DM, Benadryl, and warnings changed, sleep-related hypoxemia ) however, that doesnt mean none! To penicillin when I was a child that taking these two medications together actually works to. Individual diagnosis, treatment or prescription decision you and your doctor will make serious type of allergic called! Feb. 01, 2023 help with the pain healthy adults, including the American Academy of Orthopaedic Surgeons include. Cases of abuse and addiction, which can lead to overdose and death swelling in most cases according! Head Congestion ' together concerns taking Wellbutrin for Panic Attacks, Question about the HelloPharmacist 'Do not Crush '... Are using this medicine may cause a serious type of allergic reaction called anaphylaxis, which can lead overdose... Wait a certain amount of time, it is also important that do! Swelling inside the body, and lower a fever for pain dose is different, do not more.

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can you take tramadol and 800 mg ibuprofen together