Reported Reactions

Drugs › Opioid agonist

Generic name

Tramadol hydrochloride and acetaminophen: adverse event reports filed with FDA

557 reports list it as a suspect or interacting product, 2006–2026. Class: Opioid agonist. Also reported as Tramadol Hydrochloride/Acetaminophen, Tramadol Hydrochloride And Acetaminophen Tablets Usp, Tramadol Hcl/Acetaminophen.

557
reports as suspect product
0% of all reports · about 27 a year
22
reports, 12 months to June 2026
16 in the 12 months before
87.6%
marked serious by the reporter
91.7% across the class
14%
record death among outcomes, as reported
78 reports · not verified by FDA

Between March 2006 and May 2026, 557 adverse event reports received by FDA list tramadol hydrochloride and acetaminophen, a generic name as a suspect or interacting product. Reports that mention it only as a concomitant medication (567) are left out of every figure here.

In the 12 months to June 2026, 22 reports listed it, up 38% from 16 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 27 reports a year and 0% of the 20,646,523 reports in the database, and 0.1% of the reports for the opioid agonist class. How many people take it is not in the data, so a count is not a rate of occurrence.

Reporters most often recorded nausea (12.2%), off label use (8.4%) and drug ineffective (7.4%). A report can list several reactions, so shares add to more than 100%; 315 different terms appear across these reports. Nausea is recorded in 12.2% of these reports, a larger share than in the median opioid agonist drug (2.7%).

87.6% of the reports are marked serious by the reporter (91.7% across the class); 14% record death among the outcomes and 33.8% record hospitalisation, as reported. 31.4% of the reports came from physicians, and the largest patient age group is 75 and over (21.5%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

047Jul 2021: 2Aug 2021: 0Sep 2021: 1Oct 2021: 0Nov 2021: 0Dec 2021: 12022Jan 2022: 1Feb 2022: 0Mar 2022: 0Apr 2022: 4May 2022: 2Jun 2022: 0Jul 2022: 1Aug 2022: 2Sep 2022: 0Oct 2022: 2Nov 2022: 3Dec 2022: 22023Jan 2023: 4Feb 2023: 1Mar 2023: 1Apr 2023: 0May 2023: 3Jun 2023: 0Jul 2023: 1Aug 2023: 1Sep 2023: 3Oct 2023: 1Nov 2023: 0Dec 2023: 02024Jan 2024: 3Feb 2024: 2Mar 2024: 0Apr 2024: 1May 2024: 4Jun 2024: 1Jul 2024: 0Aug 2024: 0Sep 2024: 4Oct 2024: 0Nov 2024: 1Dec 2024: 32025Jan 2025: 1Feb 2025: 0Mar 2025: 0Apr 2025: 0May 2025: 4Jun 2025: 3Jul 2025: 2Aug 2025: 2Sep 2025: 0Oct 2025: 2Nov 2025: 1Dec 2025: 22026Jan 2026: 3Feb 2026: 2Mar 2026: 0Apr 2026: 1May 2026: 7Jun 2026: 0

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

0621232006: 620062007: 212008: 112009: 1620092010: 132011: 852012: 12320122013: 32014: 52015: 2520152016: 112017: 122018: 8920182019: 432020: 72021: 620212022: 172023: 152024: 1920242025: 172026: 13

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Tramadol hydrochloride and acetaminophen reports recording the termmedian drug in opioid agonist

  1. Nauseafeeling sick12.2%68
  2. Off label useused for a purpose or in a way not on the label8.4%47
  3. Drug ineffectivethe medicine did not work as expected7.4%41
  4. Dizzinesslight-headedness or unsteadiness7%39
  5. Vomitingbeing sick6.8%38
  6. Malaisegeneral feeling of being unwell6.3%35
  7. Dyspnoeashortness of breath5.6%31
  8. Confusional stateconfusion4.5%25
  9. Loss of consciousnesspassing out4.3%24
  10. Somnolencedrowsiness4.3%24
  11. Condition aggravatedthe condition being treated got worse4.1%23
  12. Drug interactionan interaction between medicines4.1%23
  13. Headachehead pain3.9%22
  14. Drug hypersensitivityan allergic-type reaction to a medicine3.8%21
  15. Drug intolerancethe medicine was not tolerated3.8%21
  16. Fatiguetiredness3.8%21
  17. Injurya physical injury3.6%20
  18. Arthralgiajoint pain3.4%19
  19. Dyspepsiaindigestion3.4%19
  20. Falla fall3.4%19
  21. Product use in unapproved indicationused for a purpose not on the label3.4%19
  22. Decreased appetitereduced appetite3.2%18
  23. Hepatic enzyme increasedraised liver enzymes3.2%18
  24. Infusion related reactiona reaction during or soon after an infusion3.2%18
  25. Systemic lupus erythematosuslupus, an autoimmune disease3.2%18
  26. Wound3.2%18

Top 30 of 315 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 42 drugs in the opioid agonist class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death14%78
Life-threatening7.5%42
Hospitalisation (initial or prolonged)33.8%188
Disability5.7%32
Congenital anomaly3.8%21
Other serious58.2%324
Not serious12.4%69

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 965,051 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 20.2%1
2 to 110%0
12 to 170.7%4
18 to 4416.9%94
45 to 6414%78
65 to 7411.8%66
75 and over21.5%120
Age not given34.8%194

Patient sex

Female53.7%299
Male31.6%176
Not given14.7%82

Who reported

Physician31.4%175
Pharmacist28.7%160
Other health professional22.1%123
Lawyer0.4%2
Consumer or non-health professional15.6%87
Not given1.8%10

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 19.4% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Pain13023.3%
Back pain142.5%
Analgesic therapy101.8%
Suicide attempt50.9%
Ill-defined disorder40.7%
Procedural pain40.7%

The indication field is filled in by the reporter and is often blank; shares are of all 557 reports.

In context

MeasureTramadol hydrochloride and acetaminophenOpioid agonistAll reports
Reports as suspect product557965,05120,646,523
Share of that pool—0.1%0%
Reports, latest 12 months22—1,332,454
Marked serious87.6%91.7%57.4%
Death recorded among outcomes, per 1,000 reports14035791
Hospitalisation recorded, per 1,000 reports338126213
Consumer-filed share15.6%32.5%45.8%
Top term, share of reportsNausea 12.2%median 2.7%3.8%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the opioid agonist class

DrugName typeReportsLatest 12 monthsMarked serious
OxyContinbrand146,26358494.6%
Oxycodone hydrochloridegeneric113,2202,59894.7%
Dilaudidbrand64,19117395.7%
Morphine sulfategeneric60,0921,57779.8%
Hydrocodone bitartrate and acetaminophengeneric59,05217096.2%
Percocetbrand57,79319895.4%
Fentanylgeneric53,6563,29286.2%
MS Continbrand52,1285598.7%
Oxycodonegeneric35,6712,85391.8%
Hysingla ERbrand30,703692.1%
Morphinegeneric28,4211,42190.5%
Nucyntabrand27,57512790.4%
Tramadol hydrochloridegeneric27,4471,95292.4%
Oxycodone and acetaminophengeneric24,91911294%
Norcobrand24,6614293.1%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Tramadol hydrochloride and acetaminophen reports

How many adverse event reports has FDA received for Tramadol hydrochloride and acetaminophen?

557 reports list Tramadol hydrochloride and acetaminophen as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 22 of them arrived in the latest 12 months. Another 567 list it only as a concomitant medication.

What reactions are recorded in Tramadol hydrochloride and acetaminophen reports?

nausea (12.2%), off label use (8.4%), drug ineffective (7.4%), dizziness (7%) and vomiting (6.8%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Tramadol hydrochloride and acetaminophen was responsible.

How serious are the reports?

87.6% are marked serious by the reporter. Among the outcomes recorded, 14% of reports include death and 33.8% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

physician (31.4%), pharmacist (28.7%) and other health professional (22.1%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Tramadol hydrochloride and acetaminophen rising?

22 reports in the 12 months to June 2026, up 38% from 16 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Tramadol hydrochloride and acetaminophen was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Tramadol hydrochloride and acetaminophen?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Tramadol hydrochloride and acetaminophen as a suspect or interacting product; reports listing it only as a concomitant medication (567) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.