**No—don’t take tramadol with sertraline unless a clinician who knows your medications specifically prescribes and monitors it.** The combination can increase the risk of:
- **Serotonin syndrome**: agitation, confusion, sweating, diarrhea, fever, fast heartbeat, tremor, muscle stiffness or jerking
- **Seizures**
- Excessive drowsiness or impaired breathing, especially with alcohol or sedatives
Don’t stop sertraline abruptly to make tramadol “safe,” and don’t take medication prescribed to someone else.
If you already took tramadol, **don’t take more**. Seek emergency care now for severe sleepiness, trouble breathing, seizure, high fever, marked confusion/agitation, or rigid/jerking muscles. Otherwise, contact a pharmacist, your prescriber, or Poison Control for individualized advice (US: **1-800-222-1222**).
For tooth pain, arrange urgent dental care. Acetaminophen and/or ibuprofen are often safer and more effective, if you normally can take them; check with a pharmacist because ibuprofen can modestly increase bleeding risk with sertraline and isn’t suitable for everyone. Facial swelling, fever, difficulty swallowing/breathing, or swelling near the eye requires urgent evaluation.