I was told to take Tylenol with it once, if the Tramadol alone wasn't quite enough.
A caution though, I have noticed some signs of physical dependency in myself to this medication. When I run out, after a day or so, I have severe allergy attacks & occasional bouts of Big D. Nothing fatal, but just because its not Narcotic, it doesn't mean there aren't dependecy risks. Most meds to have them anyway. Like our old friend, Prednisone! LOL
Matthew